A Retrospective Evaluation of the Effects of Dimethyl Fumarate on Hematological Parameters In Patients with Multiple Sclerosis

Abstract

Aim: Multiple Sclerosis (MS) is a chronic, inflammatory, and demyelinating disease of the central nervous system. Typically seen in young adults, MS progressively leads to neurological impairments and significantly affects quality of life. The lack of a definitive cure necessitates long-term monitoring and disease-modifying treatments. Dimethyl fumarate (DMF) is one of the disease-modifying agents used in MS treatment, and it is notable for its antioxidant and anti-inflammatory effects. Materials and Methods: In the present study, hematological, biochemical, and systemic inflammation parameters before and after DMF treatment in MS patients were retrospectively analyzed. The study aimed to investigate the effects of DMF on peripheral blood parameters and immune indices in MS patients. Results: The findings demonstrated a statistically significant decreases in leukocyte, neutrophil, lymphocyte, and platelet counts following DMF treatment. While a significant reduction was detected in creatinine levels, did not reveal significant changes were observed in BUN, ALT, AST, sedimentation rate, CRP, eosinophils, basophils, hemoglobin, and monocyte levels. After DMF treatment, a statistically significant increases were seen in PIV, PLR, NLR, MLR, and SIRI indices. However, these increases are considered mathematical consequences of the lymphocyte-reducing effect of DMF rather than an actual rise in inflammation, as most of these indices use lymphocyte count in the denominator. Therefore, it is important to interpret these indices considering lymphocyte suppression. Conclusion: In conclusion, the present study demonstrates that DMF treatment significantly affects peripheral hematological parameters and inflammatory indices. These parameters might serve as practical and low-cost biomarkers for monitoring treatment response in MS patients.