PNA Medical Corner: PNA-affiliated Doctors Coauthor Endocrine Society’s New Guidelines on Hypopituitarism

This month the PNA Medical Corner highlights an article co-authored by several PNA-affiliated physicians: Drs. Maria Fleseriu, Shlomo Melmed and Roberto Salvatori. They collaborated with four other doctors to issue the Endocrine Society’s new guidelines on hormonal replacement in adult hypopituitarism patients. It is published in the November edition of the Journal of Clinical Endocrinology Metabolism. Read a write-up about it here.

Hormonal Replacement in Hypopituitarism in Adults: An Endocrine Society Clinical Practice Guideline.
Fleseriu M, Hashim IA, Karavitaki N, Melmed S, Murad MH, Salvatori R, Samuels MH.
J Clin Endocrinol Metab. 2016 Nov;101(11):3888-3921.


Fleseriu Shlomo Melmed Dr. Roberto Salvatori
Dr. Maria Fleseriu Dr. Shlomo Melmed Dr. Roberto Salvatore



To formulate clinical practice guidelines for hormonal replacement in hypopituitarism in adults.


The participants include an Endocrine Society-appointed Task Force of six experts, a methodologist, and a medical writer. The American Association for Clinical Chemistry, the Pituitary Society, and the European Society of Endocrinology co-sponsored this guideline.


The Task Force developed this evidence-based guideline using the Grading of Recommendations, Assessment, Development, and Evaluation system to describe the strength of recommendations and the quality of evidence. The Task Force commissioned two systematic reviews and used the best available evidence from other published systematic reviews and individual studies.


One group meeting, several conference calls, and e-mail communications enabled consensus. Committees and members of the Endocrine Society, the American Association for Clinical Chemistry, the Pituitary Society, and the European Society of Endocrinology reviewed and commented on preliminary drafts of these guidelines.


Using an evidence-based approach, this guideline addresses important clinical issues regarding the evaluation and management of hypopituitarism in adults, including appropriate biochemical assessments, specific therapeutic decisions to decrease the risk of co-morbidities due to hormonal over-replacement or under-replacement, and managing hypopituitarism during pregnancy, pituitary surgery, and other types of surgeries.


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