{"id":97596,"date":"2023-12-23T10:56:51","date_gmt":"2023-12-23T15:56:51","guid":{"rendered":"https:\/\/wfh.org\/article\/declaration-de-la-fmh-ajout-du-cryoprecipite-dans-les-eml-et-emlc-de-loms\/"},"modified":"2024-04-03T12:22:42","modified_gmt":"2024-04-03T16:22:42","slug":"declaration-de-la-fmh-ajout-du-cryoprecipite-dans-les-eml-et-emlc-de-loms","status":"publish","type":"post","link":"https:\/\/wfh.org\/fr\/article\/declaration-de-la-fmh-ajout-du-cryoprecipite-dans-les-eml-et-emlc-de-loms\/","title":{"rendered":"D\u00e9claration de la FMH : ajout du cryopr\u00e9cipit\u00e9 dans les EML et EMLc de l\u2019OMS"},"content":{"rendered":"\t\t<div data-elementor-type=\"wp-post\" data-elementor-id=\"97596\" class=\"elementor elementor-97596 elementor-97475\" data-elementor-post-type=\"post\">\n\t\t\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-6be26cf elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"6be26cf\" data-element_type=\"section\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-100 elementor-top-column elementor-element elementor-element-9e96b7e\" data-id=\"9e96b7e\" data-element_type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-54c13df elementor-widget elementor-widget-text-editor\" data-id=\"54c13df\" data-element_type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t<style>\/*! elementor - v3.23.0 - 25-07-2024 *\/\n.elementor-widget-text-editor.elementor-drop-cap-view-stacked .elementor-drop-cap{background-color:#69727d;color:#fff}.elementor-widget-text-editor.elementor-drop-cap-view-framed .elementor-drop-cap{color:#69727d;border:3px solid;background-color:transparent}.elementor-widget-text-editor:not(.elementor-drop-cap-view-default) .elementor-drop-cap{margin-top:8px}.elementor-widget-text-editor:not(.elementor-drop-cap-view-default) .elementor-drop-cap-letter{width:1em;height:1em}.elementor-widget-text-editor .elementor-drop-cap{float:left;text-align:center;line-height:1;font-size:50px}.elementor-widget-text-editor .elementor-drop-cap-letter{display:inline-block}<\/style>\t\t\t\t<p>La troisi\u00e8me \u00e9dition des <em>Lignes directrices pour la prise en charge de l\u2019h\u00e9mophilie<\/em> de la FMH, publi\u00e9e en 2020, recommande les concentr\u00e9s de facteur de coagulation (CFC) et les anticorps bisp\u00e9cifiques qui imitent le facteur\u00a0VIII comme traitement prophylactique de choix dans la pr\u00e9vention des saignements, les CFC \u00e9tant la norme de soins pour le traitement des saignements. Le cryopr\u00e9cipit\u00e9 r\u00e9duit en agents pathog\u00e8nes n\u2019est en aucun cas \u00e0 privil\u00e9gier dans le traitement des saignements et la FMH n\u2019y souscrit qu\u2019en cas d\u2019indisponibilit\u00e9 des CFC. Elle souligne \u00e9galement que le cryopr\u00e9cipit\u00e9 sans r\u00e9duction des agents pathog\u00e8nes ne doit \u00eatre utilis\u00e9 que dans des circonstances mena\u00e7ant le pronostic vital ou les membres et en l\u2019absence de tout autre traitement ayant subi une inactivation virale, en raison du risque \u00e9lev\u00e9 de transmission d\u2019infections par le sang, telles que le VIH et les virus de l\u2019h\u00e9patite\u00a0B et C.<\/p>\n<p>La F\u00e9d\u00e9ration mondiale de l\u2019h\u00e9mophilie s\u2019inqui\u00e8te par ailleurs de la sup\u00e9riorit\u00e9 implicite du rapport co\u00fbt-efficacit\u00e9 du cryopr\u00e9cipit\u00e9 r\u00e9duit en agents pathog\u00e8nes par rapport aux CFC, en raison du statut essentiel qui lui est attribu\u00e9 dans l\u2019EML de l\u2019OMS par rapport au statut compl\u00e9mentaire des CFC. Les co\u00fbts de fabrication tout compris des CFC recombinants sont souvent inf\u00e9rieurs \u00e0 ceux des CFC d\u00e9riv\u00e9s du plasma, les CFC recombinants sont dans certains pays moins chers \u00e0 l\u2019achat que les facteurs de coagulation d\u00e9riv\u00e9s du plasma et, dans de nombreux pays, il est possible de se procurer des CFC d\u00e9riv\u00e9s du plasma pour un co\u00fbt inf\u00e9rieur au processus de r\u00e9duction des agents pathog\u00e8nes du cryopr\u00e9cipit\u00e9.