FrancophonIA/ELRC3.0 huggingface dataset:
English: In the phase III clinical study, alanine aminotransferase (ALT) or aspartate aminotransferase (AST) three times the upper limit of normal (ULN) was observed in 5.6% of patients treated with siponimod 2 mg compared to 1.5% of patients who received placebo (see section 4.8).
Croatian: U kliničkom ispitivanju faze III bile su opažene razine alanin aminotransferaze (ALT) ili aspartat aminotransferaze (AST) tri puta veće od gornje granice normale (GGN) u 5,6% bolesnika liječenih siponimodom 2 mg, u usporedbi s 1,5% bolesnika koji su primali placebo (vidjeti dio 4.8).
English: The recommended maintenance dose of siponimod in all other CYP2C9 genotype patients is 2 mg.
Croatian: Preporučena doza održavanja siponimoda u bolesnika sa svim ostalim genotipovima CYP2C9 je 2 mg.
English: • Be informed before treatment initiation and regularly thereafter by their physician about siponimod serious risks to the foetus and about the contraindication in pregnant women and in women of childbearing potential not using effective contraception, facilitated by the Pregnancy Reminder Card.
Croatian: • Prije početka liječenja i redovno nakon toga biti informirane od svog liječnika o ozbiljnom riziku siponimoda za fetus i o kontraindikaciji u trudnica i žena reproduktivne dobi koje ne koriste učinkovitu kontracepciju, što će olakšati Kartica s podsjetnikom o trudnoći.
English: • Initiate treatment with a titration pack that lasts for 5 days.
Croatian: • Započnite liječenje pakiranjem za titraciju koje traje 5 dana.
English: If the resting heart rate is >50 bpm under chronic beta-blocker treatment, siponimod can be introduced.
Croatian: Ako je srčana frekvencija u mirovanju >50 otkucaja u minuti pod kroničnom terapijom beta blokatorom, siponimod se može uvesti.
English: • carbamazepine and certain other medicines can lower the levels of Mayzent in your blood and can therefore stop it from working properly.
Croatian: • karbamazepin i neki drugi lijekovi mogu smanjiti razine Mayzenta u Vašoj krvi i mogu stoga spriječiti ispravno djelovanje lijeka.
English: Therefore, before initiation of treatment in women of childbearing potential a negative pregnancy test result must be available and counselling should be provided regarding serious risk to the foetus.
Croatian: Zato prije početka liječenja u žena reproduktivne dobi mora biti dostupan negativan rezultat testa na trudnoću te ih je potrebno informirati o ozbiljnom riziku za fetus.
English: • Novartis has put in place a PRegnancy outcomes Intensive Monitoring (PRIM) programme, which is a registry based on enhanced follow-up mechanisms to collect information about pregnancy in patients exposed to siponimod immediately before or during pregnancy and on infant outcomes 12 months post-delivery.
Croatian: PRegnancy outcomes Intensive Monitoring, PRIM), registar temeljen na unaprijeđenim mehanizmima naknadnog praćenja za prikupljanje informacija o trudnoći u bolesnica izloženih siponimodu neposredno prije ili tijekom trudnoće te o ishodima za dojenčad 12 mjeseci nakon poroda.
English: Patients should tell any doctor they see that they are being treated with siponimod.
Croatian: Bolesnici trebaju obavijestiti svakog liječnika kod kojeg se liječe da uzimaju siponimod.
English: MAINTENANCE
Croatian: ODRŽAVANJE
English: Co-administration with siponimod did not reveal clinically relevant effects on the pharmacokinetics and pharmacodynamics of the combined ethinylestradiol and levonorgestrel oral contraceptive.
Croatian: Istodobna primjena sa siponimodom nije otkrila klinički relevantne učinke na farmakokinetiku i farmakodinamiku oralnog kontraceptiva s kombinacijom etinilestradiola i levonorgestrela.
English: Blood and lymphatic system disorders Common
Croatian: Poremećaji krvi i limfnog sustava Često
English: Although there are no data to establish that patients with pre-existing liver disease are at increased risk of developing elevated liver function test values when taking siponimod, caution should be exercised in patients with a history of significant liver disease.
