Endocrine Society and European Society of Endocrinology publish joint guideline on glucocorticoid-induced adrenal insufficiency

The joint guideline is designed to help clinicians manage patients who have, or are at risk of developing, glucocorticoid-induced adrenal insufficiency. At least 1% of the global population uses chronic glucocorticoid therapy as anti-inflammatory or immune-suppressive agents.

The guideline, titled “Diagnosis and Therapy of Glucocorticoid-induced Adrenal Insufficiency,” will appear in the May 2024 issues of the Societies’ respective journals, The Journal of Clinical Endocrinology & Metabolism and the European Journal of Endocrinology. Patient-facing materials on glucocorticoid-induced adrenal insufficiency are also in development and will be made available via the ESE Patient Zone in May 2024.

This is the first guideline developed and published jointly by the Endocrine Society and the European Society of Endocrinology (ESE). The Societies are planning to publish a new joint guideline each year to maximize outreach as well as to cover potential differences in clinical practice between Europe and the United States.

As focal points for endocrinology and hormone research, both the Endocrine Society and ESE regularly produce clinical guidelines with recommendations for patient care, either in collaboration with other Societies or independently.

Guideline development at each Society is overseen by a clinical committee, and all guidelines are subject to a rigorous review process before being published. This is undertaken by Society members and relevant parties, such as patient advocacy groups.

Where it is considered beneficial, patient support literature is prepared alongside the guidelines to provide patients with assistance in understanding and managing their condition.

The working group behind this joint guideline was led by co-chairs Tobias Else, M.D., of the University of Michigan in Ann Arbor, Mich., and Professor Felix Beuschlein, M.D., of the University Hospital Zurich in Zurich, Switzerland.

“The Endocrine Society and ESE collaborative guidelines on glucocorticoid-induced adrenal insufficiency are an important step towards a global collaboration in guideline development. Despite having differences in access to medications and other clinical resources, the evidence for diagnosing and treating a condition is the same,” said Else. “I believe the future will bring us closer to true global guidelines, which integrate the global diversity in culture and medical practices and can be adapted locally in accordance with resources. The work on the combined guidelines brought a tremendous learning experience for me personally, and hopefully they will be a useful resource for medical providers worldwide!”

“Our starting point was to define the clinical problem and knowledge gaps that come with glucocorticoid-induced adrenal insufficiency, for which we set out to provide some guidance – even in the absence of strong scientific evidence. We also wanted to make sure that we had good representation both from Europe and the U.S. to cover potential differences in clinical practice. In this, we were privileged to gather an excellent team of specialists with great knowledge, diligence and enthusiasm—all of which is required to get through the process of writing a guideline from scratch,” said Beuschlein. “The discussions between the panel members during the writing of the guideline, and the review process which included all members of both societies, has resulted in a level of consensus that has not been reached before. I hope that the global reach of this joint guideline goes beyond what either Society could reach independently.”

In 2025, the Societies plan to publish a joint guideline on diabetes in pregnancy; in 2026, a joint guideline on arginine vasopressin resistance and arginine vasopressin deficiency; and in 2027, a joint guideline on male hypogonadism.

Funding for the development of these joint guidelines is provided by the Societies. No other entity provides financial or other support.

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About Endocrine Society

Endocrinologists are at the core of solving the most pressing health problems of our time, from diabetes and obesity to infertility, bone health, and hormone-related cancers. The Endocrine Society is the world’s oldest and largest organization of scientists devoted to hormone research and physicians who care for people with hormone-related conditions.

The Society has more than 18,000 members, including scientists, physicians, educators, nurses, and students in 122 countries. To learn more about the Society and the field of endocrinology, visit our site at www.endocrine.org. Follow us on X (formerly Twitter) at @TheEndoSociety and @EndoMedia.

About the European Society of Endocrinology

The European Society of Endocrinology (ESE) provides a platform to develop and share leading research and best knowledge in endocrine science and medicine. By uniting and representing every part of the endocrine community, we are best placed to improve the lives of patients. With over 5,000 individual members and through the 48 National Societies involved with the ESE Council of Affiliated Societies (ECAS) ESE represents a community of over 20,000 European endocrinologists. We inform policy makers on health decisions at the highest level through advocacy efforts across Europe. The European Journal of Endocrinology is ESE’s flagship with a current Impact Factor of 5.8, five-year Impact Factor: 6.3. The journal (published by Oxford University Press) publishes high-quality original clinical and translational research papers and reviews in adult and paediatric endocrinology, as well as international clinical practice guidelines and position statements. Website: https://academic.oup.com/ejendo/

To find out more about ESE, please visit www.ese-hormones.org. Follow us on Twitter @ESEndocrinology, Facebook @EuropeanSocietyofEndocrinology and LinkedIn: linkedin.com/company/european-society-of-endocrinology.