FrancophonIA/ELRC3.0 huggingface dataset:
English: Overall summary of the scientific evaluation of Furosemide Vitabalans and associated names (see Annex I)
Estonian: Furosemide Vitabalansi ja sarnaste nimetuste (vt I lisa) teadusliku hindamise üldkokkuvõte
English: At the request of the applicant, an ad-hoc expert meeting was convened.
Estonian: Taotleja nõudel toimus ajutise ekspertrühma koosolek.
English: The results have shown that furosemide absorption is highly variable (AUC value varies from 793.8 to 3953 ng*h/ml, Cmax from 283,6 to 2636 ng/ml and ln Cmax values are almost a tenfold difference).
Estonian: Nende andmete alusel on furosemiidi imendumine väga varieeruv (AUC 793,8-3953 ng·h/ml, Cmax 283,6-2636 ng/ml ja ln Cmax varieerub peaaegu kümme korda).
English: The decentralised procedure was closed on day 210, with most of the Concerned Member States agreeing with the conclusions of the Reference Member State's assessment report except Poland and Lithuania which raised a potential serious risk to public health (PSRPH).
Estonian: Detsentraliseeritud menetlus lõpetati 210. päeval, mil enamik asjaomastest liikmesriikidest nõustus viiteliikmesriigi hindamisaruandega, välja arvatud Poola ja Leedu, kes tõstatasid küsimuse, et ravim võib ohustada rahvatervist.
English: Diuretic efficacy of high dose furosemide pharmacokinetics and pharmacodynamics in health and diseasean update.
Estonian: 1 Dormans et al. Diuretic efficacy of high dose furosemide pharmacokinetics and pharmacodynamics in health and diseasean update.
English: Following the adoption of the CHMP opinion and recommendations during the October 2012 CHMP meeting, a request for a re-examination was received from the applicant Vitabalans Oy on 12
Estonian: Pärast inimravimite komitee arvamuse ja soovituste vastuvõtmist oktoobris 2012 toimunud komitee istungil saadi 12. novembril 2012 taasläbivaatamise taotlus müügiloa hoidjalt Vitabalans Oy.
English: As a result, procedural and legal considerations are outside the remit of the CHMP, and therefore the re-examination of the referral procedure under Article 29(4) of Directive 2001/83/EC focussed only on the scientific points addressed in the grounds for reexamination.
Estonian: Protseduurilised ja juriidilised kaalutlused on seega väljaspool inimravimite komitee vastutusala ja seetõttu keskendus komitee direktiivi 2001/83/EÜ artikli 29 lõike 4 kohase esildismenetluse taasläbivaatamisel ainult taasläbivaatamise põhjendustes tõstatatud teaduslikele küsimustele.
English: The applicant expressed its disagreement on some procedural aspects of the mutual recognition procedure, the CMDh procedure and the referral procedure under Article 29(4) of Directive 2001/83/EC.
Estonian: Taotleja ei olnud nõus vastastikuse tunnustamise menetluse, koordineerimisrühma menetluse ja direktiivi 2001/83/EÜ artikli 29 lõike 4 kohase esildismenetluse mõne aspektiga.
English: In addition, it is also noted that according to the Guideline on the Definition of a Potential Serious Risk to Public Health, a potential serious risk to public health in relation to a particular medicinal product can be considered to exist if the data submitted to support therapeutic efficacy do not provide sound justification for the claims of efficacy and/or the clinical safety data does not provide adequate support for the conclusion that all potential safety issues have been appropriately and adequately addressed.
Estonian: Peale selle tuleb märkida, et rahvatervise võimaliku tõsise ohu määratlemise juhiste kohaselt võib rahvatervisele seoses konkreetse ravimiga avalduvat tõsist ohtu pidada tõestatuks, kui terapeutilise efektiivsuse toetamiseks esitatud andmed ei anna kindlaid põhjendusi väidete efektiivsuse kohta ja/või kliinilise ohutuse andmed ei toeta piisavalt järeldust, et kõiki võimalikke ohutusprobleeme on sobival ja piisaval moel käsitletud.
