Conclusion: The period prevalence of AEs recorded during MMF treatment appeared as high as 71.7% in our real life setting. Even though we did not record any serious AE, our analysis suggests a close monitoring of this therapy in SSc. Background: Interstitial lung disease in systemic sclerosis (SSc-ILD) occurs frequently and carries a high burden of morbidity and mortality. To date, there are no existing guidelines for screening, diagnosis and management of SSc-ILD that would aid early

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... n and treatment and improve the care of these patients. Objectives: To develop expert consensus recommendations for the identification and management of SSc-ILD. Methods: Based on the results of a comprehensive systematic literature analysis conducted in line with NICE/CRD and IQWiG guidelines and PRISMA methodology, evidence-based statements on SSc-ILD risk, screening, diagnosis, treatment and follow-up were developed. A modified Delphi process was then used to establish consensus statements for the identification and management of SSc-ILD. Briefly, an expert panel of 27 European-based pulmonologists, rheumatologists and internists with experience in treating SSc-ILD was established. Between July and November 2018, the panel took part in 3 rounds of online surveys, a face-toface discussion and a WebEx meeting to establish consensus-based recommendations for the management of SSc-ILD. Statements were categorised by topic: risk factors (including biomarkers); screening; diagnosis; assessment of severity; treatment initiation; treatment options; disease progression; treatment escalation; other management options. Panellists indicated their level of agreement with proposed statements on a scale of 1 (strong disagreement) to 7 (strong agreement), and consensus was considered achieved when !80% either disagreed (score of 1-3) or agreed (score of 5-7) with a statement. Based on panel feedback, statements that did not reach consensus were modified and re-voted in later rounds. Results: At the close of the Delphi process, the panel agreed on the following: