Abstract
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.
Highlights
Is a rare disease characterized by excess growth hormone (GH) secretion, which promotes the increased synthesis of insulin-like growth factor-I (IGF-I)
Owing to its diverse clinical presentation and the slow progression of symptoms that often overlap with those of other diseases, acromegaly is first suspected and eventually diagnosed by endocrinologists in the vast majority of cases [2, 4]. After their initial primary care evaluation, patients with acromegaly often seek consultation in different disciplines for their symptoms, such as gynecologists for amenorrhea and fertility problems, ENT specialists for snoring, pulmonologists for obstructive sleep apnea, diabetologists for new-onset diabetes, and orthopedic surgeons for carpal tunnel syndrome. This time lag between the initial signs and symptoms and confirmed acromegaly diagnosis represents an important issue, and this varies somewhat by country across Central and Eastern European region (CEE), Israel, and Kazakhstan (Table 1)
It is noteworthy that this study showed a narrowing in the time gap between initial symptom presentation and diagnosis in recent years, which appears to be related to improved diagnostic modalities [4]
Summary
Is a rare disease characterized by excess growth hormone (GH) secretion, which promotes the increased synthesis of insulin-like growth factor-I (IGF-I). Owing to its diverse clinical presentation and the slow progression of symptoms that often overlap with those of other diseases, acromegaly is first suspected and eventually diagnosed by endocrinologists in the vast majority of cases [2, 4] After their initial primary care evaluation, patients with acromegaly often seek consultation in different disciplines for their symptoms, such as gynecologists for amenorrhea and fertility problems, ENT specialists for snoring, pulmonologists for obstructive sleep apnea, diabetologists for new-onset diabetes, and orthopedic surgeons for carpal tunnel syndrome. This time lag between the initial signs and symptoms and confirmed acromegaly diagnosis represents an important issue, and this varies somewhat by country across CEE, Israel, and Kazakhstan (Table 1).
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