The effect of fingolimod on complete blood count, lipid panel, and relationship with clinicoradiologic features in patients with multiple sclerosis

Abstract

Objectives: This study aimed to determine the impact of fingolimod treatment on complete blood count (CBC) or lipid panel results and the association of these changes with clinical or radiologic features.

Patients and methods: The medical records of 214 patients (154 females, 60 males; mean age: 34.6±10.6 years; range, 16 to 65 years) with multiple sclerosis treated with fingolimod were retrospectively analyzed between January 1, 2015, and January 1, 2023. Pre- and posttreatment demographic data, disease-modifying therapies used previously, total number of attacks, annualized relapse rate, Expanded Disability Status Scale score, radiologic activation change, NEDA (no evidence of disease activity)-3, CBC, and lipid panel results were recorded, and the relationship between clinicoradiological features and laboratory changes were analyzed.

Results: The mean duration of exposure to fingolimod was 28.92±20.83 months. Neutrophil and lymphocyte (predominantly) counts decreased (p=0.011 and p<0.001, respectively), whereas monocyte counts did not change. Low-density lipoprotein (LDL) and total cholesterol levels were higher over 40 years of age (p=0.021 and p=0.047, respectively), and high-density lipoprotein (HDL) levels were higher in females (p<0.001). Total cholesterol, LDL, and HDL levels were slightly increased (p<0.001, p=0.002, and p=0.003, respectively). The LDL level was higher in those with an annualized relapse rate <0.3 (p=0.003). There were no significant differences with other clinical or radiologic parameters.

Conclusion: Fingolimod reduced the number of lymphocytes (more markedly) and neutrophils. It caused a slight increase within normal limits for LDL and HDL and above normal limits for total cholesterol. However, these changes were not associated with clinical or radiologic activation and usually did not require medical treatment. Therefore, close monitoring is unnecessary except in the presence of risk factors or persistent severe lymphopenia.

Cite this article as: Sarıdaş F, Lazrak SH, Koç ER, Özkaya G, Turan ÖF. The effect of fingolimod on complete blood count, lipid panel, and relationship with clinicoradiologic features in patients with multiple sclerosis. Turk J Neurol 2025;31(4):450-457. doi: 10.55697/tnd.2025.213.

The data that support the findings of this study are available from the corresponding author upon reasonable request.

Idea/concept, design, writing the article: F.S.; Control/supervision: O.F.T.; Data collection and/or processing: F.S., S.H.L., G.O.; Analysis and/or interpretation: F.S., G.O., E.R.K.; Literature review: F.S., S.H.L., E.R.K.; Critical review: E.R.K., O.F.T.; Materials: F.S., E.R.K., O.F.T.

The authors declared no conflicts of interest with respect to the authorship and/or publication of this article.

The authors received no financial support for the research and/or authorship of this article.