Hypopituitarism is managed by replacing the deficient hormones — glucocorticoids for ACTH deficiency, levothyroxine for TSH deficiency, sex steroids for gonadotropin deficiency, and growth hormone where indicated — and recent progress has focused on making that replacement more physiological and convenient. Modified-release hydrocortisone formulations better mimic the natural circadian cortisol rhythm, potentially improving metabolic outcomes and quality of life. And where the earlier literature described long-acting growth hormone as investigational, several once-weekly GH formulations are now approved (somapacitan, lonapegsomatropin, and somatrogon), reducing injection frequency from daily to weekly and improving adherence. A growing clinical issue is immune-checkpoint-inhibitor-induced hypophysitis — most strongly associated with ipilimumab and with CTLA-4/PD-1 combination therapy — which can cause secondary adrenal insufficiency and hypothyroidism, requiring vigilant monitoring and prompt hormone replacement in patients on these cancer therapies.
Further reading: advances in hypopituitarism (Iglesias, 2024); checkpoint-inhibitor pituitary complications (Chamorro-Pareja et al., Endocrinology 2024); once-weekly growth hormone formulations.