Croatian: Iako nema podataka prema kojima bi se utvrdilo da bolesnici s od prije postojećom bolešću jetre imaju povećan rizik pojave odstupanja u rezultatima pretraga jetrene funkcije tijekom primjene siponimoda, potreban je oprez u bolesnika sa značajnom bolešću jetre u anamnezi.
English: The addition of propranolol on top of siponimod pharmacokinetic/pharmacodynamic steady state had less pronounced negative chronotropic effects (less than additive) in comparison to addition of siponimod on top of propranolol pharmacokinetic/pharmacodynamic steady state (additive HR effect).
Croatian: Dodavanje propranolola siponimodu u stanju farmakokinetičke/farmakodinamičke ravnoteže imalo je manje izražene negativne kronotropne učinke (manje nego aditivne) u usporedbi s dodavanjem siponimoda propranololu u stanju farmakokinetičke/farmakodinamičke ravnoteže (aditivni učinak na srčanu frekvenciju).
English: Treatment has to be started with a titration pack that lasts for 5 days.
Croatian: Liječenje se mora započeti pakiranjem za titraciju koje traje 5 dana.
English: No cases of progressive multifocal leukoencephalopathy (PML) have been reported for siponimod in the development programme; however, they have been reported for another S1P receptor modulator.
Croatian: Nije bilo prijavljenih slučajeva progresivne multifokalne leukoencefalopatije (PML) kod primjene siponimoda u programu razvoja lijeka; međutim, bilo je prijavljenih slučajeva za drugi modulator S1P receptora.
English: If patients develop symptoms suggestive of hepatic dysfunction during treatment with siponimod, request a liver enzymes check.
Croatian: Ako bolesnici razviju simptome koji upućuju na disfunkciju jetre tijekom liječenja siponimodom, zatražite provjeru jetrenih enzima.
English: • if you have symptoms such as unexplained nausea, vomiting, abdominal pain, tiredness, yellowing of the skin or whites of the eyes or abnormally dark urine.
Croatian: • ako imate simptome poput neobjašnjive mučnine, povraćanja, boli u trbuhu, umora, žutila kože ili bjeloočnica ili neuobičajeno tamne mokraće.
English: Due to the characteristics and duration of alemtuzumab immune suppressive effects described in its product information, initiating treatment with siponimod after alemtuzumab is not recommended.
Croatian: Zbog karakteristika i trajanja imunosupresivnih učinaka alemtuzumaba opisanih u njegovim informacijama o lijeku, ne preporučuje se započeti liječenje siponimodom nakon alemtuzumaba.
English: However, should a patient on siponimod treatment develop any unexpected neurological or psychiatric symptoms/signs (e.g. cognitive deficits, behavioural changes, cortical visual disturbances or any other neurological cortical symptoms/signs or any symptom/sign suggestive of an increase in intracranial pressure) or accelerated neurological deterioration, a complete physical and neurological examination should promptly be scheduled and MRI should be considered.
Croatian: Međutim, ako se u bolesnika na terapiji siponimodom razviju bilo kakvi neočekivani neurološki ili psihijatrijski simptomi/znakovi (npr. kognitivni deficiti, promjene ponašanja, kortikalne vidne smetnje ili bilo koji drugi neurološki kortikalni simptomi/znakovi ili bilo koji simptom/znak koji ukazuje na povećanje intrakranijalnog tlaka) ili ubrzano neurološko pogoršanje, potrebno je odmah dogovoriti kompletan fizikalni i neurološki pregled te razmotriti snimanje MR-om.
English: Your blood pressure will need to be checked regularly.
Croatian: Morat ćete redovito provjeravati krvni tlak tijekom liječenja.
English: How much Mayzent to take
Croatian: Koliko Mayzenta uzeti
English: By acting as a functional antagonist on S1P1 receptors on lymphocytes, siponimod prevents egress from lymph nodes.
Croatian: Djelujući kao funkcionalni antagonist na S1P1 receptore na limfocitima, siponimod sprječava izlazak iz limfnih čvorova.
English: Mayzent 2 mg film-coated tablets are available in packs containing 28 tablets.
Croatian: Mayzent 2 mg filmom obložene tablete dostupne su u pakiranjima koja sadrže 28 tableta.
English: The ARR (confirmed relapses) was reduced by 46% (ARR ratio 0.54; 95% CI: 0.39, 0.77) compared to placebo.
