FrancophonIA/ELRC3.0 huggingface dataset:
English: The CMDh took into consideration all the new elements available since the previous CMDh position.
Danish: CMDh tog hensyn til alle de nye elementer, der er blevet tilgængelige siden den foregående udtalelse fra CMDh.
English: This controlled access program should be described in a Risk Management Plan which shall be submitted to the National Competent Authorities for assessment within 3 months from the Commission Decision.
Danish: Dette program for kontrolleret adgang beskrives i en risikostyringsplan, der forelægges de nationale kompetente myndigheder til vurdering senest tre måneder efter Kommissionens afgørelse.
English: The training materials should be based on interactive learning tools in order to ensure the active involvement of the HCPs.
Danish: Oplysningsmaterialet baseres på interaktive læringsredskaber for at sikre aktiv inddragelse af sundhedspersonerne.
English: During the decision-making process, at a meeting of the Standing Committee on Medicinal Products for Human Use, some EU Member States raised new questions of technical nature which they considered had not been sufficiently addressed in the PRAC recommendation and CMDh position.
Danish: Under et møde i Det Stående Udvalg for Humanmedicinske Lægemidler blev der af nogle medlemsstater under beslutningsprocessen rejst nye spørgsmål af teknisk art, som de ikke fandt tilstrækkeligt behandlet i PRAC's anbefaling og CMDh's udtalelse.
English: The CMDh finally encouraged the integration of the training activities abovementioned in the continuing medical education at national level.
Danish: CMDh tilskyndede endelig til integration af ovennævnte oplysningsaktiviteter i den nationale medicinske videreuddannelse.
English: The safety concerns of primary importance in this referral are increased mortality and a higher incidence of renal failure - the opposite of the benefit expected.
Danish: De vigtigste sikkerhedsmæssige betænkeligheder i denne indbringelsesprocedure er øget dødelighed og højere incidens af nyresvigt - det modsatte af den forventede fordel.
English: This reflects a long-standing controversy among health-care professionals and echoes the range of stakeholder responses received in the current review.
Danish: Dette afspejler en langvarig kontrovers blandt sundhedspersoner og viser de mange forskellige interessentsvar i den aktuelle gennemgang.
English: The PRAC considered that despite arguments raised by some Member States, the potential for unmet medical need is not established.
Danish: PRAC fandt, at der trods argumenterne fra nogle medlemsstater ikke er godtgjort at være potentiale for et udækket medicinsk behov.
English: In terms of readability, the warning should be strongly emphasised (e.g. capitalized, bold letters or use of colours).
Danish: Hvad læsbarheden angår, bør advarslen være kraftigt fremhævet (f.eks. ved kapitalisering, fed skrift eller farver).
English: It is proposed to mention explicitly in the new warnings ‘renal impairment' in addition to ‘sepsis' and ‘critically ill patients'; this would add further emphasis on this specific critically ill patients.
Danish: Det foreslås, at de nye advarsler udtrykkeligt nævner "nedsat nyrefunktion" foruden "sepsis" og "kritisk syge patienter"; dette ville yderligere specifikt fremhæve disse kritisk syge patienter.
English: In light of the well-established risk for serious harm when HES solutions for infusion are used in patients with critical illness, including sepsis, together with the above-mentioned newly available data, Sweden triggered, on 17th October 2017, an urgent Union procedure under Article 107i of Directive 2001/83/EC.
Danish: På baggrund af den velunderbyggede risiko for alvorlig skade ved brug af HES-infusionsvæske, opløsning, hos patienter med kritisk sygdom, herunder sepsis, samt på baggrund af de ovennævnte nytilkomne data indledte Sverige en hasteprocedure den 17. oktober 2017, jf. artikel 107i i direktiv 2001/83/EF.
English: In view of the above and whilst noting the PRAC's reservations on the expected effectiveness of this measure, notably in view of the non-adherence by prescribers not only due to a lack of awareness, the CMDh considered that:
Danish: På ovenstående baggrund, og under samtidig konstatering af PRAC's forbehold vedrørende denne foranstaltnings forventede effektivitet, navnlig i betragtning af de ordinerendes manglende overholdelse heraf ikke alene som følge af manglende bevidsthed, var CMDh af følgende opfattelse:
English: The CMDh also noted that treatment characteristics in some of the previously assessed clinical studies such as strength, dose or length of treatment may differ from current practice.
Danish: CMDh bemærkede også, at behandlingsparametrene i nogle af de tidligere vurderede kliniske studier, såsom styrke, dosis eller behandlingsvarighed, kan afvige fra den nuværende praksis.
