Association of HALP score with clinical and radiological activity following fingolimod discontinuation in patients with multiple sclerosis.

•Fingolimod is an effective treatment option for Multiple Sclerosis(MS), but controlled or uncontrolled discontinuation can lead to serious clinical and radiological deterioration, processed as Rebound Activity(RA), especially in young female MS patients for pregnancy reason.•The HALP Score, as a nutritional and inflammatory biomarker, can be lower in individuals with MS compared to healthy control groups.•Conversely, a higher HALP score was found in the group with clinical and radiological activity after discontinuation of Fingolimod compared to the group without activity.•An increase in the HALP score in these situations may indicate properties reflecting an intense inflammatory process and may suggest a strong response following drug discontinuation.•It can reveal also that, in MS, the inflammatory period during which disease-modifying therapies are effective-namely, the "window of opportunity"-may be more dominant in patients exhibiting RA.•Similarly elevated monocyte/lymphocyte ratio(MLR) may be used as an inflammatory biomarker both in diagnosing MS and in detecting RA.