English: Furthermore, the group considered that there is a safety concern to put a product on the market for such indication (heart failure) when the efficacy has not been demonstrated.
Estonian: Peale selle leidis ekspertrühm, et ohutusprobleemiks on ravimi turustamine sellise näidustusega (südamepuudulikkus), kui ravimi efektiivsust ei ole näidatud.
English: The applicant expressed its disagreement with the CHMP opinion, focusing its scientific grounds on the following points, for which the applicant argued that clear justification or evidence had not been presented to explain:
Estonian: Taotleja ei olnud nõus inimravimite komitee arvamusega ja keskendas oma teaduslikud põhjendused järgmistele küsimustele, mille puhul ei ole taotleja väitel esitatud selgeid õigustusi ega tõendeid, mis selgitaksid:
English: Considering the foreseeable high variability of the product, the main risk with furosemide would be a lack of efficacy.
Estonian: Arvestades ravimi eeldatavat suurt varieeruvust, on furosemiidi peamine risk efektiivsuse puudus.
English: • how the applied furosemide 40 mg product would cause a potential serious risk to public health
Estonian: • kuidas taotletav 40 mg furosemiidi sisaldav ravim põhjustaks võimalikku tõsist riski rahvatervisele;
English: The decentralised marketing authorisation application for Furosemide Vitabalans was made in accordance with Article 10(a) of Directive 2001/83/EC, which is a well-established use application.
Estonian: Ravimi Furosemide Vitabalans detsentraliseeritud müügiloa taotlus oli direktiivi 2001/83/EÜ artikli 10a kohane hästi tõestatud meditsiinilise kasutuse taotlus.
English: • why the pharmacokinetics parameters of the applied furosemide 40 mg product would be different than the pharmacokinetics parameters in other furosemide products described in literature and to what extent they would be expected to be different, and how this difference would cause a concrete potential serious risk to public health.
Estonian: • miks taotletava 40 mg furosemiidi sisaldava ravimi farmakokineetilised parameetrid oleksid erinevad kirjanduses toodud teiste furosemiidi sisaldavate ravimite farmakokineetilistest parameetritest; millises ulatuses eeldatakse nende erinevust ja kuidas erinevus põhjustaks võimalikku tõsist riski rahvatervisele.
English: Furosemide is a loop diuretic which acts along the entire nephron with the exception of the distal exchange site.
Estonian: Furosemiid on lingudiureetikum, mis toimib kogu nefroni ulatuses peale distaalse osa, kus toimub ioonivahetus.
English: Therefore, the CHMP concluded that the efficacy of Furosemide Vitabalans has not been demonstrated in the applied indications, and this constitutes a potential serious risk to public health.
Estonian: Inimravimite komitee järeldas seetõttu, et Furosemide Vitabalansi efektiivsust ei ole taotletud näidustuste korral näidatud ja see kujutab endast tõsist riski rahvatervisele.
English: An ad-hoc expert meeting was convened on 13 February 2013 at the request of the applicant.
Estonian: Taotleja palvel toimus ajutise ekspertrühma koosolek 13. veebruaril 2013.
English: • It has not been sufficiently demonstrated by the applicant that a potentially lower or higher exposure to furosemide would not influence the efficacy or safety.
Estonian: • müügiloa taotleja ei ole piisavalt tõendanud, et võimalik suurem või väiksem kokkupuude furosemiidiga ei mõjuta ravimi ohutust ja efektiivsust;
English: • Ad-hoc expert meeting
Estonian: • Ajutise ekspertrühma koosolek
English: The group considered that manufacturing methods or dissolution data could not predict how the product would behave in vivo.
Estonian: Rühm leidis, et tootmismeetodite või lahustuvusandmete põhjal ei saa prognoosida, kuidas ravim käitub in vivo.
English: • why the safety and efficacy of the applied furosemide 40 mg product would be effectively different than in other furosemide 40 mg products
Estonian: • miks taotletava 40 mg furosemiidi sisaldava ravimi ohutus ja efektiivsus oleks erinev teistest 40 mg furosemiidi sisaldavatest ravimitest;
English: The non-clinical overview referred to 29 publications up to year 2010 describing pharmacodynamics, general pharmacology, pharmacokinetic and toxicology studies.
