Acromegaly is a rare condition typically caused by benign pituitary adenomas, resulting in excessive production of growth hormone. Clinical manifestations of acromegaly are diverse, varying from the overgrowth of body tissue to cardiovascular, metabolic, and osteoarticular disorders. Symptoms may emerge slowly, overlapping with other diseases and often involve many different healthcare specialists. In the last decade, efforts to provide an accurate and timely diagnosis of acromegaly have improved disease management and clinical experience. Despite this progress, marked differences in the diagnosis, treatment, and management of acromegaly exist from country-to-country. To address these inconsistencies in the region comprising Central and Eastern Europe, Israel, and Kazakhstan, a panel of acromegaly experts from 13 of these countries was convened. Acromegaly experts from each country provided available information on the approaches from their country, including regional treatment centers and multidisciplinary teams, treatment access, reimbursement and availability, and physician education, disease awareness, and patient advocacy. Across several areas of acromegaly management, divergent approaches were identified and discussed, including the provision of multidisciplinary care, approved and available treatments, and disease awareness programs. These were recognized as areas of potential improvement in the management of acromegaly, in addition to participation in national and regional acromegaly registries. Further experience exchange will facilitate the identification of specific strategies that can be adapted in each country, and widespread participation in acromegaly registries will enable their evaluation. It is anticipated that this approach will support the optimization of acromegaly patient care across this region.

3rd Department of Internal Medicine 1st Faculty of Medicine Charles University and General University Hospital Prague Czechia

Central and Eastern Europe Medical Affairs Pfizer Rare Disease Paris France

Comenius University Faculty of Medicine 5th Department of Internal Medicine University Hospital Bratislava Bratislava Slovakia

Department of Endocrinology Carol Davila University of Medicine and Pharmacy Bucharest Romania

Department of Endocrinology Diabetes and Isotope Therapy Wroclaw Medical University Wroclaw Poland

Department of Endocrinology Diabetes and Metabolic Diseases University Medical Centre Ljubljana Ljubljana Slovenia

Department of Endocrinology Specialized Hospital for Active Treatment of Endocrinology Medical University Sofia Bulgaria

Department of Endocrinology University Hospital Center Zagreb Zagreb Croatia

Department of Internal Medicine and Oncology Semmelweis University Budapest Hungary

Department of Transsphenoidal Surgery Romodanov Neurosurgery Institute Kyiv Ukraine

Division of Endocrinology and Metabolism Bar Ilan Faculty of Medicine Clalit Medical Health Care Services Safed Israel

Faculty of Medicine University of Ljubljana Ljubljana Slovenia

Global Medical Affairs Pfizer Rare Disease Brussels Belgium

Kazakh National Medical University Almaty Kazakhstan

Medical Affairs Pfizer Rare Disease Bucharest Romania

Neuroendocrine Unit Endocrinology Department Moscow Regional Research and Clinical Institute Moscow Russia

Neuroendocrinology Department Clinic for Endocrinology Diabetes and Metabolic Diseases Clinical Centre of Serbia Medical Faculty University of Belgrade Belgrade Serbia

Rabin Medical Center Petah Tikva and Sackler Faculty of Medicine Tel Aviv University Tel Aviv Israel

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