Croatian: ARR (potvrđeni relapsi) bio je smanjen za 46% (ARR omjer 0,54; 95% CI: 0,39; 0,77) u usporedbi s placebom.
English: Titration dose
Croatian: Doza titracije
English: If treatment with siponimod is considered in patients with pre-existing significant QT prolongation or who are already being treated with QT-prolonging medicinal products with known arrhythmogenic properties, advice from a cardiologist should be sought prior to initiation of treatment in order to determine the most appropriate monitoring strategy during treatment initiation.
Croatian: Ako se razmatra liječenje siponimodom u bolesnika s već postojećim značajnim produljenjem QT intervala ili koji se već liječe lijekovima koji produljuju QT interval i imaju poznata aritmogena svojstva, potrebno je zatražiti savjet kardiologa prije početka liječenja kako bi se odredila najprikladnija strategija praćenja tijekom početka liječenja.
English: Siponimod may be combined with most types of CYP2C9 and CYP3A4 inducers.
Croatian: Siponimod se može kombinirati s većinom tipova CYP2C9 i CYP3A4 induktora.
English: While in rats a higher number of foetuses with external, skeletal and visceral malformations (e.g. cleft palate and misshapen clavicles, cardiomegaly and oedema) were noted, in rabbit foetuses skeletal and visceral variations were predominantly observed.
Croatian: Dok je u štakora bio opažen veći broj fetusa s vanjskim, koštanim i visceralnim malformacijama (npr. rascjep nepca i nepravilne ključne kosti, kardiomegalija i edem), u fetusa kunića bile su uglavnom opažene koštane i visceralne varijacije.
English: Increased hepatic enzymes (mostly ALT elevation) have been reported in MS patients treated with siponimod.
Croatian: Povišeni jetreni enzimi (uglavnom povišeni ALT) bili su prijavljeni u oboljelih od MS-a liječenih siponimodom.
English: Bradycardia was reported in 6.2% of patients treated with siponimod compared to 3.1% on placebo and AV block in 1.7% of patients treated with siponimod compared to 0.7% on placebo (see section 4.4).
Croatian: Bradikardija je bila prijavljena u 6,2% bolesnika liječenih siponimodom u usporedbi s 3,1% na placebu, a AV blok u 1,7% bolesnika liječenih siponimodom u usporedbi s 0,7% na placebu (vidjeti dio 4.4).
English: Patients were randomised 2:1 to receive either once-daily siponimod 2 mg or placebo.
Croatian: Bolesnici su bili randomizirani u omjeru 2:1 na primanje siponimoda 2 mg jedanput na dan ili placeba.
English: The relative rate reduction of cumulative number of Gd-enhancing T1 weighted lesions over 24 months was 85% (rate ratio 0.155; 95% CI: 0.104, 0.231) compared to placebo.
Croatian: Relativno smanjenje stope kumulativnog broja Gd-pojačanih T1 lezija tijekom 24 mjeseca bilo je 85% (omjer stope 0,155; 95% CI: 0,104; 0,231) u usporedbi s placebom.
English: Tell your doctor straight away if you think your MS worsens after you have stopped treatment with Mayzent (see “If you stop taking Mayzent” in section 3).
Croatian: Odmah se obratite svom liječniku ako mislite da se Vaš MS pogoršava nakon što ste prestali uzimati Mayzent (vidjeti „Ako prestanete uzimati Mayzent“ u dijelu 3).
English: • Should a pregnancy occur during treatment or within 10 days following discontinuation of treatment with siponimod, please report it to Novartis by calling [insert local number] or visiting [insert URL], irrespective of adverse outcomes observed.
Croatian: • U slučaju da dođe do trudnoće tijekom liječenja ili unutar 10 dana nakon prekida liječenja siponimodom, molimo Vas da prijavite Novartisu pozivom na [upisati lokalni broj] ili posjetom stranici [upisati URL], bez obzira na opažene negativne ishode.
English: Steady-state plasma concentrations are reached after approximately 6 days of once-daily dosing and steady-state levels are approximately 2- to 3-fold greater than after the initial dose.
Croatian: Koncentracije u plazmi u stanju dinamičke ravnoteže postižu se nakon otprilike 6 dana doziranja jedanput dnevno, a razine u stanju dinamičke ravnoteže otprilike su 2 do 3 puta veće nego nakon inicijalne doze.