Estonian: Mittekliinilises ülevaates viidati 29 publikatsioonile (avaldamisaasta kuni 2010), mis käsitlesid furosemiidi farmakodünaamikat, üldist farmakoloogiat, farmakokineetikat ning toksikoloogiauuringuid.
English: The clinical part of the dossier referred to 77 publications up to 2009 supporting the effect of furosemide in the treatment of oedema associated with congestive heart failure, cirrhosis of the liver and renal disease, including nephrotic syndrome and mild to moderate hypertension.
Estonian: Taotluse dokumentatsiooni kliinilises osas viidati 77 publikatsioonile (avaldamisaasta kuni 2009), mis tõendasid furosemiidi efektiivsust kongestiivse südamepuudulikkuse, maksatsirroosi ja neeruhaigusega seotud tursete ravis, sealhulgas nefrootilise sündroomi ja kerge kuni mõõduka hüpertensiooni ravis.
English: The application for Furosemide Vitabalans is therefore based on publicly available bibliographic data as it is possible to replace results of the pre-clinical and clinical trials by detailed references to published scientific literature (information available in the public domain) if it can be demonstrated that the active substances of a medicinal product have been in well-established medicinal use within the Community for at least ten years, with recognized efficacy and an acceptable level of safety.
Estonian: Seega põhines Furosemide Vitabalansi taotlus avalikult kättesaadavatel bibliograafilistel andmetel, sest prekliiniliste ja kliiniliste uuringute tulemused võib asendada täpsete viidetega avaldatud teaduskirjandusele (avalikule teabele), kui on tõendatud, et ravimi toimeaine on juba vähemalt kümme aastat olnud Euroopa Liidus hästi tõestatud meditsiinilises kasutuses koos tunnustatud efektiivsuse ja vastuvõetava ohutustasemega.
English: To support the efficacy and safety of Furosemide Vitabalans, the applicant only referred to published studies.
Estonian: Furosemide Vitabalansi efektiivsuse ja ohutuse osas viitas müügiloa taotleja üksnes avaldatud uuringutele.
English: • Clinical data
Estonian: • Kliinilised andmed
English: The lack of data regarding the bioavailibity of the product could lead to unforeseeable changes in the pharmacodynamics response and therapeutic failure, as well as the occurrence of toxic effects.
Estonian: Ravimi biosaadavuse andmete puudumise tõttu võib farmakodünaamilises ravivastuses esineda ettenägematuid muutusi ja ravi võib ebaõnnestuda, samuti võib tekkida toksilisi toimeid.
English: • Pharmacokinetics data
Estonian: • Farmakokineetilised andmed
English: It is agreed that the manufacturing method is adequately described, however a robust manufacturing process is only a basis for further investigations on efficacy and safety of the applied product, and cannot be accepted as proof of equivalence to an authorised product.
Estonian: Tootmismeetodit on küll piisavalt kirjeldatud, ent tootmisprotsess on ainult aluseks taotletava ravimi efektiivsuse ja ohutuse edasistele uuringutele ning seda ei saa pidada taotletava ja müügiluba omava ravimi samaväärsuse tõendiks.
English: It was considered necessary to have in vivo data especially with a drug exhibiting such wide range of pharmacokinetic values.
Estonian: Vaja on in vivo andmeid, eriti ravimi puhul, mille farmakokineetilised väärtused nii ulatuslikult varieeruvad.
English: The use of furosemide is wide in clinical practice and a number of published papers have been submitted in support of efficacy and safety during the decentralised procedure.
Estonian: Furosemiidi kasutatakse kliinilises praktikas laialdaselt ning käesolevas detsentraliseeritud menetluses esitati efektiivsuse ja ohutuse toetuseks arvukalt avaldatud teaduspublikatsioone.
English: Furthermore, in vitro data cannot be sole proof that the clinical data from the submitted studies are applicable to Furosemide Vitabalans.
