MTP 2019 ( Meet The Professor ) Endocrine Case Management

309 Pages·2019·11.115 MB·English

F R O M T H E E X P E R T S ! N E f\J D O C R ! f\J O L O G Y
2019 MEET-THE-PROFESSOR
ENDOCRINE
CASE MANAGEMENT
ENDOCRINE.,. ·
SOCIETY ..,1
FROM THE EXPERTS IN ENDOCRINOLOGY
ENDOCRINE
CASE M NAGEM NT
ENDOCRINE.,.
SOCIETY ..,1
ENDOCRINE._,_
SOCIETY_,•
2055 L Street, NW, Suite 600
Washington, DC 20036
www .endocrine.org
Other Publications:
press.endocrine.org
The Endocrine Society is the world's largest, oldest, and most active organization working to advance the clinical practice of
endocrinology and hormone research. Founded in 1916, the Society now has more than 18,000 global members across a range
of disciplines.
The Society has earned an international reputation for excellence in the quality of its peer-reviewed journals, educational
resources, meetings, and programs that improve public health through the practice and science of endocrinology.
Clinical Practice Chair, ENDO 2019
Susan A. Sherman, MD
The statements and opinions expressed in this publication are those of the individual authors and do not necessarily reflect the
views of the Endocrine Society. The Endocrine Society is not responsible or liable in any way for the currency of the
information, for any errors, omissions or inaccuracies, or for any consequences arising therefrom. With respect to any drugs
mentioned, the reader is advised to refer to the appropriate medical literature and the product information currently provided by
the manufacturer to verify appropriate dosage, method and duration of administration, and other relevant information. In all
instances, it is the responsibility of the treating physician or other health care professional, relying on independent experience
and expertise, as well as knowledge of the patient, to determine the best treatment for the patient.
Copyright© 2019 by the Endocrine Society, 2055 L Street, NW, Suite 600, Washington, DC 20036. All rights reserved. No
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ISBN: 978-1-879225-45-9
eISBN: 978-1-879225-46-6
Library of Congress Control Number: 2018965670
ENDO 2019 • CONTENTS iii
......................................................................................
FACULTY iv
OVERVIEW vii
, ••••••••••••·•·•·•·••·• ..
·••tt■■■■■■■■■■■■■■■ll■ll■ll■■l■■I■■ l■■■■!l■l■■■■■■M■■I■■■
.....
TOPIC INDEX X
••••••••••••••••••••••••••• ., ••••••••••••••• ■:11■1■11••······················
SPEAKER HANDOUT INDEX .............................................................. . xiv
ADIPOSE TISSUE, APPETITE, AND OBESITY . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
AD RENAL ............................................................................. ,. . . . . . . . . 23
....................... ..............................
BONE AND MINERAL METABOLISM ,. 45
"
CARDIOVASCULAR ENDOCRINOLOGY . .. .. . . . . . . . .. . .. .. .. . . .. . . .. . . . .. .. . . . . . . . . . . . . . . . 93
DIABETES MELLITUS AND GLUCOSE METABOLISM 113
.............................. 11••·
NEUROENDOCRINOLOGY AND PITUITARY 135
• • • • • • • • • • • • • • • • • •••••••••••••••• II ••••••••••
PEDIATRIC ENDOCRINOLOGY •11••··········· ....................... 11.••······-·••11••······· 181
REPRODUCTIVE ENDOCRINOLOGY ······••11••··········································· 215
THYROID 261
