Prevalence of Antinuclear Antibodies in Multiple Sclerosis: A Systematic Review and Meta-analysis

Abstract

Antinuclear antibodies (ANAs) are autoantibodies that target the constituents of cell nuclei and cytoplasm. In systematic autoimmune rheumatic disease (SARD), ANAs have both a diagnostic and prognostic value. Clinicians often request ANAs during a diagnostic workup for MS, although not explicitly required by any established criterion for MS. This systematic review and meta-analysis was primarily designed to determine prevalence of ANAs in MS.

A systematic literature search was conducted in the Embase, PubMed, and Web of Science databases for publications available on February 28, 2025. The research question was formulated using the PICO (Population, Intervention, Comparator, Outcome) framework as follows: population: adult patients with a confirmed diagnosis of MS; intervention: ANA test irrespective of the specific methodology employed; comparator: MS patients without detectable ANAs; and outcome: prevalence of ANA positivity, and reporting was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines.

ANA positivity in MS is not uncommon. MS patients are more likely to show ANA positivity than healthy individuals; however, this positivity rate is not higher than that seen in other autoimmune diseases, which limits the utility of differentiating MS from other autoimmune diseases based solely on ANA status.