Introduction: Given the involvement of monocytes in multiple sclerosis (MS) pathogenesis, we aimed to compare the pan-immune-inflammation value (PIV) with the systemic immune-inflammation index (SII) in differentiating MS patients from healthy controls and in detecting relapse (attack) periods of disease activity. Methods: This case–control study included 43 newly diagnosed, treatment-naïve MS patients and 44 healthy controls. Blood neutrophil, lymphocyte, platelet, and monocyte counts were measured, and the SII and PIV values were calculated. Samples from patients with MS were collected during both the relapse and remission phases. SII and PIV were then compared between the patient and control groups and between relapse and remission states in the MS cohort. Results: Neither SII nor PIV differed significantly between patients with MS and healthy controls or between the relapse and remission phases (p>0.05 for all comparisons). In contrast, the median Expanded Disability Status Scale (EDSS) score was significantly higher during relapses than during remission (median 2.5 vs. 1.0, p<0.001), confirming greater disability during attack periods. Notably, although statistically non-significant, PIV yielded lower p-values than SII, which may indicate a weak trend requiring further study in larger samples. in the relapse vs remission comparison (PIV, p=0.261; SII, p=0.819). Conclusions: Hemogram-derived inflammatory indices, such as SII and PIV, appear insufficient for diagnosing MS or distinguishing relapses from remission. However, the consistently lower p-values observed with PIV suggest that it may be a slightly more sensitive marker than SII. Further large-scale studies, including both newly diagnosed and treated MS populations, are warranted to clarify the potential role of PIV in monitoring MS disease activity.
Mehdiyev et al. (2026) studied this question.