■ • ■ ■ ■ • ■ • • • I • ■ • • • • • • ■ 11 ■ ■ • • ■ • • • • ■ ••• ■ ■ • II I • ■ ■ • I ■ ■ • ■ ■ ■ W ■ ■ • I ■ I ■ • ■ • I • • ■ ■ ■ • • ■ • ■ • ■ I ■ • • • • ■ ■ I • •
MISCELLANEOUS ·(j'········································•111••·························-··· 293
iv ENDO 2019 • FACULTY
2019 MEET-THE-PROFESSOR CASE MANAGEMENT FACULTY
Jasna Aleksova, MBBS, BMedSci Ellen L. Connor, MD
Monash Health Melbourne University of Wisconsin
Australia American Family Children's Hospital
Bradley D. Anawalt, MD Marc-Andre Cornier, MD
University of Washington University of Colorado School of Medicine
Katherine Araque, MD Wouter W. de Herder, MD, PhD
National lnstitutes of Health
Erasmus Medical Center
Netherlands
Wiebke Arlt, MD, DSc
University of Birmingham Laura E. Dichtel, MD
United Kingdom
Massachusetts General Hospital
Richard J. Auchus, 1\ID, PhD
William T. Donahoo, MD
University of Michigan
University or Florida
Ricardo Azziz, MD, MPH, MBA
Andrea Dunaif, 1\ID
State University or New York
Icahn School of Medicine at Mount Sinai
Linda A. Barbour, MSPH, MD
University or Colorado School of Medicine Peter R. Ebeling, MD
Monash University
Andrew J. Bauer, MD Australia
The Children's Hospital of Philadelphia
Robert Eckel, MD
Carolyn B. Becker, MD University of Colorado Anschutz Medical Campus
Brigham and Women's Hospital
Azeez Farooki, MD
Sarah L. Berga, MD
Memorial Sloan Kettering Cancer Center
University of Utah School of Medicine
Sergio Fazio, MD, PhD
Daniel H. Bessesen, MD
Oregon Health and Science University
University of Colorado School of Medicine
Patricia Y. Fechner, MD
Petter M. Bjornstad, MD
Seattle Children's Hospital
University of Colorado School of Medicine
Kenneth Feingold, MD
Henry B. Burch, MD
University of California, San Francisco
National Institutes or Health
Marcelle I. Cedars, MD James W. Findling, MD
University of California, San Francisco Medical College of Wisconsin
Herbert Chen, MD Maria Fleseriu, MD
University of Alabama, Birmingham Oregon Health and Science University
ENDO 2019 • FACULT V V
Stephen Franks, MBBS, MD Sarah E. Mayson, MD
Imperial College London University of Colorado School of Medicine
United Kingdom
Shlomo Melmed, MD
Sheila M. Fraser, MBChB, MD Cedars-Sinai Medical Center
Leeds Teaching Hospitals NHS Trust
United Kingdom Deborah P. Merke, MD, MS
National Institutes of Health
Andrea Giustina, MD
San Raffaele Vita-Salute University Mark E. Molitch, MD
Italy Northwestern University
Feinberg Medical School
Jacqueline N. Gutmann, MD
RMA of Philadelphia Lynnette K. Nieman, MD
Thomas Jefferson University National Institutes of Health
Bryan Haugen, MD Asha Pathak, l\ID
University of Colorado School of Medicine Cedars-Sinai Medical Center
Camilo Jimenez, MD
Anne Peters, MD
University of Texas MD Anderson Cancer Center
University of Southern California
Jacqueline Jonklaas, MD, PhD
Daniel A. Pryma, MD
Georgetown University Medical Center
University of Pennsylvania Perelman School of Medicine
Jens 0. Jorgensen, MD, Pl1D
Melissa S. Putman, MD
Aarhus University Hospital
Boston Children's Hospital
Denmark
Stephen M. Rosenthal, MD
Laurence Katznelson, MD
University California, San Francisco
Stanford University
Micol S. Rothman, MD
Janice M. Kerr, MD
University of Colorado, Denver
University of Colorado Health Science Center
Joshua D. Safer, MD
Joanna Klubo-Gwiezdzinslrn, MD, PhD, MHSc
Mount Sinai Health System
