Subgroup and meta-regression analyses showed significant associations between the effect size and geographical location (studies investigating SSc patients and controls), year of publication (studies investigating SSc patients with limited and diffuse cutaneous SSc), and biological matrix assessed (studies investigating SSc patients with and without digital ulcers).<h4>Conclusion</h4>The results of this systematic review and meta-analysis highlight the potential role of endothelin-1 as a candidate biomarker of SSc. The gene discussed is EDN1; the disease is systemic sclerosis.