Historically, the discovery of new pharmaceutical therapies has constituted a lengthy and cost-intensive process. Between the initial identification of a drug candidate and successful regulatory approval, 10 to 15 years commonly elapse, with development costs reaching the order of billions of dollars. Research activities, which are still largely empirical in nature, are frequently marked by setbacks, for example due to toxicological findings or insufficient efficacy in preclinical disease models. Technological breakthroughs, such as the sequencing of the human genome, have given rise to largely unmet expectations that medicines could be developed more rapidly and efficiently. Accordingly, expectations for the application of artificial intelligence (AI) in pharmaceutical research and development are high. Indeed, workflows in the preclinical phase are currently being fundamentally transformed by AI. In the following, the individual stages of preclinical research are analysed, and the potential applications of AI are described. In addition, selected critical aspects are discussed to realistically contextualize expectations regarding AI. As a result of the integration of AI, both preclinical and clinical research are undergoing profound transformation. There is justified hope that effective and safe therapies can finally be developed more rapidly and cost-efficiently.

This review summarizes the immunologic approach to systemic sarcoidosis and presents the use of novel, targeted therapies such as TNF-alpha inhibitors and Janus kinase (JAK) inhibitors. Sarcoidosis is a granulomatous multisystem disease with diverse clinical manifestations that requires differentiated diagnostic and therapeutic strategies. The recommendations presented here are based on extensive clinical experience and expert opinion from the certified sarcoidosis center of excellence at University Hospital Zurich. The article provides an overview of immunopathogenesis, immunoserologic and imaging diagnostic pathways, as well as an evaluation of established and novel therapeutic concepts. Practical guidance for the use of TNF-alpha and JAK inhibitors, for adverse effect management, and for therapy escalation is presented. A focus is also placed on the indication for consultation in difficult cases to support primary care physicians in the effective and individually tailored care of patients with systemic sarcoidosis.

Melanoma arises from malignant transformation of melanocytes and accounts for approximately 3500 new cases per year in Switzerland. The most important risk factors include intermittent UV exposure, fair skin, a high number of nevi, five or more atypical nevi, and a positive family history. The most common type is the superficial spreading melanoma, followed by the nodular type. Diagnosis is primarily clinical, for example using the ABCDE rule, and is supported by dermoscopy performed by dermatologists. If there is a suspicion, a narrow complete excision should be performed to confirm the diagnosis. Treatment options have improved drastically over the years, so nowadays there are indeed good chances of cure, even in a metastatic setting. Immunotherapy as well as targeted therapies have led to major breakthroughs. While adjuvant or neoadjuvant therapy is recommended in earlier stages of disease, PD-1 blockage plays a central role in metastatic disease, preferably in combination with anti-CTLA-4-antibody or, according to more recent data, with an anti-LAG-3-antibody. Targeted therapy also has an established role today in treatment, both in the adjuvant and curative settings. After successful treatment, regular follow-ups should be performed to detect relapses at an early stage.

Therapeutic apheresis (TA) is an important treatment for certain conditions. TA refers to various procedures in which either plasma (plasmapheresis) or specific blood cell fractions (cyta-pheresis) are removed. These include, among others, extracorporeal photopheresis (EP), erythrocytapheresis (EA), therapeutic plasma exchange (TPE), and therapeutic erythrocyte exchange (TEE). The indications for these procedures in specific diseases are published by the American Society for Apheresis (ASFA) as well as by hematology societies such as the American Society of Hematology (ASH) and the British Society of Haematology (BSH). There are only a few indications for therapeutic apheresis as first-line therapy for hematologic diseases, either as primary treatment or in combination with other therapies, for which strong evidence (Grade 1A-1C) exists. These indications include TPE for symptomatic hyperviscosity syndrome, hyperviscosity syndrome prophylaxis during rituximab therapy for Waldenström's macroglobulinemia, TEE for acute complications of sickle cell disease such as stroke and for the prophylaxis of such events, as well as the use of TPE for thrombotic thrombocytopenic purpura. Less well-known indications with strong evidence include the treatment of erythrocytosis in polycythemia vera and the treatment of iron overload in hereditary hemochromatosis using EA. Similarly, EP is an established treatment option for mycosis fungoides and Sézary syndrome. The aim of this paper is to summarize these indications.

Immune checkpoint inhibitors have fundamentally transformed the treatment of numerous malignant diseases and are now part of standard therapy plans across many tumor entities. With their increasing use, physicians outside specialized oncology centres are more frequently confronted with immune-related adverse events. These adverse events result from enhanced immune activity and can, in principle, affect any organ system. The clinical presentation is often non-specific and ranges from mild symptoms to potentially life-threatening conditions. Moreover, immune-related adverse events may occur not only during treatment but also with a delayed onset after therapy has been disconti-nued. In clinical practice, the early recognition of immune-related adverse events represents a key challenge, particularly in general practice and internal medicine settings. This review provides an overview of the pathophysiology, typical clinical manifestations, and important warning signs of immune-related adverse events. Its aim is to raise awareness of these complications and to promote timely referral for specialized evaluation.