National Institutes of Health
Icahn School of Medicine at Mount Sinai
National lnstii-ute of Diabetes and Digestive
and Kidney Diseases
Marzieh Salehi, MD, MS
University of Texas Health at San Antonio
Helen M. Lawler, MD
University of Colorado, Denver
Desmond Schatz, MD
Kevin 0. Lillehei, MD University of Florida College of Medicine
University of Colorado Anschutz Medical Campus
Dolores M. Shoback, MD
Daria Lizneva, MD, PhD U11iversity of California, San Francisco
Icahn School of Medicine at Mount Sinai VA Medical Center
Naim Maalouf, IVID _Jennifer A. Sipos, MD
University of Texas Southwestern Medical Center The Ohio State University
Susan J. Mandel, MD, MPH Julie A. Sosa, MD, MA
Perelman School of Medicine University of California, San Francisco
University of Pennsylvania
Robert C. Stanton, MD
Michael Mannstadt, MD Joslin Diabetes Center
Massachuselts General Hospital Beth Israel Deaconess Medical Center
Harvard Medical School Harvard Medical School
Vi ENDO 2019 • FACULTY
Paul M. Stewart, MD ANNUAL :MEETING STEERING COMMITTEE CLINICAL CHAIRS
University of Leeds
United Kingdom Gregory A. Brent, MD, ENDO 2019 Chair
VA Greater LA Healthcare
Cynthia A. Stuenkel, MD
University of California, San Diego Susan A. Sherman, MD, Clinical Practice Chair
Aurora Medical Associates, PC
Dennis M. Styne, MD
University of California, Davis
Ghada El-Hajj Fuleihan, MD, MPH, C)jnical Science Chair
American University of Beirut
Tamara J. Vokes, MD
University of Chicago
Annual Meeting Steering Committee Clinical Peer Reviewers
Steven G. Waguespack, MD Eliot Brinton, MD; Francesco S. Celi, MD; Mark S. Cooper, MD, PhD, FRCP,
FRACP; Ann Danoff, MD; Dawn B. Davis, MD, PhD; MarieB. Demay, MD;
University of Texas Iv!D Anderson Cancer Center
Matthew T. Drake, Iv!D, PhD; Maralyn R. Druce, MD. PhD; Richard A.
Nelson B. Watts, MD Feelders, MD, PhD; Lauren M. Fishbein, MD, PhD; Lairy A. Fox, MD;
Mercy Health Megan R. Haymart, MD; Anders Juul. MD, PhD, DMSC; Bassil Kublaoui,
MD; Margareta D. Pisarska, MD; Peter Kopp, MD; Nicola Napoli, MD, PhD;
Kelly L. Wentworth, MD Sally Radovick, l\ID; Jennifer A. Sipos, MD; Adrian V. Vella, MD, FRCP;
University of California, San Francisco Selma F. Witchel, MD
Margaret E. Wierman, MD
University of Colorado School of Medicine
Michael W. Yeh, MD
University of California, Los Angeles
William F. Young, Jr., MD, MSc
Mayo Clinic
Philip S. Zeitler, MD, PhD
Children's Hospital Colorado
University of Colorado
ENDO 2019 • OVERVIEW vii
OVERVIBW developed under lhe supervision of the Endocrine Society's Annual Meeting
Steering Committee.
Meet-The-Professor Case Ma11age111e11t is designed to provide physicians with
a concise and high-quality review of 55 common and rare endocrine disorders
to help you keep your practice cuITenl. It consists of case-based clinical cases DISCLOSURE POLICY
and rationale by experts in all areas of endocrinology, diabetes, and
The faculty, committee members, and staff who are in position to control the
metabolism.
content of this activity are required lo disclose to the Endocrine Society and
to learners any relevant financial relationship(s) of the individual or spouse/
ACCREDITATION STATEMENT
partner that have occurred within the last 12 months with any commercial
The Endocrine Society is accredited by interest(s) whose products or services are related to the CME content.
