Revue medicale suisse最新文献

In this article, several studies published in 2025 that provide new insights into the field of arterial hypertension are reviewed. The first focuses on breastfeeding in women with a history of hypertensive disorders during pregnancy. Recent developments in chronotherapy, that is, the optimal timing of antihypertensive medication intake are mentioned. The third section addresses the issue of medication deprescription in nursing home resident. Finally, a study assessing the impact of antihypertensive treatment on dementia is described.

Integrative medicine is gradually becoming established in the French-speaking Swiss medical landscape. Driven by both patient demand and the desire of institutions to structure the services on offer, this model of care has become established both in the private and public sectors. This article presents public initiatives in French-speaking Switzerland that have reached a milestone in 2025 in the field of integrative medicine. These initiatives are notable for their commitment to research and teaching. They consolidate the integration of complementary practices in hospitals and form communities of practice.

In 2025, osteoporosis management in Switzerland benefited from the introduction of abaloparatide, an anabolic PTHrP analogue that effectively reduces the risk of vertebral and non-vertebral fractures, with reimbursement criteria identical to those of romosozumab. Zoledronate, administered preventively only twice at a five-year interval in recently menopausal, non-osteoporotic women, lowers 10-year fracture risk by about 40 %. Calcium and/or vitamin D supplements are now subject to reimbursement restrictions. Burosumab, an anti-FGF23 antibody, has become the treatment of choice for X-linked hypophosphatemic rickets, though access remains limited in Switzerland. Finally, artificial intelligence is emerging as a valuable tool for radiographic diagnosis and opportunistic screening of osteoporotic fractures.

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.