<\/p>\n<p>La FMH convient que la Liste mod\u00e8le des m\u00e9dicaments essentiels de l\u2019OMS est un outil important \u00e0 disposition des gouvernements pour les orienter dans le choix et le financement des m\u00e9dicaments. En tant qu\u2019acteur non \u00e9tatique dans les relations officielles avec l\u2019OMS, la FMH a \u00e9t\u00e9 proactive dans le dialogue engag\u00e9 avec le si\u00e8ge de l\u2019OMS pour faire face aux risques graves pour la sant\u00e9 et la s\u00e9curit\u00e9 auxquels la communaut\u00e9 mondiale des h\u00e9mophiles est confront\u00e9e, l\u2019OMS ayant au pr\u00e9alable donn\u00e9 l\u2019assurance que ce point serait trait\u00e9 lors de la prochaine r\u00e9vision de l\u2019EML. Avant la publication de la liste de 2023, la FMH avait fourni des recommandations sp\u00e9cifiques \u2013\u00a0ignor\u00e9es\u00a0\u2013 exhortant l\u2019OMS \u00e0 accorder la priorit\u00e9 aux CFC, et non au cryopr\u00e9cipit\u00e9. Depuis, elle a demand\u00e9 le retrait imm\u00e9diat du cryopr\u00e9cipit\u00e9 sans r\u00e9duction des agents pathog\u00e8nes des EML et EMLc, ainsi que la r\u00e9vision du statut des CFC de m\u00e9dicaments compl\u00e9mentaires \u00e0 m\u00e9dicaments essentiels. L\u2019OMS a cependant indiqu\u00e9 qu\u2019aucun changement ne pourrait intervenir avant 2025.<\/p>\n<p>La FMH restera vigilante sur l\u2019\u00e9volution de la situation et maintiendra un dialogue \u00e9troit avec l\u2019OMS jusqu\u2019\u00e0 ce que ce probl\u00e8me soit r\u00e9solu. En attendant, elle insiste sur le fait que les recommandations relatives \u00e0 l\u2019utilisation comme m\u00e9dicament essentiel du cryopr\u00e9cipit\u00e9, r\u00e9duit en agents pathog\u00e8nes ou non, des EML et EMLc de l\u2019OMS <strong><u>ne doivent pas<\/u><\/strong> \u00eatre suivies. En effet, cela entra\u00eenerait la transmission d\u2019agents pathog\u00e8nes par le sang et des l\u00e9sions suppl\u00e9mentaires dues aux saignements pour les personnes atteintes d\u2019h\u00e9mophilie\u00a0A. Cette d\u00e9claration peut \u00eatre diffus\u00e9e dans son int\u00e9gralit\u00e9 si n\u00e9cessaire.<\/p>\n<p>Pour consulter la troisi\u00e8me \u00e9dition des <em>Lignes directrices de la FMH pour la prise en charge de l\u2019h\u00e9mophilie<\/em>, <a href=\"https:\/\/guidelines.wfh.org\/fr\/\" target=\"_blank\" rel=\"noopener\">cliquez ici<\/a>.<\/p>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<\/div>\n\t\t","protected":false},"excerpt":{"rendered":"<p>La F\u00e9d\u00e9ration mondiale de l\u2019h\u00e9mophilie (FMH) est extr\u00eamement pr\u00e9occup\u00e9e par l\u2019ajout des cryopr\u00e9cipit\u00e9s avec et sans r\u00e9duction des agents pathog\u00e8nes dans les 23e Liste mod\u00e8le des m\u00e9dicaments essentiels (EML) et Liste mod\u00e8le des m\u00e9dicaments essentiels destin\u00e9s \u00e0 l\u2019enfant (EMLc) de l\u2019Organisation mondiale de la sant\u00e9 (OMS).<\/p>\n","protected":false},"author":13,"featured_media":30514,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"inline_featured_image":false,"footnotes":""},"categories":[197],"tags":[],"search-category":[85],"class_list":["post-97596","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-declarations-publiques-et-recommandations-de-la-fmh","search-category-article"],"yoast_head":"<!-- This site is optimized with the Yoast SEO Premium plugin v23.4 (Yoast SEO v23.4) - 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