the Accreditation Council for Con Financial relationships are defined by remuneration in any amount from the
tinuing Medical Education to provide commercial interest(s) in the form of grants; research support; consulting
continuing medical education for physi fees; salary; ownership interest (eg, stocks, stock options, or ownership
cians. The Endocrine Society has received interest excluding diversified muttial funds); honoraria or other payments
Accreditation with Commendation. for participation in speakers' bureaus, advisory boards, or boards of di
rectors; or other financial benefits. The intent of this disclosure is not to
The Endocrine Society designates tJ1is prevent CME planners with relevant financial relationships from planning
enduring material for a maximum of 30.0 or delivering content, but rather to provide learners with information tlrnt
AMA PRA Catego1y 1 Creditsni. Phy allows them to make their own judgments of whether these financial re
sicians should claim only the credit lationships may have influenced the educational activity with regard to
commensurate with the extent of their exposition or conclusion. The Endocrine Society has reviewed all dis
participation in the activity. closures and resolved or managed all identified conflicts of interest, as
applicable.
LEARNING OBJECTIVES
Meet-The-Professor Case Ma11age111e11/ will allow learners to assess their The following faculty repo1ted relevant financial relationship(s) as of January
knowledge of all aspects of endocrinology, diabetes, and metabolism. I, 2019: The following faculty reported relevant financial relationships, as
identified below: Bradley D. Anawalt, MD, Other; Self; Up to Date Author.
Wiebke Arlt, MD, DSc, Consulting Fee; Self; Diurnal, Sprnce Bioscience,
Upon completion of this educational activity, learners will be able to:
Consultant. Research Investigator; Self; Diurnal, Research Investigator (Pl)
for clinical studies. Richard J. Auchus, MD, PhD, Consulting Fee; Self; US
• Recognize clinical manifestations of endocrine and metabolic disorders and
Anti-Doping Agency. Ricardo Azziz, MD, MPH, MBA, Consulting Fee;
select among current options for diagnosis, management, and therapy.
Self; Medtronic Minimed, Fractyl Laboratories, Up to Date, Ansh labs.
• Identify risk factors for endocrine and metabolic disorders and develop
Latitude Capital. Grant Recipient; Self; Ferring Pharmaceuticals. Stock
strategies for prevention.
Owner; Self; Global (Martin) PET Imaging. Andrew J. Bauer, MD, AdviSOJ)'
• Evaluate endocrine and metabolic manifestations of systemic disorders.
Board Member; Self; IBSA Pharma Inc. Carolyn B. Becker, MD, Other; Self;
• Use existing resources pertaining to clinical guidelines aod treatment
Up to Date. Sarah L. Berga, MD, Advisory Board Member; Self; AMAG.
recommendations for endocrine and related metabolic disorders to guide
Research Investigator; Self; Fening Pharmaceuticals. Other; Self; Salem
diagnosis and treatment.
Academy and College, Up to Date. Daniel H. Bessesea, MD, Other; Self;
TARGET AUDIENCE Enteromedics. Petter M. Bjornstad, MD, Speaker; Self; Horizon Pharma.
Other; Self; Boelu·inger lngelheim. Marcelle I. Cedars, MD, Research
Meet-The-Professor Case Ma11age111e11t provides case-based education to
Funding; Self; Fe1Ting Pharmaceuticals. Marc-Andre Cornier, MD, Grant
clinicians interested in improving patient care.