English: In study A2304, basal cell carcinoma was the most common neoplasm and was reported with a similiar incidence in the siponimod 2 mg (1.01%, 12 patients) and placebo (1.23%, 7 patients) groups.
Croatian: U ispitivanju A2304 karcinom bazalnih stanica bio je najčešća neoplazma i bio je prijavljen sličnom incidencijom u skupinama koje su primale siponimod 2 mg (1,01%, 12 bolesnika) i placebo (1,23%, 7 bolesnika).
English: Patients without a physician-confirmed history of varicella or without documentation of a full course of vaccination against VZV should be tested for antibodies to VZV before starting siponimod (see below section “Vaccination”).
Croatian: Bolesnike bez liječnički potvrđene varicelle u anamnezi ili bez dokumentacije o punom ciklusu cijepljenja protiv VZV-a potrebno je testirati na protutijela na VZV prije početka uzimanja siponimoda (vidjeti u nastavku dio „Cijepljenje“).
English: Two population pharmacokinetic analyses indicated that CYP2C9*1*1 and *1*2 subjects behave as extensive metabolisers, *2*2 and *1*3 subjects as intermediate metabolisers and *2*3 and *3*3 subjects as poor metabolisers.
Croatian: Dvije populacijske farmakokinetičke analize ukazale su da se ispitanici s CYP2C9*1*1 i *1*2 ponašaju kao brzi metabolizatori, ispitanici s *2*2 i *1*3 kao srednje brzi metabolizatori, a ispitanici s *2*3 i *3*3 kao spori metabolizatori.
English: Initiation of siponimod treatment results in a transient decrease in heart rate (see sections 4.8 and 5.1), and a titration scheme to reach the maintenance dose on day 6 is therefore applied at the start of treatment (see section 4.2).
Croatian: Početak liječenja siponimodom rezultira prolaznim smanjenjem srčane frekvencije (vidjeti dijelove 4.8 i 5.1) te se stoga na početku liječenja primjenjuje plan titracije do postizanja doze održavanja 6. dana (vidjeti dio 4.2).
English: Physicians should be vigilant for clinical symptoms or magnetic resonance imaging (MRI) findings that may be suggestive of PML.
Croatian: Liječnici trebaju paziti na kliničke simptome ili nalaze snimanja magnetskom rezonancijom (MR) koji bi mogli ukazivati na PML.
English: • Should a patient develop any unexpected neurological or psychiatric symptoms/signs or accelerated neurological deterioration, a complete physical and neurological examination should promptly be scheduled and MRI should be considered.
Croatian: • Ako pacijent razvije bilo kakve neočekivane neurološke ili psihijatrijske simptome / znakove ili ubrzano neurološko pogoršanje, potrebno je odmah zakazati kompletan fizički i neurološki pregled i razmotriti MR.
English: CYP2C9 and CYP3A4 inhibitors
Croatian: CYP2C9 i CYP3A4 inhibitori
English: • An ophthalmological evaluation 3-4 months after treatment initiation with siponimod is recommended.
Croatian: • Preporučuje se oftalmološka evaluacija 3-4 mjeseca nakon početka liječenja siponimodom.
English: • Contact details of the siponimod prescriber.
Croatian: • Kontakt podaci liječnika koji je propisao siponimod.
English: • Exercise caution when administering concomitant treatment with anti-neoplastic, immune-modulating or immunosuppressive therapies (including corticosteroids) due to the risk of additive immune system effects.
Croatian: • Potreban je oprez kod primjene istodobnog liječenja antineoplastičnim, imunomodulacijskim ili imunosupresivnim terapijama (uključujući kortikosteroide) zbog rizika od aditivnih učinaka na imunološki sustav.
English: Confirmed absolute lymphocyte counts <0.2 x 10
Croatian: Ako se utvrdi apsolutni broj limfocita <0,2 x 10
English: • Should a pregnancy occur during treatment or within 10 days following discontinuation of treatment with siponimod, it should be immediately reported to the doctor or to Novartis by calling [insert local number] or visiting [insert URL], irrespective of adverse outcomes observed.
Croatian: • Ako dođe do trudnoće tijekom liječenja ili unutar 10 dana nakon prestanka liječenja siponimodom, potrebno ju je odmah prijaviti liječniku ili Novartisu pozivom na [upisati lokalni broj] ili posjetom stranici [upisati URL], bez obzira na opažene neželjene ishode.
