The year 2024 saw significant advances in the therapeutic management of patients with IgA nephropathy. Strict control of proteinuria is essential to slow down the progression to kidney failure. The first immunomodulatory agent to target the pathogenesis of IgA nephropathy is now available in Belgium, and promising new targeted therapies are being investigated. In kidney transplantation, the prophylaxis and treatment of CMV disease have benefited from the advent of new drugs. Since March 2024, maribavir has been reimbursed in Belgium for the treatment of refractory or resistant CMV disease, or in cases of intolerance to treatment due to myelotoxicity or nephrotoxicity.

The year 2024 was full of events for the forensic medicine department at the Cliniques universitaires Saint-Luc. Thanks to government funding aimed at creating regional forensic institutes, we were able to strengthen the department’s team. Improvements to the autopsy room and morgue infrastructure are also planned in the next few months. Through this article, we would like to share with you this new chapter for our department and our recent scientific advancements, particularly in the field of forensic imaging.

In Endocrinology, the year 2024 has been marked by new international recommendations on the management of iatrogenic adrenal insufficiency in patients treated with glucocorticoids. Clear strategies for biological monitoring have been defined, enabling the optimization of patient follow-up and avoidance of the adrenal insufficiency risk.

Regarding diabetes complications, two major studies have opened new avenues for the prevention of diabetic kidney disease and diabetic retinopathy. The FLOW study demonstrated the nephroprotective effect of semaglutide, a GLP-1 agonist, with a 24% reduction in the risk of major renal events in diabetic patients with chronic kidney disease at high risk of progression. Furthermore, the LENS study confirmed the role of fenofibrate in preventing the progression of diabetic retinopathy, reducing the risk of visual deterioration by 27% in diabetic patients with early signs of retinal involvement. 

Additionally, tirzepatide, the first dual agonist of GLP-1 and GIP receptors, is now available in Belgium for the treatment of type 2 diabetes and obesity. Superior to semaglutide in terms of weight loss and glycemic control, it has demonstrated significant metabolic benefits in the SURPASS and SURMOUNT studies. It also showed promising effects in reducing cardiovascular complications and sleep apnea. 

Finally, teplizumab, an anti-CD3 antibody, represents a major advance in the preventive treatment of type 1 diabetes, which has been confirmed in 2024. By targeting T lymphocytes involved in the destruction of pancreatic beta cells, it significantly delays disease onset in at-risk patients and preserves beta-cell function in newly diagnosed patients.