English: The CMDh also concluded that the annual PSUR cycle should remain unchanged and would enable periodic review of the benefit-risk balance of these products and the impact of any data that would be generated.
Danish: CMDh konkluderede desuden, at den årlige PSUR-cyklus bør forblive uændret og vil muliggøre periodisk gennemgang af benefit/risk-forholdet for disse produkter og implikationerne af alle data, der genereres.
English: They should also allow adequate description of national contexts to guarantee the adequate analysis and extrapolation of the outcome and justify potential adjustments (i.e. successful/unsuccessful distribution of safety communications, adherence to the controlled access program, qualitative feedback from prescribers, etc).
Danish: De bør desuden give mulighed for tilstrækkelig beskrivelse af nationale sammenhænge til at garantere, at resultatet kan analyseres og ekstrapoleres tilstrækkeligt, og bør begrunde eventuelle justeringer (dvs. vellykket/mislykket formidling om sikkerheden, overholdelse af programmet for kontrolleret adgang, kvalitativ tilbagemelding fra de ordinerende mv.).
English: This suggests that the previous communication measures although not sufficient to ensure full compliance, have had some effectiveness.
Danish: Dette tyder på, at de tidligere foranstaltninger til kommunikation har haft en vis virkning, skønt de ikke var tilstrækkelige til at sikre fuld efterkommelse.
English: Results from two drug utilisation studies, submitted by the concerned Marketing Authorisation Holders (‘MAHs') in 2017, have shown that the recommended restrictions in use are not being sufficiently adhered to.
Danish: Resultaterne af de to studier af lægemiddelanvendelse, der blev forelagt af de pågældende markedsføringstilladelsesindehavere i 2017, har vist, at de anbefalede begrænsninger for anvendelsen ikke overholdes tilstrækkeligt.
English: The final training materials, including communication media and distribution modalities should be agreed with the National Competent Authorities.
Danish: Det endelige oplysningsmateriale, herunder kommunikationsmedier og distributionsmåde, bør aftales med de nationale kompetente myndigheder.
English: In addition, a significant decrease of the usage of HES solutions for infusion was noted in most EU Member States.
Danish: Desuden blev der konstateret et betydeligt fald i brugen af HES-infusionsvæske, opløsning, i de fleste EU-medlemsstater.
English: It should also be noted that the ultimate benefit expected from HES solutions for infusion (and treatment of hypovolemia in general) is a reduction of mortality and lower incidence of renal failure.
Danish: Det skal også bemærkes, at den ultimative fordel, der forventes ved HES-infusionsvæske, opløsning, (og behandling af hypovolæmi generelt), er reduceret dødelighed og lavere incidens af nyresvigt.
English: Hydroxyethyl starch (HES) solutions for infusion contain starch with different molecular weights (mainly 130kD; 200kD) and substitution ratio (the number of hydroxyethyl groups per glucose molecule).
Danish: Hydroxyethylstivelse (HES), infusionsvæske, opløsning, indeholder stivelse med forskellig molekylvægt (primært 130kD og 200kD) og forskelligt substitutionsforhold (antal hydroxyethylgrupper pr. glukosemolekyle).
English: Furthermore, the PRAC requested that, as conditions to the marketing authorisations of these medicinal products, further studies should be carried out on the use of these medicines in elective surgery and in trauma patients.
Danish: Derudover henstillede PRAC, at der som en betingelse for, at der kan gives markedsføringstilladelse til disse lægemidler, bør gennemføres yderligere studier af anvendelsen af disse lægemidler ved elektiv kirurgi og hos traumepatienter.
English: (1) Addition of the following warning on the outer packaging and the immediate packaging: “Do not use in sepsis, renal impairment, or critically ill patients.
Danish: (1) Tilføjelse af følgende advarsel på den ydre emballage og den indre emballage: "Må ikke anvendes ved sepsis, ved nedsat nyrefunktion eller hos kritisk syge patienter.
English: • The emergency setting in which the products are used does not impede the implementation of a controlled access program based on the delivery of appropriate training to the relevant HCPs as the educational program can be organised and delivered well in advance of the use of the products.
Danish: • De akutte situationer, hvor produkterne anvendes, hæmmer ikke gennemførelsen af et program til kontrolleret adgang baseret på tilstrækkelig oplæring af de pågældende sundhedspersoner, da oplæringsprogrammet kan tilrettelægges og gennemføres i god tid inden anvendelsen af produkterne.