English: • Patients should report any unexpected neurological or psychiatric symptoms/signs (such as sudden onset of severe headache, confusion, seizures and vision changes) or accelerated neurological deterioration to their doctors.
Croatian: • Bolesnici trebaju prijaviti svojim liječnicima bilo kakve neočekivane neurološke ili psihijatrijske simptome/znakove (kao što je iznenadni nastup teške glavobolje, zbunjenost, napadaji i promjene vida) ili ubrzano neurološko pogoršanje.
English: Figure 1 Patients with 3- and 6-month CDP based on EDSS-Kaplan-Meier curves (full analysis set, study A2304)
Croatian: Slika 1 Bolesnici s 3-mjesečnim i 6-mjesečnim CDP-om na temelju EDSS-aKaplan-Meierove krivulje (analiza potpunog skupa podataka, ispitivanje A2304)
English: Siponimod is contraindicated in women of childbearing potential not using effective contraception (see section 4.3).
Croatian: Siponimod je kontraindiciran u žena reproduktivne dobi koje ne upotrebljavaju učinkovitu kontracepciju (vidjeti dio 4.3).
English: Mayzent 0.25 mg film-coated tablets are available in the following pack sizes:
Croatian: Mayzent 0,25 mg filmom obložene tablete dostupne su u sljedećim veličinama pakiranja:
English: • Instruct the patient to report visual disturbances at any time while on siponimod therapy.
Croatian: • Uputite bolesnike da prijave poremećaje vida u bilo kojem trenutku za vrijeme terapije siponimodom.
English: Caution should be exercised during concomitant administration due to the risk of additive immune effects during such therapy and in the weeks after administration of any of these medicinal products is stopped (see section 4.4).
Croatian: Potreban je oprez tijekom istodobne primjene zbog rizika od aditivnih imunoloških učinaka tijekom takve terapije te u tjednima nakon prekida primjene bilo kojeg od ovih lijekova (vidjeti dio 4.4).
English: ALT levels returned to normal within approximately 1 month after discontinuation of siponimod (see section 4.4).
Croatian: Razine ALT-a vratile su se u normalu unutar otprilike 1 mjesec nakon prekida primjene siponimoda (vidjeti dio 4.4).
English: Common (may affect up to 1 in every 10 people)
Croatian: Često (mogu se javiti u do 1 na svakih 10 osoba)
English: When stopping siponimod therapy for planning a pregnancy, the possible return of disease activity should be considered (see section 4.4).
Croatian: Kad se prekida terapija siponimodom radi planiranja trudnoće, potrebno je imati u vidu mogući povratak aktivnosti bolesti (vidjeti dio 4.4).
English: • lung function test results showing decreased function
Croatian: • nalazi testova plućne funkcije koji pokazuju smanjenu funkciju
English: With continued daily dosing, the lymphocyte count continues to decrease, reaching a nadir median (90% CI) lymphocyte count of approximately 0.560 (0.271-1.08) cells/nL in a typical CYP2C9*1*1 or *1*2 non-Japanese SPMS patient, corresponding to 20-30% of baseline.
Croatian: Uz kontinuirano dnevno doziranje broj limfocita nastavlja se smanjivati te postiže medijan najniže vrijednosti (90% CI) broja limfocita od otprilike 0,560 (0,271-1,08) stanica/nL u tipičnog bolesnika s SPMS-om i CYP2C9*1*1 ili *1*2 koji nije Japanac, što iznosi 20-30% početne vrijednosti.
English: Before initiation of treatment, patients must be genotyped for CYP2C9 to determine their CYP2C9 metaboliser status (see sections 4.4, 4.5 and 5.2).
Croatian: Prije početka liječenja bolesnicima se mora genotipizirati CYP2C9 kako bi se odredio njihov CYP2C9 metabolizatorski status (vidjeti dijelove 4.4, 4.5 i 5.2).
English: Time to onset of 3-month and 6-month CDP was significantly delayed for siponimod, with reduction in risk of 3-month CDP by 21% compared to placebo (hazard ratio [HR] 0.79, p=0.0134) and reduction in risk of 6-month CDP by 26% compared to placebo (HR 0.74, p=0.0058).
