{"id":14337,"date":"2022-07-18T18:49:44","date_gmt":"2022-07-18T17:49:44","guid":{"rendered":"https:\/\/www.heartgenetics.com\/especialistas\/farmacogenomica\/dpyd-pgx\/"},"modified":"2023-04-05T15:35:59","modified_gmt":"2023-04-05T14:35:59","slug":"p-dpyd-pgx","status":"publish","type":"page","link":"https:\/\/www.heartgenetics.com\/pt\/pacientes\/terapeutica-personalizada\/p-dpyd-pgx\/","title":{"rendered":"DPYD PGx"},"content":{"rendered":"<h2 class=\"wp-block-heading\">Estudo farmacogen\u00e9tico do Gene Dihidropyrimidina Dehidrogenase (<em>DPYD<\/em>)<\/h2><p>DPYD PGx \u00e9 um teste farmacogen\u00e9tico para estudo da resposta a fluoropirimidinas:<\/p><ul class=\"wp-block-list\"><li>Fluororacilo<\/li><li>Capecitabina<\/li><li>Tegafur<\/li><\/ul><p>A enzima dihidropirimidina desidrogenase metaboliza as pirimidinas end\u00f3genas timina e uracil e \u00e9 tamb\u00e9m fundamental para o metabolismo das fluoropirimidinas. Esta enzima \u00e9 respons\u00e1vel pela inativa\u00e7\u00e3o de aproximadamente 80-85% de 5-fluorouracilo. De acordo com a Ag\u00eancia Europeia do Medicamento (EMA) (relat\u00f3rio de avalia\u00e7\u00e3o EMA\/274404\/2020) a frequ\u00eancia da defici\u00eancia parcial e completa de dihidropiridina desidrogenase entre os caucasianos \u00e9 de aproximadamente 3%-9% e 0,01%-0,5%, respetivamente. A utiliza\u00e7\u00e3o de fluoropirimidinas em pacientes com estas defici\u00eancias pode resultar em toxicidade grave.\u00a0<\/p><p>Por esta raz\u00e3o, os testes de defici\u00eancia de dihidropiridina desidrogenase antes do tratamento com estas fluoropirimidinas s\u00e3o recomendados pelo Infarmed (a autoridade nacional portuguesa de medicamentos e produtos de sa\u00fade) e pela EMA.<\/p><div class=\"wp-block-kobu-custom-blocks-responsive-spacer responsive-spacer size-small\"><\/div><h2 class=\"wp-block-heading\">PAINEL GEN\u00c9TICO<\/h2><p>Este teste farmacogen\u00e9tico analisa os seguintes nove alelos do gene <em>DPYD<\/em>:<\/p><p>HapB3, *2A, *6, *7, *8, *10, *12, *13, c.2846A&gt;T<\/p><p>O estudo de alelos associados \u00e0 atividade reduzida da enzima dihidropiridina desidrogenase permite identificar os indiv\u00edduos com capacidade metabolizadora reduzida que, portanto, beneficiam de doses mais baixas de fluoropirimidinas ou de terap\u00eauticas alternativas.<\/p><div class=\"wp-block-kobu-custom-blocks-responsive-spacer responsive-spacer size-small\"><\/div><h2 class=\"wp-block-heading\">Diretrizes internacionais<\/h2><p>O Clinical Pharmacogenetics Implementation Consortium (CPIC\u00ae) e o Dutch Pharmacogenetics Working Group (DPWG) s\u00e3o sociedades profissionais que fornecem diretrizes para a aplica\u00e7\u00e3o da farmacogen\u00e9tica na pr\u00e1tica cl\u00ednica. Ambos os grupos publicaram recomenda\u00e7\u00f5es para a terap\u00eautica com  fluoropirimidinas baseadas no gen\u00f3tipo de <em>DPYD<\/em>, com o objetivo de minimizar a toxicidade e assim proporcionar maior seguran\u00e7a aos pacientes.