Drug development is undergoing profound change. Accelerated regulatory processes, gene and cell therapies, the use of artificial intelligence, and the increasing use of real-world evidence are fundamentally transforming the pharmaceutical innovation system. These developments offer patients faster access to effective therapies, but at the same time raise significant ethical and regulatory questions: How can the protection of trial participants be reconciled with the desire for rapid innovation transfer? How can an evidence-based risk-benefit assessment be successful when pivotal trials are small and short? What mechanisms ensure the equitable distribution of high-cost therapies in a solidarity-based healthcare system such as Switzerland's? This overview outlines the key trends and provides guidance for practising doctors on the use of innovative medicines.

Coronary angiography has evolved from the first cardiac catheterization performed by Werner Forssmann into a highly precise imaging modality of the coronary arteries. Modern techniques such as intravascular ultrasound, optical coherence tomography, and physiological measurements including FFR and iFR enable combined structural and functional assessment of coronary stenoses. At the same time, non-invasive coronary computed tomography, particularly with photon-counting technology, is gaining importance for diagnosis and procedural planning. Cardiovascular imaging is therefore becoming central to personalized management of coronary artery disease.

Sudden cardiac death (SCD) in athletes is usually the result of an undetected underlying heart disease, with physical exertion acting as the trigger. Commotio cordis is a rare cause of SCD. In young athletes, genetically determined cardiomyopathies predominate, while in older athletes coronary artery disease remains the most important differential diagnosis. Regular screening programs - consisting of medical history, physical examination, and resting ECG - can detect over 90 % of relevant conditions, particularly when international ECG criteria are applied correctly. However, these assessments are not always sufficient, as some pathologies may manifest later in life and/or require additional diagnostic tests to be recognized. The main task of screening athletes is to distinguish physiological adaptations of the athlete's heart from pathological changes. Echocardiography, MRI, and CT play a central role here.

Cardiac amyloidosis and cardiac sarcoidosis can be classified as infiltrative cardiomyopathies. Although the aetiology and underlying pathophysiology of these two conditions differ substantially, imaging techniques are becoming increasingly important for both. Only a decade ago myocardial biopsy used to be essential for establishing the diagnosis, contemporary diagnostic algorithms for both diseases now rely predominantly on non-invasive cardiac imaging, enabling not only accurate diagnosis but also guiding therapeutic decision-making. In this review, we aim to highlight the respective strengths and limitations of the available cardiac imaging modalities as they relate to these disorders. Particular emphasis will be placed on disease detection and the differential diagnosis between amyloidosis and sarcoidosis, and its value for prognostic assessment. Where appropriate, we will also discuss recent advances in multimodality imaging and how they have reshaped clinical pathways and management strategies.

Myocarditis and pericarditis represent a broad spectrum of inflammatory heart diseases and are important differential diagnoses in patients presenting with chest pain, heart failure, or arrhythmias. Diagnosis is often challenging due to non-specific clinical presentation and biomarkers. Growing recognition of the clinical relevance of myocardial inflammation, together with accumulating evidence, has led to increased scientific and clinical attention. This is reflected in emerging concepts such as the introduction of the new term "inflammatory myocardial syndrome (IMPS)" in the recently published guidelines of the European Society of Cardiology (ESC). Notably, these are the first ESC guidelines to cover the full spectrum of inflammatory diseases of the myocardium and pericardium - marking an important paradigm shift in the field. Current ESC guidelines highlight the central role of multimodality cardiac imaging in the evaluation of myocardial inflammation. While echocardiography serves as a first-line tool, cardiac magnetic resonance imaging (CMR) is considered the non-invasive gold standard for tissue characterization. Nuclear imaging techniques such as positron emission tomography (PET) are increasingly relevant, particularly in specific entities such as cardiac sarcoidosis. This review highlights the practical role of multimodality imaging in the diagnostic work-up of myocardial inflammation, with emphasis on clinically relevant decision-making.

Coronary artery disease (CAD) remains one of the leading causes of morbidity and mortality worldwide. Accurate, patient-centered, and efficient diagnostic strategies are therefore essential. Beyond clinical history, physical examination, and laboratory testing, cardiac imaging has become increasingly central to both diagnostic evaluation and risk stratification. In recent years, non-invasive imaging modalities for CAD have undergone remarkable technological and methodological advancements. They now play a pivotal role in confirming or excluding obstructive CAD, assessing the functional significance of coronary stenoses, and supporting individualized treatment decision-making. Selecting the most appropriate imaging modality is thus crucial for achieving diagnostic precision and optimal patient management. This article provides a comprehensive overview of the currently available non-invasive imaging techniques, highlights their respective strengths and limitations, and offers practical guidance on choosing the most suitable modality for different patient groups. Particular emphasis is placed on their application in routine clinical practice in Switzerland.

Heart failure is clinical syndrome with many different underlying cardiac diseases. The definition of heart failure includes the presence of typical symptoms and the proof of a structural cardiac abnormality, which is responsible for a reduced cardiac output and/or elevated cardiac filling pressures at rest or on exertion. The identification and exact description of the main mechanism of heart failure is key for the introduction of an appropriate treatment, which when appropriately selected improves symptoms and prognosis. In patients with suspected heart failure, a basic assessment including history, physical examination, ECG, measurement of natriuretic peptides, and a comprehensive transthoracic echocardiogram should always be performed. Based on the finding of this initial assessment additional imaging modalities are selected on a case-to-case basis. In this review, we discuss the role of advanced echocardiography techniques, cardiac magnetic resonance imaging, computed tomography, cardiac catheterization and nuclear medicine examinations in this context.