Recipient; Self; Regeneron Pharmaceuticals. Wouter W. de Herder, MD,
PhD, Advisory Board Member; Self; Novartis Pharmaceuticals, Ipsen. Grant
STATEMENT OF INDEPENDENCE
Recipient; Self; Ipsen. Peter R. Ebeling, MD, Advisory Board Member; Self;
As a provider of CME accredited by the Accreditation Council for Continuing Amgen lnc, Alexion Pharmaceuticals, lnc. Grant Recipient; Self; Amgen Inc,
Medical Education, the Endocrine Society has a policy of ensuring that the Eli Lilly & Company, Novartis Pharmaceuticals, Alexion Pharmaceuticals,
content and quality of tJ1is educational activity are balanced, independent, Inc. Speaker; Self; Amgen Inc, Eli Lilly & Company. Robert Eckel, MD,
objective, and scientifically rigorous. The scientific content of this activity was Advisory Board Member; Self; Sanofi-Aventis, Regeneron Pharmaceuticals,
viii ENDO 2019 • OVERVIEW
Merck, Novo Nordisk. Azeez Farooki, MD, Consultant; Self: Amgen. Sergio The.fo/lowi11g AMSC peer reviewers reporled releva111ji11a11cial rela1io11ship( s)
Fazio, MD, PhD, Consulting Fee; Self; Kowa, Akcea Therapeutics, A111gen as of January I. 20/9: Eliot Brinton, MD, Advisor and Speaker: Akcea,
Inc. Aegerion Phar111aceuticals. Kenneth Feingold, MD, Advisory Board Amarin. Amgen, Kowa, Merck, Regeneron, Sanofi-Avenlis and an Advisor,
Member; Self; Regeneron Pharmaceuticals, A111arin. Speaker; Self; Merck & Balchem, PTS Diagnostics; Speaker, Boehringer-lngelheim, Novo Nordisk.
Co., Regeneron Pharmaceuticals, Sanofi. Andrea Giustina, MD, Consulting Francesco S. Celi, MD, MHSc, Advisory Board Member, LioTriDev,
Fee: Self; Ipsen, Novartis Pharmaceuticals, Pfizer, Inc. Jens O Jorgensen, IBSA. Dawn 8. Davis, MD, PhD, Site Pl for clinical trial, Eiger Phar
MD, PhD, Advisory Board Member; Self; Pfizer, lnc .. Novo Nordisk, Ipsen. maceulicals. Marie B. Demay, MD, (Spouse) CMO - Syros Pharmaceu
Grant Recipient; Self; Merck. Novartis Pharmaceuticals. Research In ticals. Maralyn R. Druce, MD, PhD, Advisory Board Member - Specific
vestigator; Self; Pfizer, Inc .. Speaker; Self; Novartis Pharmaceuticals. Ipsen, Consultations, Ipsen. Richard A. Feelders, MD, PhD, Research Grant
Pfizer. Inc .. Sandoz. Laurence Katznelson, MD, Advisory Board Member; Recipient, Novartis, Ipsen. Anders Juul, MD, PhD, DMSC, Speakers
Self; Pfizer, Inc. Research Investigator; Self; Novartis Pharmaceuticals. Helen Bureau, Novo Nordisk, Pfizer, Ferring, Merck, Bayer, Sponsor and Pl of
M. Lawler, MD. Consulting Fee; Self; Decision Resources Group Consul a clinical mullicenter trial (NESGAS), Department research grant, Ferring,
ting. Research Investigator; Self; XOMA, Eiger BioPharmaceulicals, Xeris Department funding to participate in the clinical trial (PORIYA), Co
Phar111aceu1icals.lnc. Michael Mannstadt, MD, Advisory Board Member; invesligator in a Fen-ing-sponsored clinical trial, Depat1ment grantee, Diurnal,
Self; Shire. Consulting Fee; Self; Ascenclis. E111ployee; Spouse; Radius and Principal investigator for participation in a mullicenler study (RCT) on
Health, lnc. Sarah E. Mayson, MD, Research Investigator; Self; Rosella long-acting hydrocortisone (Chronocort) in CAH. Nicola Napoli, MD, PhD,
Genomics. CBLPath. Mark E. Molitch, MD. Advisory Board Member; Self; European Advisory Board Member, UCB, Eli Lilly, Consultant, Amgen,
Sanon. Consulting Fee: Self; Merck, Pfizer, Inc .. Grant Recipient; Self; Bayer, Lilly. Sally Radovick, MD, Consultant regarding GH Treatment, CVS
lnc., Novartis Pharmaceuticals, Jansen Phannaceuticals. Lynnette K. Nieman, Caremark; retail pharmacy and health care compru1y. Jennifer A. Sipos, MD,
MD, Research Investigator; Self; HRA Pharmaceuticals. Anne Peters, Advisory Board Consultant and Speaker, Genzyme. Adrian V. Vella, MD,
MD, Advisory Board Member; Self; Abbott Laboratories, EJj Lilly & FRCP, P1incipal lnvesligator, Novo Nordisk, Investigator, XOMA (multi-center
Co111pany, Lexicon Pharmaceuticals, Inc., Mannkind Corporation, Merck, study). Member of Advisory Board, YTV Therapeutics, Bristol Myers Squibb.