<\/p><div class=\"wp-block-kobu-custom-blocks-responsive-spacer responsive-spacer size-small\"><\/div><h2 class=\"wp-block-heading\">RELAT\u00d3RIO<\/h2><p>O relat\u00f3rio do teste indica o score de atividade da enzima dihidropirimidina desidrogenase, com base no gen\u00f3tipo obtido, e a sua tradu\u00e7\u00e3o em recomenda\u00e7\u00f5es pr\u00e1ticas de acordo com as mais recentes diretrizes do Clinical Pharmacogenetics Implementation Consortium (CPIC\u00ae) e do Dutch Pharmacogenetics Working Group (DPWG). <\/p><noscript class=\"loading-lazy\"><figure class=\"wp-block-image size-large\"><img loading=\"lazy\" decoding=\"async\" width=\"1024\" height=\"555\" src=\"https:\/\/www.heartgenetics.com\/files\/uploads\/2022\/05\/heartgenetics-dpyd-pgx-report-1024x555.png\" alt=\"\" class=\"wp-image-8850\" srcset=\"https:\/\/www.heartgenetics.com\/files\/uploads\/2022\/05\/heartgenetics-dpyd-pgx-report-1024x555.png 1024w, https:\/\/www.heartgenetics.com\/files\/uploads\/2022\/05\/heartgenetics-dpyd-pgx-report-300x162.png 300w, https:\/\/www.heartgenetics.com\/files\/uploads\/2022\/05\/heartgenetics-dpyd-pgx-report-768x416.png 768w, https:\/\/www.heartgenetics.com\/files\/uploads\/2022\/05\/heartgenetics-dpyd-pgx-report-600x325.png 600w, https:\/\/www.heartgenetics.com\/files\/uploads\/2022\/05\/heartgenetics-dpyd-pgx-report.png 1396w\" sizes=\"auto, (max-width: 1024px) 100vw, 1024px\" \/><\/figure><\/noscript><div class=\"wp-block-kobu-custom-blocks-responsive-spacer responsive-spacer size-large\"><\/div><div class=\"wp-block-kobu-custom-blocks-section-wrapper alignfull kobu-section has-background has-quinary-background-color\"><div class=\"wp-block-kobu-custom-blocks-responsive-spacer responsive-spacer size-small\"><\/div>\n\n<div class=\"wp-block-columns two-columns-icon-left is-layout-flex wp-container-core-columns-is-layout-1 wp-block-columns-is-layout-flex\"><div class=\"wp-block-column is-layout-flow wp-block-column-is-layout-flow\"><noscript class=\"loading-lazy\"><figure class=\"wp-block-image size-full is-resized\"><a href=\"https:\/\/www.heartgenetics.com\/files\/uploads\/2022\/05\/heartgenetics-turnaroundtime-icon.png\"><img loading=\"lazy\" decoding=\"async\" src=\"https:\/\/www.heartgenetics.com\/files\/uploads\/2022\/05\/heartgenetics-turnaroundtime-icon.png\" alt=\"10 days Turn around time\" class=\"wp-image-12512\" width=\"114\" height=\"114\" srcset=\"https:\/\/www.heartgenetics.com\/files\/uploads\/2022\/05\/heartgenetics-turnaroundtime-icon.png 300w, https:\/\/www.heartgenetics.com\/files\/uploads\/2022\/05\/heartgenetics-turnaroundtime-icon-150x150.png 150w, https:\/\/www.heartgenetics.com\/files\/uploads\/2022\/05\/heartgenetics-turnaroundtime-icon-100x100.png 100w\" sizes=\"auto, (max-width: 114px) 100vw, 114px\" \/><\/a><\/figure><\/noscript><\/div>\n\n<div class=\"wp-block-column is-layout-flow wp-block-column-is-layout-flow\"><h2 class=\"has-large-font-size wp-block-heading\">Tempo de resposta<\/h2>\n\n<p>3 a 5 dias \u00fateis<\/p>\n\n<div style=\"height:20px\" aria-hidden=\"true\" class=\"wp-block-spacer\"><\/div>\n\n<div class=\"wp-block-buttons