{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T06:21:23Z","timestamp":1787811683789,"version":"build-2784847793"},"reference-count":49,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T00:00:00Z","timestamp":1787702400000},"content-version":"vor","delay-in-days":237,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Anemia"],"published-print":{"date-parts":[[2026,1]]},"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Anemia appears as a common comorbidity in a different timing and underlying pathophysiology in people with MS (PwMS) and has been proposed as a prodrome finding in MS. This systematic review and meta\u2010analysis aims to fulfill the need to clarify some characteristics of anemia in PwMS.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A systematic literature search was performed using the MEDLINE PubMed, Scopus, and Google Scholar databases. Eligible studies underwent quality assessment using the Robins\u2010E, and a meta\u2010analysis of proportion was performed. The risk of anemia in PwMS versus healthy controls was calculated based on a subset of case\u2013control studies. Reliability and robustness were assessed using leave\u2010one\u2010out analysis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      In a pool of 143,879 PwMS across 21 studies, anemia had a pooled prevalence of 12.5% (95% CI [8.1%, 17.7%],\n                      <jats:italic>I<\/jats:italic>\n                      <jats:sup>2<\/jats:sup>\n                      <jats:italic>\u2009<\/jats:italic>\n                      =\u200999.0%,\n                      <jats:italic>p<\/jats:italic>\n                      <jats:sub>\n                        <jats:italic>Q<\/jats:italic>\n                      <\/jats:sub>\n                      \u2009=\u20090). In a subset of five studies, the relative risk of anemia between PwMS and healthy controls was 2.9 (95% CI [1.45, 5.79],\n                      <jats:italic>I<\/jats:italic>\n                      <jats:sup>2<\/jats:sup>\n                      \u2009=\u200997.6%,\n                      <jats:italic>p<\/jats:italic>\n                      <jats:sub>\n                        <jats:italic>z<\/jats:italic>\n                      <\/jats:sub>\n                      <jats:italic>\u2009<\/jats:italic>\n                      =\u20090.002,\n                      <jats:italic>p<\/jats:italic>\n                      <jats:sub>\n                        <jats:italic>Q<\/jats:italic>\n                      <\/jats:sub>\n                      \u2009&lt;\u20090.001) in favor of PwMS.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>The intersection between anemia and MS presents a complex, multifaceted clinical challenge due to several pathophysiological mechanisms and DMT\u2010related interactions. Further structured studies are needed to evaluate the exact underlying mechanisms and the directionality of this relationship.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1155\/anem\/1374218","type":"journal-article","created":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T06:14:03Z","timestamp":1787811243000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Prevalence and Risk of Anemia in People With Multiple Sclerosis (MS): A Systematic Review and Meta\u2010Analysis"],"prefix":"10.1155","volume":"2026","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6210-2086","authenticated-orcid":false,"given":"Vasileios","family":"Giannopapas","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Evangelia-Makrina","family":"Dimitriadou","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-1347-8543","authenticated-orcid":false,"given":"Alexandra","family":"Akrivaki","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0722-9329","authenticated-orcid":false,"given":"Dimitrios K.","family":"Kitsos","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1221-4618","authenticated-orcid":false,"given":"Konstantina","family":"Stavrogianni","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7496-1195","authenticated-orcid":false,"given":"Athanasios K.","family":"Chasiotis","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Konstantinos","family":"Tsamis","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"George P.","family":"Paraskevas","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria","family":"Kosmidou","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7948-034X","authenticated-orcid":false,"given":"John S.","family":"Tzartos","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0640-3797","authenticated-orcid":false,"given":"Georgios","family":"Tsivgoulis","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7443-5179","authenticated-orcid":false,"given":"Sotirios","family":"Giannopoulos","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,8,26]]},"reference":[{"key":"e_1_2_11_1_2","doi-asserted-by":"publisher","DOI":"10.1038\/s41392-025-02415-4"},{"key":"e_1_2_11_2_2","doi-asserted-by":"publisher","DOI":"10.5272\/jimab.2012181.203"},{"key":"e_1_2_11_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.tracli.2010.09.169"},{"key":"e_1_2_11_4_2","doi-asserted-by":"publisher","DOI":"10.4103\/jfmpc.jfmpc_599_19"},{"key":"e_1_2_11_5_2","doi-asserted-by":"publisher","DOI":"10.3390\/brainsci11060777"},{"key":"e_1_2_11_6_2","doi-asserted-by":"publisher","DOI":"10.1093\/ajcn\/85.3.778"},{"key":"e_1_2_11_7_2","doi-asserted-by":"publisher","DOI":"10.7759\/cureus.11378"},{"key":"e_1_2_11_8_2","doi-asserted-by":"publisher","DOI":"10.1177\/1352458520908163"},{"key":"e_1_2_11_9_2","doi-asserted-by":"publisher","DOI":"10.3389\/fneur.2024.1386527"},{"key":"e_1_2_11_10_2","doi-asserted-by":"publisher","DOI":"10.3389\/fimmu.2023.1137635"},{"key":"e_1_2_11_11_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejim.2013.07.011"},{"key":"e_1_2_11_12_2","unstructured":"GiannopapasV. 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