Novo Nordisk, Sanofi. Grant Recipient; Self; AstraZeneca, Mannkind Cor
poration, Dexcom. Speaker; Self; Novo Nordisk. Daniel A. Pryma, MD, The .fo/lowi11g AMSC peer reviewers reported 110 releva111 ji11a11cial rela-
Advisory Board Me111ber; Self; 5 I I Phar111a. Consulting Fee; Self; Progenies, 1io11ships as of Ja11ua1y I, 20/9: Gregory A. Brent, MD; Mark S. Cooper,
Actiniu111 Phar111aceuticals, Nordic nanoveclor. Research Investigator; Self; MD, PhD; Ann Danoff, MD; Matthew T. Drake, MD, PhD; Ghada El
Sie111ens, Progenies, 51 I Pharma. Stephen M. Rosenthal, MD, Advisory Hali Fuleihan, MD, MPH; Lauren M. Fishbein, MD, PhD; Larry A. Fox,
Board Member; Self; Endo Pharmaceuticals. Joshua D. Safer, !\ID, Advisory MD; Megan R. Haymart, MD; Peter Kopp, MD; Bassil Kublaoui, MD,
Board Member; Self: Endo Pharmaceuticals. Employee; Spouse; Parexel. PhD; Margareta D. Pisarska, MD; Susan A. Sherman, MD; Selma F.
Julie A. Sosa, MD, MA, Otber; Self; Member, Data Monitoring Committee Witchel, MD.
of the Medullary Thyroid Cancer Consortium Registry supported by
GlaxoS111i1hKline, Novo Nordisk, AstraZeneca, Eli Lilly. Robert C. Stanton, The Endocrine Society staff associated with the development of content for
MD, Advisory Board Member; Self; Jansen Pharmaceuticals, Global Renal this activity reported no relevant financial relationships.
Advisory Board. Tamara J. Vokes, MD, Advisory Board Member; Self;
Radius Health, Inc. Shire. Consulting Fee; Self; Radius Health, Inc, Shire.
DISCLAIMERS
Research lnvesligator; Self; Radius Health, Inc, Shire. Speaker; Self; Radius
Health, Inc. Shire. Nelson B. Watts, MD, Advisory Board Member; Self; The information presented in this activity represents the opinion of the faculty
Amgen Inc, Amgen. Consulting Fee; Self; Abbvie, Sanofi. Speaker; Self; and is not necessarily U1e official position of Lhe Endocrine Society.
Amgen lnc, Radius Health, Inc. Philip S. Zeitler, MD, PhD, ConsulLing Fee;
Self; Merck, Novo Nordisk, Boehringer lngelheim, Janssen Research &
USE OF PROFESSIONAL JUDGMENT:
Development Company.
The educational content in this enduring aclivity relates to basic principles of
The following faculty reported 110 relevant ji11a11cial relationships as of
diagnosis and therapy and does not substitute for individual patient assessment
Ja111w1y I, 20/9: Jasna AJeksova, MBBS, BMedSci; Katherine Araque,
based on the health care provider's examination of the patient and consid
MD; Linda A. Barbour, MSPH, MD; Henry B. Burch, MD; Herbert
eration of laboratory data and other factors unique lo the patient. Standards in
Chen, MD; Ellen L. Connor, MD; Laura E. Dichtel, MD; William T.
medicine change as new data become available.
