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. 2025 Aug 18;36(3):392-402.
doi: 10.31138/mjr.211224.alf. eCollection 2025 Sep.

Interstitial Lung Disease and Pulmonary Arterial Hypertension Screening Practices in Systemic Sclerosis: Survey Insights of Rheumatologists in the Middle East and North Africa Region

Rajaie Namas  1 , Sarah Al Qassimi  1 , Jawahir Alameri  1 , Samar Al Emadi  2 , Nelly Ziade  3 , Ahlam Almarzooqi  4 , Farida Al Balushi  5 , Mohammed A Omair  6 , Taha Qardaghi  7 , Yasameen Abbas Humadi  8 , Mohamed Alawlaqi  1 , Hanan Al Rayes  9 , Saadeya Naji  10 , Fatima Haji  11 , Fajer Altamimi  12 , Mansour Alazmi  13 , Hani Shatnawi  14 , Waleed Hafiz  15 , Deena Ahmed  16 , Mariam Almansoori  16 , Jamal Al Saleh  17 , Hazem Rifaai  18 , Mahdi Abusalameh  18 , Zaki Abou Zahr  19 , Hiba Khogali  20 , Sehriban Diab  16 , Maha Anbar  21 , Adeeba Al Herz  22 , Amal Elganzoury  23 , Shaima Ewila  24 , Basant Elnady  25 , Wafa Madanat  26 , Imad Uthman  27 , Asia Mubashir  1 , Mohamed Elarabi  1 , Suzan Attar  28
Affiliations

Interstitial Lung Disease and Pulmonary Arterial Hypertension Screening Practices in Systemic Sclerosis: Survey Insights of Rheumatologists in the Middle East and North Africa Region

Rajaie Namas et al. Mediterr J Rheumatol. .

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.

Keywords: interstitial lung disease; pulmonary arterial hypertension; screening; surveys and questionnaires; systemic sclerosis.

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Conflict of interest statement

All authors declare no conflicts of interest.

Figures

Figure 1.
Figure 1.
Survey respondents' demographic data and screening practices for SSc-ILD and SSc-PAH.
See this image and copyright information in PMC

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