PMID- 35728953
OWN - NLM
STAT- MEDLINE
DCOM- 20240226
LR  - 20240228
IS  - 2047-9956 (Print)
IS  - 2047-9964 (Electronic)
IS  - 2047-9956 (Linking)
VI  - 31
IP  - 2
DP  - 2024 Feb 22
TI  - Determination of plasma uracil as a screening for dihydropyrimidine dehydrogenase 
      deficiency: clinical application in oncological treatments.
PG  - 124-126
LID - 10.1136/ejhpharm-2021-003210 [doi]
AB  - AIMS: Treatment with dihydropyrimidines poses a significant risk of serious 
      adverse reactions for patients with dihydropyrimidine dehydrogenase (DPD) 
      deficiency. This study seeks to analyse the correlation between DPD deficiency 
      and plasmatic uracil values in patients who are candidates for a fluoropyrimidine 
      scheme. It also studies the incidence of adverse events (AEs) in patients with 
      DPD deficiency established with plasmatic uracil determination. METHODS: This was 
      a retrospective observational study conducted in a tertiary level establishment 
      from September 2020 to April 2021. Patients included were diagnosed with 
      gastrointestinal tumours, were of good status, and were initiated into a 
      fluoropyrimidine-based regimen. The incidence and grade of AEs, according Common 
      Terminology Criteria for Adverse Events (CTCAE), were collected and compared in 
      patients with and without DPD deficiency. RESULTS: 119 patients diagnosed with 
      gastrointestinal cancer met the inclusion criteria. In 92 (77%) patients there 
      was no DPD deficiency according to plasmatic uracil thresholds. In the group of 
      patients without deficit, dose reductions oscillated between 10-25% (mean 17.4%). 
      In the no DPD deficiency group, 43 (46%) patients experienced AEs. Patients who 
      had a DPD deficiency according to plasmatic uracil measurements were started on a 
      5-fluorouracil (5-FU) regimen with a dose reduction of 15-50% (mean 35%). In this 
      group, 12 patients (44%) experienced some AEs. CONCLUSION: New research is needed 
      to clarify the correlation between plasma uracil values and DPD deficiency to 
      achieve an optimal balance between clinical benefit and toxicity.
CI  - (c) European Association of Hospital Pharmacists 2024. No commercial re-use. See 
      rights and permissions. Published by BMJ.
FAU - Tejedor-Tejada, Eduardo
AU  - Tejedor-Tejada E
AUID- ORCID: 0000-0002-8687-3691
AD  - Pharmacy, Torrecardenas University Hospital, Almeria, Spain 
      edutejedor91@gmail.com.
FAU - Rubio Calvo, Daniel
AU  - Rubio Calvo D
AD  - Pharmacy, Poniente Hospital, El Ejido, Spain.
FAU - Garcia Andreo, Antonio
AU  - Garcia Andreo A
AD  - Laboratory, Torrecardenas University Hospital, Almeria, Spain.
LA  - eng
PT  - Journal Article
PT  - Observational Study
DEP - 20240222
PL  - England
TA  - Eur J Hosp Pharm
JT  - European journal of hospital pharmacy : science and practice
JID - 101578294
RN  - 56HH86ZVCT (Uracil)
RN  - EC 1.3.1.2 (Dihydrouracil Dehydrogenase (NADP))
RN  - U3P01618RT (Fluorouracil)
SB  - IM
MH  - Humans
MH  - *Dihydropyrimidine Dehydrogenase Deficiency/diagnosis/epidemiology
MH  - Uracil/adverse effects
MH  - Dihydrouracil Dehydrogenase (NADP)
MH  - Fluorouracil/adverse effects
MH  - Retrospective Studies
PMC - PMC10895180
OTO - NOTNLM
OT  - education, pharmacy
OT  - education, pharmacy, continuing
OT  - equipment design
OT  - genetic therapy
OT  - medical oncology
COIS- Competing interests: None declared.
EDAT- 2022/06/22 06:00
MHDA- 2024/02/26 06:43
PMCR- 2025/03/01
CRDT- 2022/06/21 21:45
PHST- 2021/12/27 00:00 [received]
PHST- 2022/05/24 00:00 [accepted]
PHST- 2025/03/01 00:00 [pmc-release]
PHST- 2024/02/26 06:43 [medline]
PHST- 2022/06/22 06:00 [pubmed]
PHST- 2022/06/21 21:45 [entrez]
AID - ejhpharm-2021-003210 [pii]
AID - 10.1136/ejhpharm-2021-003210 [doi]
PST - epublish
SO  - Eur J Hosp Pharm. 2024 Feb 22;31(2):124-126. doi: 10.1136/ejhpharm-2021-003210.