BACKGROUND: Global healthcare disparities, stemming from organizational differences in healthcare systems, lead to variable availability and funding, resulting in a gap between recommended and implemented practices for interleukin (IL)-1-mediated autoinflammatory diseases. We aimed to assess diagnostic, treatment and follow-up options for these diseases in Central and Eastern European countries, comparing them with the 2021 recommendations of the European Alliance of Associations for Rheumatology (EULAR)/American College of Rheumatology (ACR). METHODS: In 2023, a structured collaborative effort was organized with representatives from 10 Central and Eastern European countries to address autoinflammatory diseases. The discussion focused on potential strategies to achieve the goals mentioned above. RESULTS: Almost all the participating countries have specialized centers for the diagnosis and treatment of autoinflammatory diseases and the care is provided either by rheumatologists and/or clinical immunologists. Genetic testing is available in all countries, but there is variation in the types of tests offered. Massive parallel sequencing panels for autoinflammatory diseases are available in all countries, with waiting periods for results ranging from 3 to 6 months in most cases. The availability of disease-specific laboratory assessments, such as S100 proteins, is limited. IL-1 inhibitors are available in all countries, but there are differences in practices regarding the licensing and reimbursement of anakinra and canakinumab based on specific indications or diagnoses. The age at which the transition process begins varies, but in most countries, it typically starts around the age of 18 or beyond and in majority of the participating countries there is no structured transition program. CONCLUSIONS: Adherence to the 2021 EULAR/ACR recommendations for IL-1-mediated autoinflammatory diseases is achievable in Central and Eastern European countries. Determining the prevalence and incidence of these diseases in this region remains a persistent challenge for future research efforts, with the overarching goal of identifying new patients with autoinflammatory diseases.

2nd Department of Paediatrics Iuliu Hatieganu University of Medicine and Pharmacy Cluj Napoca Romania

Centre for Paediatric Rheumatology and Autoinflammatory Diseases ERN RITA 1St Faculty of Medicine Charles University and General University Hospital Prague Prague Czech Republic

Clinic of Children's Diseases Institute of Clinical Medicine Faculty of Medicine Vilnius University Vilnius Lithuania

Department of Allergology Rheumatology and Clinical Immunology University Children's Hospital University Medical Center Ljubljana Ljubljana Faculty of Medicine Ljubljana Slovenia

Department of Immunology Children's Memorial Health Institute Warsaw Poland

Department of Paediatrics University of Zagreb School of Medicine Division of Clinical Immunology Rheumatology and Allergology Centre of Reference for Paediatric and Adolescent Rheumatology of Ministry of Health of the Republic Croatia University Hospital Centre Zagreb Kispaticeva 12 10 000 Zagreb Croatia

Department of Pediatrics and Rheumatology Andrzej Frycz Modrzewski Krakow University St Louis Children Hospital Krakow Poland

Department of Pediatrics Riga Stradins University Riga Latvia

Department of Pediatrics School of Medicine Pediatric Rheumatology Unit Meir Medical Center Kfar Saba and Tel Aviv University Tel Aviv Israel

Division of Pediatric Rheumatology and Immunology Tuzolto Street Department Pediatric Center Semmelweis University Budapest Hungary

National Centre for Periodic Fever Syndromes Department of Pediatrics Department of Pulmonology and Phthisiology Department of Allergology and Clinical Immunology Jessenius Faculty of Medicine Comenius University in Bratislava University Teaching Hospital in Martin Martin Slovakia

Pediatric Rheumatology Unit Schneider Children's Medical Center of Israel Petach Tikva Israel

Sackler Faculty of Medicine Tel Aviv University Tel Aviv Israel

Unit of Rheumatology and Autoinflammatory Diseases IRCCS Istituto G Gaslini Genova Italy

University of Nis Faculty of Medicine University Clinical Center Clinic of Pediatrics Nis Serbia

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