Donahoo, MD; Andrea Dunaif, MD; Patricia Y. Fechner, MD; James W.
Findling, MD; Maria Fleseriu, MD; Stephen Franks, MBBS, MD; Sheila
DRUGS AND DOSAGES:
M. Fraser, MBChB, MD; Jacqueline N. Gutmann, MD; Bryan Haugen,
MD; Camilo Jimenez, MD; Jacqueline Jonklaas, MD, PhD; Janice M.
When prescribing medications, U1e physician is advised to check the product
Kerr, MD; Joanna Klubo-Gwiezdzinska, MD, PhD, MHSc; Kevin 0.
information sheet accompanying each drug lo ve1ify conditions of use and to
Lillehei, !\ID; Daria Lizneva, MD, PhD; Naim Maalouf, MD; Susan J.
identify any changes in drug dosage schedule or contraindications.
Mandel, MD, MPH; Asha Pathak, MD; Melissa S. Putman, MD; Micol S.
Rothman, MD; Marzieh Salehi, MD, MS; Desmond Schatz, MD; Dolores
POLICY ON UNLABELED/OFF-LABEL USE
M. Shoback, MD; Jennifer A. Sipos, MD; Paul M. Stewart, MD; Cynthia
A. Stuenkel, MD; Dennis M. Styne, MD; Steven G. Waguespack, MD; The Endocrine Society has determined Uiat disclosure of unlabeled/off-label
Kelly L. Wentworth, MD; Margaret E. Wierman, MD; Michael W. Yeh, or investigational use of commercial product(s) is informative for audiences
MD; William F. Young, Jr., MD, MSc. and therefore requires this infonnation to be disclosed to the learners at the
ENDO 2019 • OVERVIEW ix
beginning of the presentation. Uses of specific Lherapeulic agents, devices, module, if parlicipanls do 1101 achieve a minimum score of 70%, they have
and other products discussed in this educational activity may 1101 be lhe same the option lo change their answers and make additional allempls lo achieve
as those indicated in product labeling approved by the Food and Drug a passing score. Learners also have the option lo clear all answers and slarl
Adminislralion (FDA). The Endocrine Society requires that any discussions over.
of such "off-label" use be based on scientific research lhal conforms lo
generally accepted standards of experimental design, dala collection, and data METHOD OF PARTICIPATION
analysis. Before recommending or prescribing any therapeutic agent or
This enduring material is presented online and in prinl fomial. The estimated
device, learners should review the complete prescribing information, in
lime 10 complete this activity, including review of material, is 30 hours.
cluding indications, contrnindicntions, warnings, precautions, and adverse
Parlicipanls musl achieve a minimum score of70% lo claim CME credit. Afler
events.
initially completing the module, if participanls do not achieve a minimum
score of 70%, they have the option lo change their answers and make ad
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ACKNOWLEDGMENT OF COMMERCIAL SUPPORT
LAST REVIEW DATE: February 2019
This activity is 1101 suppo11ed by an educational grant or other funds from any
commercial supporter.
ACTIVITY RELEASE DATE: March 17, 2019
AMA PRA CATEGORY 1 CREDJT (CME) INFORJVIATION
ACTIVITY EXPIRATION DATE: March 30, 2021 (dale after which this
To receive a maximum of 30.0 AMA PRA Category I Credi1sn.1, pai1icipanls enduring material is no longer certified for AMA PRA Catego1y I Credits,.,.,)
must complete the on line interactive module and activity evaluation localed al
https://education.endocrine.org/MTP2019. Participants must achieve a For questions about content or obtaining CME credit, please contact the
minimum score of 70% lo claim CME credit. After initially completing lhe Endocrine Society al hllp://educalion.endocrine.org/conlacl.