is-layout-flex wp-block-buttons-is-layout-flex\"><div class=\"wp-block-button\"><a class=\"wp-block-button__link\" href=\"https:\/\/www.heartgenetics.com\/pt\/contactos\/\">Clique aqui para contactar o departamento de vendas<\/a><\/div><\/div><\/div><\/div>\n\n<div class=\"wp-block-kobu-custom-blocks-responsive-spacer responsive-spacer size-small\"><\/div><\/div><div class=\"wp-block-kobu-custom-blocks-responsive-spacer responsive-spacer size-small\"><\/div><h2 class=\"wp-block-heading\">Estudos cient\u00edficos<\/h2><div class=\"wp-block-group is-layout-flow wp-block-group-is-layout-flow\">[1] Clinical Pharmacogenetics Implementation Consortium (CPIC) guideline for dihydropyrimidine dehydrogenase genotype and fluoropyrimidine dosing: actualiza\u00e7\u00e3o de 2017.<br>[2] Diretriz do Grupo de Trabalho de Farmacogen\u00e9tica Holand\u00eas (DPWG) para a intera\u00e7\u00e3o geno-droga de DPYD e fluoropirimidinas.<br>[3] Ag\u00eancia Europeia de Medicamentos. 2020. Recomenda\u00e7\u00f5es da EMA sobre testes de DPYD antes do tratamento com fluorouracil, capecitabina, tegafur e flucytosina. EMA\/229267\/2020<br>[4] Infarmed. 2020. Circular Informativa: Fluorouracilo, capecitabina, tegafur e flucitosina &#8211; novas recomenda\u00e7\u00f5es de seguran\u00e7a. N.\u00ba 072\/CD\/550.20.001 (18\/03\/2020)<\/p><\/div>","protected":false},"excerpt":{"rendered":"<p>Estudo farmacogen\u00e9tico do Gene Dihidropyrimidina Dehidrogenase (DPYD) DPYD PGx \u00e9 um teste farmacogen\u00e9tico para estudo da resposta a fluoropirimidinas: Fluororacilo Capecitabina Tegafur A enzima dihidropirimidina [&hellip;]<\/p>\n","protected":false},"author":68,"featured_media":15102,"parent":15287,"menu_order":153,"comment_status":"closed","ping_status":"closed","template":"templates\/mygenes.php","meta":{"_acf_changed":false,"footnotes":""},"class_list":["post-14337","page","type-page","status-publish","has-post-thumbnail","hentry"],"acf":[],"aioseo_notices":[],"_links":{"self":[{"href":"https:\/\/www.heartgenetics.com\/pt\/wp-json\/wp\/v2\/pages\/14337","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.heartgenetics.com\/pt\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/www.heartgenetics.com\/pt\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/www.heartgenetics.com\/pt\/wp-json\/wp\/v2\/users\/68"}],"replies":[{"embeddable":true,"href":"https:\/\/www.heartgenetics.com\/pt\/wp-json\/wp\/v2\/comments?post=14337"}],"version-history":[{"count":40,"href":"https:\/\/www.heartgenetics.com\/pt\/wp-json\/wp\/v2\/pages\/14337\/revisions"}],"predecessor-version":[{"id":15432,"href":"https:\/\/www.heartgenetics.com\/pt\/wp-json\/wp\/v2\/pages\/14337\/revisions\/15432"}],"up":[{"embeddable":true,"href":"https:\/\/www.heartgenetics.com\/pt\/wp-json\/wp\/v2\/pages\/15287"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.heartgenetics.com\/pt\/wp-json\/wp\/v2\/media\/15102"}],"wp:attachment":[{"href":"https:\/\/www.heartgenetics.com\/pt\/wp-json\/wp\/v2\/media?parent=14337"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}