The Effect of Fingolimod (FTY720) Treatment on Liver Enzyme Levels in Relapsing-Remitting Multiple Sclerosis Patients

Abstract

Aim: Multiple sclerosis (MS) is a chronic inflammatory pathology affecting the central nervous system. Many therapeutic options have been approved against MS until today. In this study, it was aimed to investigate the effect of fingolimod treatment (FT) on the liver enzyme levels of relapsing-remitting multiple sclerosis (RRMS) patients.
 Material and Methods: Body mass index, FT (0.5 mg/day) duration, and liver enzyme (alanine aminotransferase, ALT; gamma glutamyl transferase, GGT) levels of 102 RRMS patients (66 female, 36 male, mean age was 40.9±10.9 years) were gathered from polyclinic records retrospectively.
 Results: The FT duration of MS patients was between 0.5 and 6 years. Increased ALT and GGT levels were detected in RRMS patients after >3 month-long FT. After FT, ALT and GGT levels elevated in males almost 2 times higher than in females. It was observed that ALT and GGT levels increased by 1.3 and 1.5 times in females, while 1.6 and 1.9 times in males, respectively. Of the MS patients with increased transaminases post-FT, 7 (23.3%) males and 8 (17.4%) females were at upper limit of normal for ALT whereas 9 (34.6%) males and 14 (32.6%) females as for GGT. Age and FT duration did not affect ALT and GGT levels.
 Conclusion: Overall, FT elevated ALT and GGT levels of RRMS patients. Thus, it is of high importance to monitor MS patients throughout FT. So that, we suggest tracking ALT and GGT levels during and after FT to prevent possible liver damage or the occurrence of other systemic diseases.