Evidence map›Paper›PMID 42608789›Full record

ArticleMultiple sclerosis (Houndmills, Basingstoke, England)2026

Lymphocyte count polygenicity underlies dimethyl fumarate-associated lymphopenia in multiple sclerosis.

Kaarina Kowalec, Ali Manouchehrinia, Elaine Kingwell, Robert Carruthers, Ruth Ann Marrie, Charity Evans, Dalia Rotstein, Annie J Kuan, Wenzhuo Luo, Daniel Luo and 22 more

Abstract read
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In one paragraph

Article in Multiple sclerosis (Houndmills, Basingstoke, England), 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

32 authors.

Kaarina KowalecCollege of Pharmacy, University of Manitoba, Winnipeg, MB, Canada; Department of Biochemistry & Medical Genetics, Max Rady College of Medicine, University of Manitoba, Winnipeg, MB, Canada; Department of Medical Epidemiology & Biostatistics, Karolinska Institutet, Stockholm, Sweden.ORCID 0000-0003-3928-9879
Ali ManouchehriniaCollege of Pharmacy, University of Manitoba, Winnipeg, MB, Canada; Karolinska Neuroimmunology and Multiple Sclerosis Center, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden.ORCID 0000-0003-4857-5762
Elaine KingwellDepartment of Primary Care and Population Health, Institute of Epidemiology and Health Care, University College London, London, UK.ORCID 0000-0002-1956-1700
Robert CarruthersDepartment of Medicine, University of British Columbia, Vancouver, BC, Canada.
Ruth Ann MarrieDepartment of Medicine and Community Health and Epidemiology, Faculty of Medicine, Dalhousie University, Halifax, NS, Canada; Nova Scotia Health, Halifax, NS, Canada; Department of Internal Medicine, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, Canada.ORCID 0000-0002-1855-5595
Charity EvansCollege of Pharmacy and Nutrition, University of Saskatchewan, Saskatoon, SK, Canada.
Dalia RotsteinDepartment of Medicine, Division of Neurology, University of Toronto, Toronto, ON, Canada.
Annie J KuanFaculty of Medicine (Neurology), University of British Columbia, Vancouver, BC, Canada.
Wenzhuo LuoCollege of Pharmacy, University of Manitoba, Winnipeg, MB, Canada.
Daniel LuoCollege of Pharmacy, University of Manitoba, Winnipeg, MB, Canada.
Brianne DesrochersCollege of Pharmacy, University of Manitoba, Winnipeg, MB, Canada.
Vilija G JokubaitisDepartment of Neuroscience, School of Translational Medicine, Monash University, Melbourne, VIC, Australia; Department of Neurology, Alfred Health, Melbourne, VIC, Australia.ORCID 0000-0002-3942-4340
Jeannette Lechner-ScottDepartment of Neurology, John Hunter Hospital, Newcastle, NSW, Australia; School of Medicine and Public Health, University of Newcastle, Newcastle, NSW, Australia; Immune Health Research Program, Hunter Medical Research Institute, Newcastle, NSW, Australia.
Vicki E MaltbyDepartment of Neurology, John Hunter Hospital, Newcastle, NSW, Australia; School of Medicine and Public Health, University of Newcastle, Newcastle, NSW, Australia; Immune Health Research Program, Hunter Medical Research Institute, Newcastle, NSW, Australia.ORCID 0000-0002-3785-4742
Kira GroenImmune Health Research Program, Hunter Medical Research Institute, Newcastle, NSW, Australia.
Galen Eb WrightDepartment of Biochemistry & Medical Genetics, Max Rady College of Medicine, University of Manitoba, Winnipeg, MB, Canada; Department of Pharmacology and Therapeutics, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, Canada; PrairieNeuro Research Centre, Kleysen Institute for Advanced Medicine, Health Sciences Centre and Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, Canada; Children's Hospital Research Institute of Manitoba, Winnipeg, MB, Canada.
Britt I DrögemöllerDepartment of Biochemistry & Medical Genetics, Max Rady College of Medicine, University of Manitoba, Winnipeg, MB, Canada; Children's Hospital Research Institute of Manitoba, Winnipeg, MB, Canada; CancerCare Manitoba Research Institute, Winnipeg, MB, Canada; Centre on Aging, Winnipeg, MB, Canada.
Sasha BernatskyDepartment of Medicine, Divisions of Clinical Epidemiology and Rheumatology, Research Institute of the McGill University Health Centre, Montreal, QC, Canada.