English: The CMDh through its representatives of NCAs have further discussed the national specificities of the healthcare systems and was of the view that the proposed controlled access program is likely to be feasible for the following reasons:
Danish: CMDh har gennem sine repræsentanter hos de nationale kompetente myndigheder yderligere drøftet de nationale forskelligheder i sundhedssystemerne og var af den opfattelse, at det foreslåede program til kontrolleret adgang må forventes at være gennemførligt af følgende grunde:
English: Whilst some concerns related to the use of these products in clinical settings not covered by the terms of the MA, the CMDh acknowledged concerns on the medical need related to the authorised use and therefore should be taken into account, even if it might be rare.
Danish: Mens nogle af betænkelighederne vedrørende brugen af disse produkter i klinikken ikke svarer til vilkårene for markedsføringstilladelsen, anerkendte CMDh de betænkeligheder vedrørende det medicinske behov, der er knyttet til den godkendte anvendelse og derfor bør tages i betragtning, skønt det måske er sjældent.
English: Having reviewed the revised PRAC recommendation7, the CMDh disagreed with the PRAC overall conclusions and grounds for recommendation.
Danish: Efter gennemgang af PRAC's reviderede henstilling7 var CMDh uenig i PRAC's overordnede konklusioner og begrundelse for henstillingen.
English: • A reference to section 4.3 of the SmPC will avoid undermining the importance of other contraindications, and ensure these continue to be adhered to.
Danish: 4.3 i produktresuméet vil det undgås, at andre kontraindikationer svækkes, og sikres, at de fortsat overholdes.
English: Patients in the approved indication may become critically ill or septic shortly after receiving HES solutions for infusion and these patients cannot be identified prospectively.
Danish: Patienter med den godkendte indikation kan blive kritisk syge eller få sepsis kort tid efter indgivelsen af HES-opløsninger til infusion, og disse patienter kan ikke identificeres prospektivt.
English: The PRAC duly considered the view of the majority of the experts in the meeting that HES is used in clinical practice.
Danish: PRAC tog hensyn til det synspunkt blandt størstedelen af eksperterne, at HES bliver anvendt i klinisk praksis.
English: The PRAC also reviewed responses from Member States in relation to the potential unmet medical need and proposals for additional risk minimisation measures.
Danish: PRAC gennemgik også svarene fra medlemsstaterne vedrørende det potentielle udækkede medicinske behov og forslag til supplerende risikominimeringsforanstaltninger.
English: In conclusion, the CMDh is of the position that a controlled access program is feasible and likely to be effective to minimise the risk, in combination with other risk minimization measures.
Danish: Sammenfattende er CMDh af den opfattelse, at et program for kontrolleret adgang er gennemførligt og må forventes effektivt at minimere risikoen i kombination med andre risikominimeringsforanstaltninger.
English: The European Society of Anaesthesiology and some national learned societies, stated that HES solutions for infusion play a role in the therapeutic armamentarium of hypovolemic shock in patients who cannot be stabilised with crystalloids alone.
Danish: European Society of Anaesthesiology og visse nationale videnskabelige samfund udtalte, at HES-infusionsvæske, opløsning, har en rolle i det terapeutiske arsenal mod hypovolæmisk shock hos patienter, der ikke kan stabiliseres med krystalloider alene.
English: Annex II Scientific conclusions and CMDh's detailed explanation on the scientific grounds for differences with the PRAC recommendation
Danish: Bilag II Videnskabelige konklusioner og CMDh's detaljerede redegørelse for den videnskabelige begrundelse for afvigelserne fra PRAC's anbefaling
English: In 2012 and 2013, PRAC reviewed the benefits and risks of HES solutions for infusion in the treatment and prophylaxis of hypovolaemia, within Article 311 and 107i2 referral procedures.
Danish: I 2012 og 2013 gennemgik PRAC fordele og risici ved HES-infusionsvæske, opløsning, til behandling og profylakse af hypovolæmi, jf. indbringelsesprocedurerne i henhold til artikel 311 og 107i2.
English: Proposals to amend the indications and contraindications were not considered have a sufficient impact on prescriber behaviour and were not supported by appropriate scientific evidence.
Danish: Forslag om at ændre indikationer og kontraindikationer blev ikke anset for at ville have tilstrækkelig indvirkning på ordinationsadfærden og var ikke støttet med tilstrækkelig videnskabelig evidens.
English: The CMDh acknowledged the complexity of managing patient suffering from hypovolemia due to an acute blood loss, and the fact that these patients require an individual evaluation.