Croatian: Vrijeme do nastupa 3-mjesečnog i 6-mjesečnog CDP-a bilo je značajno odgođeno uz siponimod, sa smanjenjem rizika od 3-mjesečnog CDP-a za 21% u usporedbi s placebom (omjer hazarda [HR] 0,79, p=0,0134) i smanjenjem rizika od 6-mjesečnog CDP-a za 26% u usporedbi s placebom (HR 0,74, p=0,0058).
English: The efficacy of siponimod has been investigated in a phase III study evaluating once-daily doses of 2 mg in patients with SPMS.
Croatian: Djelotvornost siponimoda bila je ispitivana u ispitivanju faze III u kojem su se u bolesnika s SPMSom ocjenjivale doze od 2 mg uzimane jedanput na dan.
English: If post-dose bradyarrhythmia or conduction-related symptoms occur or if ECG 6 hours post-dose shows new onset second-degree or higher AV block or QTc ≥500 msec, appropriate management should be initiated and observation continued until the symptoms/findings have resolved.
Croatian: Ako nakon doze dođe do bradiaritmije ili simptoma povezanih s provođenjem ili ako EKG 6 sati nakon doze pokaže nov nastup AV bloka drugog ili višeg stupnja ili QTc ≥500 msec, potrebno je započeti odgovarajuće zbrinjavanje i nastaviti promatranje dok se simptomi/nalazi ne povuku.
English: In carcinogenicity investigations, siponimod induced lymphoma, haemangioma and haemangiosarcoma in mice, whereas follicular adenoma and carcinoma of the thyroid gland were identified in male rats.
Croatian: U istraživanjima kancerogenosti, siponimod je inducirao limfom, hemangiom i hemangiosarkom u miševa, dok su u mužjaka štakora bili utvrđeni folikularni adenom i karcinom štitne žlijezde.
English: Proportion of patients with 4-point worsening in Symbol Digit Modality Test Risk reduction
Croatian: Udio bolesnika s pogoršanjem od 4 boda na testu analogije simbola i znamenki (SDMT) Smanjenje rizika
English: Siponimod should be used with caution in patients with a history of diabetes mellitus, uveitis or underlying/co-existing retinal disease due to a potential increase in the risk of macular oedema (see section 4.8).
Croatian: Siponimod se mora s oprezom primjenjivati u bolesnika koji u anamnezi imaju šećernu bolest, uveitis ili osnovnu/istodobnu bolest mrežnice zbog potencijalnog povećanja rizika od makularnog edema (vidjeti dio 4.8).
English: • Adjust the maintenance dose to 1 mg in patients with CYP2C9*2*3 or *1*3 genotypes.
Croatian: • Prilagodite dozu održavanja na 1 mg u bolesnika s CYP2C9*2*3 ili *1*3 genotipovima.
English: Time to 6-month CDP versus placebo
Croatian: Vrijeme do 6-mjesečnog CDP-a u odnosu na placebo
English: Mean siponimod half-life and Cmax (total and unbound) were comparable between subjects with severe renal impairment and healthy subjects.
Croatian: Srednja vrijednost poluvijeka siponimoda i Cmax (ukupni i nevezani) usporedivi su između ispitanika s teškim oštećenjem funkcije bubrega i zdravih ispitanika.
English: • Siponimod is contraindicated during pregnancy and in women of childbearing potential not using effective contraception.
Croatian: • Siponimod je kontraindiciran tijekom trudnoće i u žena reproduktivne dobi koje ne upotrebljavaju učinkovitu kontracepciju.
English: Based on clinical pharmacology studies, no dose adjustment is needed in patients with renal impairment (see section 5.2).
Croatian: Na temelju kliničkih farmakoloških ispitivanja, nije potrebna prilagodba doze u bolesnika s oštećenjem funkcije bubrega (vidjeti dio 5.2).
English: Siponimod has not been studied in patients with arrhythmias requiring treatment with class Ia (e.g. quinidine, procainamide) or class III (e.g. amiodarone, sotalol) antiarrhythmic medicinal products.
Croatian: Siponimod nije bio ispitivan u bolesnika s aritmijama kojima je bilo potrebno liječenje antiaritmicima klase Ia (npr. kinidin, prokainamid) ili klase III (npr. amiodaron, sotalol).