Estonian: Ka in vitro andmeid ei saa kasutada ainsa tõendusena, et esitatud uuringute kliinilised andmed kehtivad ka Furosemide Vitabalansi kohta.
English: One of the factors influencing furosemide's pharmacokinetic variability is precisely the absorption process which is dependent on the intrinsic properties of this substance/low solubility, low permeability associated with unknown formulation effects.
Estonian: Üks teguritest, mis mõjutab furosemiidi farmakokineetilist varieeruvust, on imendumisprotsess, mis sõltub toimeaine eriomadustest / väikesest lahustuvusest ja väikesest permeaablusest, mis on seotud ravimvormi teadmata mõjudega.
English: As discussed previously, in vitro data demonstrating similarity of dissolution profiles between Furosemide Vitabalans and other products containing furosemide do not prove that the bioavailability of these products would be similar, in particular, with a BCS class IV drug substance (low solubility, low permeability).
Estonian: Nagu juba mainitud, ei tõenda in vitro andmed, mis näitavad Furosemide Vitabalansi ja teiste furosemiidi sisaldavate ravimite lahustuvusprofiili sarnasust, et nende ravimite biosaadavus on sarnane, eriti väikese permeaablusega (BCS IV klass) toimeaine puhul (väike lahustuvus, väike permeaablus).
English: Therefore, it not possible to conclude that the efficacy and safety of Furosemide Vitabalans will be the same as that of the products containing furosemide included in the submitted literature.
Estonian: Seetõttu ei ole võimalik järeldada, et Furosemide Vitabalansi efektiivsus ja ohutus oleksid samad mis viidatud kirjanduses kirjeldatud furosemiidi sisaldavatel ravimitel.
English: In addition, for highly variables drugs, as it is the product under application, it is considered necessary to investigate the pharmacokinetics behaviour in order to exclude any other potential product-related variations.
Estonian: Lisaks tuleks uurida suure varieeruvusega ravimite (nagu taotletav ravim) farmakokineetilist käitumist, et välistada kõik võimalikud ravimiga seotud variatsioonid.
English: The CHMP considered that a wide range of pharmacokinetic values for different furosemide 40 mg products did not prove that the pharmacokinetic parameters of Furosemide Vitabalans will be within the same range.
Estonian: Inimravimite komitee leidis, et farmakokineetiliste parameetrite suur varieeruvus furosemiidi 40 mg tablettide korral ei tõenda, et Furosemide Vitabalansi tablettide farmakokineetilised parameetrid oleksid samas vahemikus.
English: In order to show the relevance of the bibliographic data used in support of the application for Furosemide Vitabalans, the applicant made reference to:
Estonian: Furosemide Vitabalansi müügiloa taotluse toetuseks esitatud bibliograafiliste andmete asjakohasuse tõendamiseks viitas taotleja järgmistele andmetele:
English: The dossier submitted by the applicant did not include any in vivo clinical data which could have demonstrated that pharmacokinetic profile of Furosemide Vitabalans is similar to the products containing furosemide included in the submitted literature.
Estonian: Taotleja esitatud toimik ei sisaldanud in vivo kliinilisi andmeid, mis oleksid näidanud, et Furosemide Vitabalansi farmakokineetiline profiil on sarnane viidatud kirjanduses kirjeldatud furosemiidi sisaldavate ravimitega.
English: Furthermore, the applicant provided a set of dissolution profiles comparing Furosemide Vitabalans with nine other furosemide 40 mg tablets.
Estonian: Peale selle esitas müügiloa taotleja mitu lahustuvusprofiili, milles Furosemide Vitabalansi tablette oli võrreldud furosemiidi üheksa muu 40 mg tabletiga.
English: The study in support of the safety of furosemide (Dormans et al.1) presented by the applicant, was not considered as relevant by the CHMP, as furosemide in this study was used intravenously and Furosemide Vitabalans is intended to be used in oral administration as a 40mg tablet.
