Revue medicale suisse最新文献

Diabetology is a discipline in continuous evolution, numerous molecules are developed, and treatment recommendations change regularly based on the latest published studies. It is therefore often difficult for the primary care physician to stay up to date. This article gives help in choosing the most appropriate pharmacological treatment for each patient, considering the 2025 novelties in the field of diabetes. The aim is also to recall the adverse effects of the different categories of antidiabetic drugs and to know how to prevent or deal with them. The therapeutic perspectives available soon are also presented.

Healthcare systems are adapting to digital transformation. For skin diseases, the main challenge lies in better structuring the sharing, storage, and processing of clinical and histological images. Innovation in teledermatology promotes secure platforms and the development of numerous mobile applications. Mobile health and e-health in dermatology are advancing through the integration of artificial intelligence (AI) systems. AI-assisted dermatological diagnosis is becoming very interesting in the context of skin tumors. This needs to be further consolidated for other skin conditions. Patients, practitioners, dermatologists, and any other healthcare professionals are open to the proper use of these new tools, provided their quality and safety are guaranteed by recent international regulations.

Pulmonary sarcoidosis is typically treated with prednisone, but its side effects are prompting the search for alternatives. The PREDMETH study compared methotrexate and prednisone, demonstrating similar efficacy on lung function at 24 weeks. Methotrexate causes fewer metabolic effects but more gastrointestinal and liver disturbances. These results support an alternative approach in sarcoidosis. Non-cystic fibrosis bronchiectasis (NCFBE) has long been limited to repeating what works in cystic fibrosis patients, such as supportive treatments, inhaled antibiotics and macrolides. The first phase 3 trial for a treatment targeting specifically neutrophil inflammation: brensocatib, is presented in this article.

In 2025, for rheumatoid arthritis (RA), new stratification criteria offer the opportunity to detect individuals at risk of developing the disease, and preventive treatments aimed at delaying its onset are being studied, but their benefit appears to be limited in time after discontinuation. For established RA, new therapeutic options are emerging for difficult-to-treat RA: anti-PD-1, GM-CSF (Granulocyte Macrophage Colony-Stimulating Factor) inhibitors, bispecific antibodies, as well as the first non-pharmacological treatment registered by the FDA using vagal neurostimulation. Finally, a new marker for RA, pentraxin 3, appears promising as a complement to existing inflammatory markers which are still imperfect.

Complement inhibitors are expanding their indications in nephrology. In patients with type 2 diabetes, semaglutide prevents chronic kidney disease (CKD), while retatrutide reduces albuminuria in patients with diabetes and established CKD. Obinutuzumab improves the renal response in patients with lupus nephropathy. A double dose of icodextrin did not reduce mortality, peritonitis, or hospitalization rates compared to standard peritoneal dialysis treatment, though it increased ultrafiltration. In patients on hemodialysis, using a dialysate with an intermediate potassium concentration combined with a potassium chelator appears to stabilize serum potassium levels and reduce the occurrence of arrhythmias. Xenotransplantation and ex vivo perfusion techniques are being perfected in the search for a solution to organ shortage.

In 2025, major advances in HIV prevention and treatment, including long-acting therapies and pre-exposure prophylaxis, were incorporated into the new WHO guidelines. Despite this progress, a concerning proportion of patients still enter care at an advanced stage of infection, putting them at increased risk of morbidity and mortality. This situation may be further exacerbated by the sharp reduction in international funding, particularly the cuts to the President's Emergency Plan for AIDS Relief, which threatens the continuity of HIV programs in resource-limited settings. This article contrasts recent medical innovations with current clinical realities and discusses the structural efforts required to safeguard progress and achieve the 2030 targets.

This article reviews a selection of recent developments in various fields of endocrinology. Advances in the diagnosis and management of endocrine disorders of general interest are highlighted, focusing on the following areas: a) new recommendations for the diagnosis and management of primary hyperaldosteronism; b) confirmation of the validity of therapeutic deescalation in low-risk differentiated thyroid cancer and c) the expansion of indications for genetic testing in multiple endocrine neoplasia syndromes.

The year 2025 saw major advances in gastroenterology and hepatology. Having long been overshadowed by other chronic viral hepatitis, Hepatitis D now benefits from new therapeutic options, including bulevirtide, offering markedly improved clinical prospects. In metabolic dysfunction-associated steatotic liver disease, semaglutide has generated strong interest, with promising outcomes in fibrotic steatohepatitis, underscoring the close link between metabolism and liver health. Finally, endo-hepatology is emerging as an innovative tool for both the evaluation and targeted management of portal hypertension, while metabolic endoscopic techniques are paving the way for promising minimally invasive alternatives. This article aims to provide an in-depth overview of these recent developments and to discuss their implications for everyday clinical practice.

The field of addiction medicine is rapidly evolving due to shifting drug markets and emerging patterns of use. In Switzerland, the possible arrival of highly potent synthetic opioids highlights the need for interprofessional preparedness, particularly through wider training in naloxone use. At the same time, the rise in recreational ketamine use brings an underestimated urological complication: ketamine-induced cystitis, whose early detection is crucial. Growing digitalisation also fosters compulsive pornography use, where craving plays a key role; new tools such as the PCE-S scale help to better assess these mechanisms. Together, these trends call for strengthened monitoring, prevention, and adaptive clinical strategies.

Obesity and overweight cause 1.6 million premature deaths annually, yet only 7% of countries have health systems prepared to address this global crisis, with an estimated economic impact of $3 trillion per year. A shift in care delivery is emerging, moving beyond physical stereotypes and redefining obesity in terms of diagnosis, pathophysiology, and complications. Pharmacological treatment is undergoing a major evolution, driven by incretin-based therapies and supported by over 1,000 ongoing clinical trials, with two-thirds in phases II and III. This article highlights this year's major advances, emerging treatments, and future therapeutic prospects.