Danish: CMDh vedgik kompleksiteten af at behandle patienter med hypovolæmi som følge af akut blodtab, og det forhold, at sådanne patienter bør vurderes individuelt.
English: • The PRAC conclusions of previous reviews under Article 31 of Directive and Article 107i of Directive 2001/83/EC were that HES solutions for infusion are associated with an increased risk of mortality and renal failure in patients with sepsis or critical illness.
Danish: • PRAC's konklusioner fra tidligere gennemgange i henhold til artikel 31 og artikel 107i i direktiv 2001/83/EF var, at HES er forbundet med øget risiko for død og nyresvigt hos patienter med sepsis eller kritisk sygdom.
English: A medication form to be filled before administration would also raise feasibility issues in an emergency setting.
Danish: En medicinformular, der skulle udfyldes før administration, ville desuden medføre problemer hvad angår gennemførligheden i akutte situationer.
English: There is a direct relation between the degree of hypovolemia and the risk for renal injury and death.
Danish: Der er en direkte relation mellem graden af hypovolæmi og risikoen for nyreskade og død.
English: However, the CMDh considered that this assumption is not supported by sufficient evidence and might not be representative of a significant portion of the prescribers population and that in any case, the learned societies will have an important role in channelling the messages of the DHPC.
Danish: CMDh fandt imidlertid, at denne antagelse ikke understøttes af tilstrækkelig evidens og ikke nødvendigvis er repræsentativ for en væsentlig del af de ordinerende, og at de videnskabelige samfund under alle omstændigheder vil have en vigtig rolle i kanaliseringen af budskaberne i det direkte brev til sundhedspersoner.
English: • The CMDh, through its representatives of Member States also considered feasibility at national level of some additional risk minimisation measures for which PRAC raised feasibility questions.
Danish: • CMDh har gennem sine repræsentanter for medlemsstaterne desuden vurderet gennemførligheden på nationalt plan af visse supplerende risikominimeringsforanstaltninger, hvis gennemførlighed PRAC betvivlede.
English: Indeed, the CMDh noted the results of the DUSs whereby there was adherence to some of the key restrictions of use recommended following the 2013 referrals (i.e. the maximum daily dose and treatment duration).
Danish: CMDh noterede dig således resultaterne af studierne af lægemiddelanvendelse, som viste, at man overholdt nogle af de vigtigste begrænsninger for anvendelsen, som blev anbefalet efter indbringelserne i 2013 (dvs. maksimal dagsdosis og behandlingsvarighed).
English: • The CMDh also considered that the effectiveness of these additional risk minimisation measures must be assessed through the conduct of a drug utilisation study.
Danish: • CMDh fandt desuden, at effektiviteten af disse supplerende risikominimeringsforanstaltninger skal vurderes gennem udførelse af et studie af lægemiddelanvendelse.
English: For lifting the suspension, the MAHs should provide reliable and convincing evidence on a favourable benefit risk balance in a well-defined population, with feasible and effective measures to adequately minimise exposure of patients at an increased risk of serious harm.
Danish: For at kunne ophæve suspenderingen skal indehaverne af markedsføringstilladelse fremskaffe pålidelig og overbevisende evidens for et gunstigt benefit/risk-forhold i en veldefineret population, med gennemførlige og effektive foranstaltninger til tilstrækkelig minimering af eksponeringen af patienter, der har forhøjet risiko for alvorlig skade.
English: The DUS final study report shall be submitted within 24 months from the Commission Decision.
Danish: Den endelige rapport om studiet af lægemiddelanvendelse skal forelægges inden 24 måneder fra Kommissionens afgørelse.
English: • In view of the seriousness of the risks related to the use of HES solutions for infusion outside the terms of the MA, the CMDh considered this measure as proportionate.
Danish: • I betragtning af alvorligheden af de risici, der er forbundet med brugen af HES-infusionsvæske, opløsning, uden for betingelserne i markedsføringstilladelsen, anså CMDh denne foranstaltning for at være proportional.
English: The CMDh considered also the divergence of positions of the learned societies in the EU.
Danish: CMDh tog desuden de delte holdninger mellem de videnskabelige samfund i EU i betragtning.
English: In view of this exposure and the results from the two DUSs, the PRAC concluded that the estimated level of continued usage in populations where serious harm has been demonstrated raises important public health concerns, including a potentially increased mortality.
Danish: I lyset af denne eksponering og resultaterne fra de to studier af lægemiddelanvendelsen konkluderede PRAC, at det skønnede niveau af fortsat anvendelse hos populationer, hvor der er påvist alvorlig skade, giver anledning til væsentlige bekymringer for den offentlige sundhed, herunder potentielt øget dødelighed.