Estonian: Uuringut, mille müügiloa taotleja esitas furosemiidi ohutuse toetuseks (Dormans et al1), ei pidanud inimravimite komitee asjakohaseks, sest uuringus manustati furosemiidi intravenoosselt, kuid Furosemide Viatabalansi 40 mg tablette kavatseti manustada suu kaudu.
English: Based only on published literature data, it is not possible to conclude that the pharmacokinetic parameters of Furosemide Vitabalans would be within the same range than other furosemide 40 mg tablets referred to.
Estonian: Avaldatud kirjanduse andmete alusel ei ole võimalik järeldada, et Furosemide Vitabalansi farmakokineetilised parameetrid oleksid samas vahemikus kui teiste viidatud 40 mg furosemiidi sisaldavate tablettide omad.
English: Part II.1.d) of Annex I of Directive 2001/83/EC states that “the non-clinical and/or clinical overviews must explain the relevance of any data submitted which concern a product different from the product intended for marketing.
Estonian: Direktiivi 2001/83/EÜ I lisa II osa punkti 1 alapunkt d sätestab: „Kliinilistest ja mittekliinilistest ülevaadetest peab selguma, miks müügiks mõeldud preparaadist erineva preparaadi kohta esitatud andmeid võib asjakohaseks pidada.
English: The applicant also argued that dissolution behaviour together with evident pharmaceutical equivalence proves bridging between Furosemide Vitabalans and other authorised furosemide 40mg products.
Estonian: Taotleja väitis ka, et lahustuvuskäitumine koos ilmse farmatseutilise samaväärsusega tõendab Furosemide Vitabalansi ja teiste müügiloaga 40 mg furosemiidi sisaldavate ravimite sarnasust.
English: The pharmacokinetic parameters available in the literature are not sufficient to claim that Furosemide Vitabalans would have a similar bioavailability.
Estonian: Kirjanduses avaldatud farmakokineetilised parameetrid ei ole piisavad väitmaks, et Furosemide Vitabalansi tablettide biosaadavus on sarnane.
English: • CHMP conclusion on grounds for re-examination
Estonian: • Inimravimite komitee järeldused taasläbivaatamise aluste kohta
English: The major concern raised by Poland and Lithuania could not be solved during the CMD(h) referral and the issue was therefore referred to the CHMP.
Estonian: Koordineerimisrühma esildises ei suudetud Poola ja Leedu tõstatatud küsimust lahendada, mistõttu tehti esildis inimravimite komiteele.
English: In response to the CHMP, the applicant further referred to published pharmacokinetics data presenting PK parameters of similar tablets formulations to Furosemide Vitabalans as well as different formulations (e.g. tablet 20mg).
Estonian: Vastuses inimravimite komiteele viitas müügiloa taotleja avaldatud farmakokineetilistele andmetele, mis sisaldasid farmakokineetilisi parameetreid nii Furosemide Vitabalansiga sarnaste kui ka erinevate tablettide kohta (nt 20 mg tabletid).
English: The applicant's argument that traditional manufacturing methods as well as excipients widely used are sufficient to demonstrate the bridging between Furosemide Vitabalans and other furosemide products cannot be accepted.
Estonian: Taotleja argumendiga, et traditsioonilised tootmismeetodid ja laialdaselt kasutatavad abiained on piisavad, et näidata Furosemide Vitabalansi ja teiste furosemiidi sisaldavate ravimite seost, ei saa nõustuda.
English: Furthermore, given that furosemide is a highly variable compound, the submission of in vivo data was considered necessary in order to characterise the PK of the product together with justification that would allow establishing a bridge to the published data.
Estonian: Kuivõrd furosemiid on väga varieeruv ühend, on ravimi farmakokineetika iseloomustamiseks vaja in vivo andmeid koos põhjendusega, mis võimaldaks neid seostada kirjandusandmetega.
English: The ad-hoc expert group considered that the published literature and the dissolution data provided by the applicant were not sufficient to prove the safety and efficacy of Furosemide Vitabalans.
Estonian: Ajutine ekspertrühm leidis, et taotleja esitatud avaldatud kirjanduse ja lahustuvuse andmed ei ole piisavad tõendamaks Furosemide Vitabalansi ohutust ja efektiivsust.
