Elevated circulating VEGF levels were observed in small (n ≤50) (SMD 0.57, 995% CI 0.33–0.81, P <0.0001) and large (n >50) (SMD 0.52, 95% CI 0.28–0.75, P <0.0001) studies on SSc (Figure 4C-ii). The gene discussed is VEGFA; the disease is systemic sclerosis.