English: • The CMDh took into consideration the revised PRAC recommendation as well as all the new elements submitted by the MAHs and the Member States regarding potential medical need and the feasibility and likely effectiveness of additional risk minimisation measures and available since the previous CMDh position adopted in January 2018.
Danish: • CMDh tog i betragtning den reviderede anbefaling fra PRAC samt alle de nye elementer, som var forelagt af indehaverne af markedsføringstilladelse og medlemsstaterne om det potentielle medicinske behov og de supplerende risikominimeringsforanstaltningers gennemførlighed og forventede effektivitet, og som havde foreligget siden CMDh's tidligere udtalelse, der blev vedtaget i januar 2018.
English: It is therefore considered that a DHPC with more targeted messages and with the involvement of the learned societies in the distribution of this DHPC is likely to reinforce the effectiveness of this measure.
Danish: Det vurderes derfor, at et direkte brev til sundhedspersoner med mere målrettede budskaber og med inddragelse af de videnskabelige samfund i distributionen af brevet må forventes at styrke effektiviteten af denne foranstaltning.
English: With regard to the impact on a suspension of the marketing authorisations for HES solutions for infusion, fifteen EU Member States and Norway mentioned that no unmet medical need is expected in case of suspension of the marketing authorisations for HES solutions for infusion.
Danish: Vedrørende virkningen af en suspendering af markedsføringstilladelserne for HES-infusionsvæske, opløsning, nævnte femten EU-medlemsstater og Norge, at der ikke forventes at være noget udækket medicinsk behov i tilfælde af en suspendering af markedsføringstilladelserne for HES-infusionsvæske, opløsning.
English: The new data provided does not change the conclusions from the previous 2013 referral that the benefits of HES solutions for infusion do not outweigh the serious risks in patients with sepsis or critical illness.
Danish: De nytilkomne data ændrer ikke konklusionerne fra den tidligere indbringelsesprocedure fra 2013 om, at fordelen ved HES-opløsninger til infusion ikke opvejer de alvorlige risici hos patienter med sepsis eller kritisk sygdom.
English: • Whilst patients eligible to treatment with HES solutions for infusion cannot be restricted to specific hospitals or hospital departments, it is possible to identify within a hospital/centre the relevant HCPs who would be prescribing/administrating HES solutions for infusion.
Danish: • Mens patienter, der er egnede til behandling med HES-infusionsvæske, opløsning, ikke kan begrænses til bestemte hospitaler eller hospitalsafdelinger, er det muligt inden for et hospital/center at identificere de relevante sundhedspersoner, som i givet fald vil ordinere/administrere HES-infusionsvæske, opløsning.
English: The medication form/checklists would also raise feasibility issues in an emergency setting, and implementation of a restricted access/distribution program is unlikely to be feasible and sufficiently effective across EU Member States considering the particular type of distribution and usage of HES solutions for infusion and some national limitations.
Danish: Medicinformular/checklister vil også medføre problemer vedrørende gennemførligheden i akutte situationer, og indførelse af et program for begrænset adgang/distribution vil næppe være gennemførlig og tilstrækkelig effektiv i alle EU's medlemsstater i betragtning af den særlige form for distribution og anvendelse af HES-infusionsvæske, opløsning, og visse nationale begrænsninger.
English: Having reviewed the PRAC recommendation6, the CMDh agreed by a majority on 24 January 2018 with the PRAC overall conclusions and grounds for recommendation.
Danish: Efter gennemgang af PRAC's henstilling6 tilsluttede CHMP sig ved en flertalsafgørelse den 24. januar 2018 PRAC's overordnede konklusioner og begrundelse for henstillingen.
English: The PRAC also noted the view of an expert concerning shared clinical experience in handling cases in a EU Member State where HES solutions for infusion are little used and where no medical need is raised.
Danish: PRAC noterede sig også synspunktet hos en ekspert vedrørende delte kliniske erfaringer ved behandling af tilfælde i en EU-medlemsstat, hvor HESinfusionsvæske, opløsning, kun har ringe anvendelse, og hvor der ikke nævnes et medicinsk behov.
English: • The assumption that the non-adherence is not only due to lack of awareness is not supported by sufficient evidence and might not be representative of a significant portion of the prescribers population.
Danish: • Den opfattelse, at den manglende overholdelse ikke alene skyldes manglende bevidsthed, støttes ikke af tilstrækkelig evidens og er ikke nødvendigvis repræsentativ for en væsentlig del af de ordinerende.