English: The CHMP is of the opinion that the applicant has not adequately demonstrated that the submitted published literature on furosemide was directly applicable to Furosemide Vitabalans.
Estonian: Inimravimite komitee arvates ei tõendanud taotleja piisavalt, et furosemiidi käsitlev kirjandus on otseselt kohaldatav Furosemide Vitabalansile.
English: The CHMP is of the opinion that the comparability of the bioavailability between the applied product and a product included in the submitted literature should have been shown in order to claim the same indication.
Estonian: Inimravimite komitee on arvamusel, et sama näidustuse taotlemiseks tuleb näidata taotletava ravimi ja viidatud kirjanduses kirjeldatud ravimi biosaadavuse võrreldavust.
English: The applicant's argument that traditional manufacturing methods as well as excipients widely used in tablet formulations would not cause potential lower or higher exposure to furosemide when Furosemide Vitabalans is used (compared to the exposure obtained following administration of other furosemide 40 mg tablets) cannot be considered as sufficient evidence to bridge the applied product and other furosemide described in the literature.
Estonian: Müügiloa hoidja argumenti, et Furosemide Vitabalansi tablettide tavapäraste tootmismeetodite ja laialdaselt kasutatavate abiainete tõttu ei suurenda ega vähenda tablettide kasutamine kokkupuudet furosemiidiga (võrreldes furosemiidi muude 40 mg tablettide manustamisel esineva kokkupuutega), ei saa pidada piisavaks tõendusmaterjaliks, et kirjanduses esitatud furosemiidide andmed saab üle kanda taotletavale ravimile.
English: Indeed, it cannot be excluded that the formulation of the applied product would behave differently in terms of pharmacokinetics compared to the products containing furosemide included in the submitted literature.
Estonian: Ei saa välistada, et taotletava ravimi ravimvorm käitub farmakokineetika osas erinevalt võrreldes viidatud kirjanduses kirjeldatud furosemiidi sisaldavate ravimitega.
English: A referral was thus triggered at the CMD(h) and the applicant was asked to justify that the literature provided in support of this application was applicable to the product applied for and to demonstrate that the potentially lower or higher exposure to furosemide, when Furosemide Vitabalans is used compared to the exposure obtained following administration of the product used in the pivotal clinical studies described in the submitted literature, would not influence efficacy or safety.
Estonian: Inimravimite vastastikuse tunnustamise ja detsentraliseeritud menetluste koordineerimisrühm (CMD(h)) tegi seepärast esildise ning müügiloa taotlejal paluti põhjendada, miks taotluse toetuseks esitatud kirjandusandmed on asjakohased ravimi puhul, mille müügiluba taotletakse, ja näidata, et Furosemide Vitabalansi kasutamisel - võrreldes ravimiga, mida kasutati taotluses viidatud olulistes kliinilises uuringutes - ei põhjusta võimalik suurem või väiksem kokkupuude furosemiidiga efektiivsus- ega ohutusprobleeme.
English: The results of this study showing that Furosemide Vitabalans had a similar dissolution profile as the other furosemide presented were not considered sufficient by the CHMP to demonstrate efficacy and safety of the product applied for.
Estonian: Selle uuringu tulemusi, mis näitasid Furosemide Vitabalansi sarnast lahustuvusprofiili furosemiidi muude ravimvormide lahustuvusprofiiliga, ei pidanud inimravimite komitee piisavaks, et tõendada taotletava ravimi efektiivsust ja ohutust.
English: As mentioned previously, Annex I of Directive 2001/83/EC states that the non-clinical and/or clinical overviews must explain the relevance of any data submitted which concern a product different from the product intended for marketing.
Estonian: Nagu märgitud, sätestab direktiivi 2001/83/EÜ I lisa: „Kliinilistest ja mittekliinilistest ülevaadetest peab selguma, miks müügiks mõeldud preparaadist erineva preparaadi kohta esitatud andmeid võib asjakohaseks pidada.