Abstract
BACKGROUND: Interstitial lung disease (ILD) and pulmonary arterial hypertension (PAH) are significant causes of morbidity and mortality in systemic sclerosis (SSc). Our objective was to determine screening practices for ILD and PAH in patients with SSc among rheumatologists in the Middle East and North Africa (MENA) region. METHODS: An online questionnaire was distributed to rheumatologists across the MENA region. Participants were asked to estimate the proportion of SSc patients in their practice, indicate whether they screen for ILD and PAH, and specify how often they utilise screening modalities, including chest X-ray (CXR), high-resolution CT (HRCT), pulmonary function tests (PFTs), echocardiograms (ECHO), and the use of the DETECT algorithm. Data were analysed using descriptive statistics, with p-values ≤0.05 regarded as statistically significant. RESULTS: 394 respondents completed the questionnaire from 17 MENA countries. 389 (98.73%) reported screening for ILD, and 369 (93.65%) screened for PAH. 270 respondents performed screening at the time of SSc diagnosis (68.53%). Screening approaches for ILD included CXR (211, 53.55%), HRCT (321, 81.47%), and PFTs (299, 75.89%), while PAH screening included ECHO (346, 87.82%), and the DETECT algorithm (26.14%). Statistical differences were observed in the average number of SSc patients seen per year (p=0.0008), gender of respondents (p=0.02), current age (p=0.02), background training (p<0.00001), use of ECHO as PAH screening (p=0.01), and the DETECT algorithm (p=0.000017) between SSc experts and non-SSc experts. CONCLUSIONS: Our findings reflect real-world screening practices in SSc patients, emphasising discrepancies which could stem from variations in clinical training, resource availability, or institutional protocols across healthcare settings.