Les autorit\u00e9s sanitaires fran\u00e7aises renforcent le cadre de s\u00e9curisation des traitements anticanc\u00e9reux par fluoropyrimidines (5-fluorouracile et cap\u00e9citabine) en s\u2019appuyant sur les r\u00e9sultats d\u2019une enqu\u00eate nationale men\u00e9e en novembre 2025 par le r\u00e9seau ResOMEDIT dans les \u00e9tablissements de sant\u00e9. Cette enqu\u00eate, conduite \u00e0 la demande de la Direction g\u00e9n\u00e9rale de la sant\u00e9 (DGS), avait confirm\u00e9 l\u2019int\u00e9gration syst\u00e9matique du d\u00e9pistage du d\u00e9ficit en dihydropyrimidine d\u00e9shydrog\u00e9nase (DPD) avant l\u2019initiation des traitements, tout en identifiant plusieurs marges de progression : harmonisation de l\u2019adaptation des doses en cas de d\u00e9ficit partiel en DPD, am\u00e9lioration des syst\u00e8mes d\u2019alerte dans les logiciels de prescription et de dispensation, et meilleure tra\u00e7abilit\u00e9 des r\u00e9sultats biologiques.<\/p>\n
Le d\u00e9ficit constitutionnel en DPD modifie fortement la pharmacocin\u00e9tique des fluoropyrimidines et peut entra\u00eener des toxicit\u00e9s graves voire l\u00e9tales. La mesure pr\u00e9alable de l\u2019uracil\u00e9mie avant tout traitement par fluoropyrimidines est obligatoire. En cas de d\u00e9ficit complet, la non\u2011administration de ces traitements est imp\u00e9rative. En revanche, les pratiques n\u2019\u00e9taient pas harmonis\u00e9es entre \u00e9tablissements en situation de d\u00e9ficit partiel.<\/p>\n
Pour r\u00e9pondre \u00e0 ces constats, la DGS, la D\u00e9l\u00e9gation au num\u00e9rique en sant\u00e9 (DNS), l\u2019Institut national du cancer (INCa), l\u2019Agence nationale de s\u00e9curit\u00e9 du m\u00e9dicament et des produits de sant\u00e9 (ANSM) et le ResOMEDIT poursuivent la mise en \u0153uvre des engagements pris \u00e0 l\u2019issue de l\u2019enqu\u00eate de 2025. Un avis national d\u2019experts a \u00e9t\u00e9 \u00e9labor\u00e9 sous pilotage de l\u2019INCa, en lien avec l\u2019ANSM et avec la participation du ResOMEDIT, afin de proposer des recommandations nationales d\u2019adaptation posologique des fluoropyrimidines en fonction du niveau d\u2019uracil\u00e9mie. Cet avis fournit, pour la premi\u00e8re fois, un cadre national partag\u00e9 pour ajuster la dose initiale chez les patients pr\u00e9sentant un d\u00e9ficit partiel en DPD, tout en pr\u00e9cisant que ces recommandations doivent \u00eatre appliqu\u00e9es en tenant compte de la situation clinique individuelle.<\/p>\n
Parall\u00e8lement, une \u00e9volution des fonctionnalit\u00e9s d\u2019alerte des logiciels de prescription et de dispensation, ainsi que plusieurs actions d\u2019accompagnement ciblant les professionnels de sant\u00e9, sont pr\u00e9vues pour soutenir l\u2019am\u00e9lioration continue des pratiques et renforcer la s\u00e9curit\u00e9 des patients. Ces mesures s\u2019inscrivent dans une d\u00e9marche de consolidation du pilotage national de la s\u00e9curit\u00e9 des traitements anticanc\u00e9reux, impliquant \u00e9troitement les autorit\u00e9s sanitaires centrales, l\u2019agence du m\u00e9dicament, l\u2019institut sp\u00e9cialis\u00e9 en canc\u00e9rologie, le r\u00e9seau de suivi des m\u00e9dicaments et le secteur du num\u00e9rique en sant\u00e9.\u00a0(contenu r\u00e9sum\u00e9 par l’IA)Lire la Suite<\/a>\u200b<\/p>","protected":false},"excerpt":{"rendered":" Les autorit\u00e9s sanitaires fran\u00e7aises renforcent le cadre de s\u00e9curisation des traitements anticanc\u00e9reux par fluoropyrimidines (5-fluorouracile et cap\u00e9citabine) en s\u2019appuyant sur les r\u00e9sultats d\u2019une enqu\u00eate nationale men\u00e9e en novembre 2025 par […]<\/p>\n","protected":false},"author":1,"featured_media":3852,"comment_status":"","ping_status":"","sticky":false,"template":"","format":"standard","meta":{"site-sidebar-layout":"default","site-content-layout":"","ast-site-content-layout":"default","site-content-style":"default","site-sidebar-style":"default","ast-global-header-display":"","ast-banner-title-visibility":"","ast-main-header-display":"","ast-hfb-above-header-display":"","ast-hfb-below-header-display":"","ast-hfb-mobile-header-display":"","site-post-title":"","ast-breadcrumbs-content":"","ast-featured-img":"","footer-sml-layout":"","ast-disable-related-posts":"","theme-transparent-header-meta":"","adv-header-id-meta":"","stick-header-meta":"","header-above-stick-meta":"","header-main-stick-meta":"","header-below-stick-meta":"","astra-migrate-meta-layouts":"default","ast-page-background-enabled":"default","ast-page-background-meta":{"desktop":{"background-color":"var(--ast-global-color-5)","background-image":"","background-repeat":"repeat","background-position":"center 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