Michael C LevinOffice of the Saskatchewan Multiple Sclerosis Research Chair, Department of Medicine, Division of Neurology, College of Medicine, University of Saskatchewan, Saskatchewan, Saskatoon, SK, Canada; Department of Anatomy, Physiology and Pharmacology, College of Medicine, University of Saskatchewan, Saskatoon, SK, Canada.
Katherine KnoxDepartment of Physical Medicine and Rehabilitation, College of Medicine, University of Saskatchewan, Saskatoon, SK, Canada.
Abdullah Al MarufCollege of Pharmacy, University of Manitoba, Winnipeg, MB, Canada; Children's Hospital Research Institute of Manitoba, Winnipeg, MB, Canada; Department of Psychiatry, Max Rady College of Medicine, University of Manitoba, Winnipeg, MB, Canada.
Michael ZhongDepartment of Neuroscience, School of Translational Medicine, Monash University, Melbourne, VIC, Australia; Department of Neurology, Alfred Health, Melbourne, VIC, Australia.
Lars AlfredssonKarolinska Neuroimmunology and Multiple Sclerosis Center, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden; Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden.
Jan HillertKarolinska Neuroimmunology and Multiple Sclerosis Center, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden.ORCID 0000-0002-7386-6732
Ingrid KockumKarolinska Neuroimmunology and Multiple Sclerosis Center, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden.ORCID 0000-0002-0867-4726
Tomas OlssonKarolinska Neuroimmunology and Multiple Sclerosis Center, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden; Center for Molecular Medicine, Karolinska University Hospital, Stockholm, Sweden.
Pernilla StridhKarolinska Neuroimmunology and Multiple Sclerosis Center, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden; Center for Molecular Medicine, Karolinska University Hospital, Stockholm, Sweden.ORCID 0000-0003-4855-0039
Klementy ShchetynskyKarolinska Neuroimmunology and Multiple Sclerosis Center, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden; Center for Molecular Medicine, Karolinska University Hospital, Stockholm, Sweden.
Kristy DeverEdwin SH Leong Centre for Healthy Aging, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada; Centre for Molecular Medicine and Therapeutics and Department of Medical Genetics, University of British Columbia, Vancouver, BC, Canada; British Columbia Children's Hospital Research Institute, Vancouver, BC, Canada.
Julie MacIsaacEdwin SH Leong Centre for Healthy Aging, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada; Centre for Molecular Medicine and Therapeutics and Department of Medical Genetics, University of British Columbia, Vancouver, BC, Canada; British Columbia Children's Hospital Research Institute, Vancouver, BC, Canada.
Michael S KoborEdwin SH Leong Centre for Healthy Aging, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada; Centre for Molecular Medicine and Therapeutics and Department of Medical Genetics, University of British Columbia, Vancouver, BC, Canada; British Columbia Children's Hospital Research Institute, Vancouver, BC, Canada.
Helen TremlettFaculty of Medicine (Neurology), University of British Columbia, Vancouver, BC, Canada; The Djavad Mowafaghian Centre for Brain Health, Vancouver, BC, Canada.ORCID 0000-0001-5804-2535

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeOne in 20 people using dimethyl fumarate (DMF), a commonly used disease-modifying therapy for multiple sclerosis (MS), develops severe lymphopenia. We aimed to identify genetic variation associated with DMF-related lymphopenia.

methodsUsing a case-control design, we included cases that had either grade 2 (absolute lymphocyte count <0.8 × 10

findingsThe discovery cohort comprised 238 PwMS of European genetic ancestry from Canada/Australia (

conclusionCommon polygenic variation of lymphocyte counts was significantly associated with moderate lymphopenia during DMF treatment.

Indexed as

adverse drug reactiondimethyl fumaratelymphopeniaMultiple sclerosispharmacogenomicspolygenic score

Identifiers

PMID42608789

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.