FrancophonIA/ELRC3.0 huggingface dataset:
English: These results were irrespective of the type of fixed ICS/LABA comparator (budesonide/formoterol or salmeterol/fluticasone), and irrespective of whether the maintenance dose of the comparator was similar or up to two fold higher.
Slovenian: Ti rezultati so bili neodvisni od vrste primerjalne fiksne kombinacije ICS/LABA (budezonid/formoterol ali salmeterol/flutikazon) in od tega, ali je bil vzdrževalni odmerek primerjalnega zdravila podoben ali do dvakrat večji.
English: It was concluded that the key factor of the MART approach is not the overall amount of ICS given, but when the dose is given.
Slovenian: Zaključeno je bilo, da ključni dejavnik pri zdravljenju po shemi MART ni velikost skupnega odmerka ICS, ampak pravočasno dajanje odmerka.
English: Annex II Scientific conclusions and grounds for the variation to the terms of the marketing authorisations
Slovenian: Znanstveni zaključki in podlaga za spremembo pogojev dovoljenj za promet z zdravilom
English: Kantos Master in MART was also significantly efficacious regarding the mean number of rescue medication at entry to the study (>0 and ≤1, >1 and ≤2, and >2) in the three groups (similar hazard ratio of 0.51, 0.64 and 0.52, respectively).
Slovenian: Zdravljenje z zdravilom Kantos Master po shemi MART je bilo pomembno učinkovito tudi glede povprečnega števila rešilnih zdravil ob vstopu v študijo (> 0 in ≤ 1, > 1 in ≤ 2 ter > 2) v vseh treh skupinah (podobno razmerje tveganja 0,51, 0,64 oziroma 0,52).
English: A post hoc analysis was conducted with two subgroups of patients in order to demonstrate that both groups of patients in the study CT07 were not overtreated or undertreated.
Slovenian: Post hoc analiza je bila izvedena z dvema podskupinama bolnikov, namen analize pa je bil dokazati, da skupini bolnikov v študiji CT07 nista prejemali prevelikih ali premajhnih odmerkov.
English: It was also observed that the group of patients using Kantos Master as reliever took on average approximately 80µg more of BDP per day which is equivalent to less than one extra inhaler actuation per day.
Slovenian: Opaženo je bilo tudi, da je skupina bolnikov, ki je prejemala zdravilo Kantos Master kot olajševalno zdravljenje, v povprečju jemala 80 µg več BDP na dan, kar je enako enemu dodatnemu vdihu iz inhalatorja na dan.
English: Literature data
Slovenian: Podatki iz literature
English: Moreover, the onset of action of formoterol as a bronchodilator is faster compared to other LABAs such as salmeterol, and is therefore well suited for the acute relief of bronchospasm.
Slovenian: Poleg tega začne formoterol učinkovati kot bronhodilator hitreje kot drugi dolgo delujoči beta-2-agonisti, kot je salmeterol, in je zato primernejši za akutno lajšanje bronhospazmov.
English: Kantos Master is a fixed-dose combination (FDC) of the inhaled corticosteroid (ICS) beclometasone diproprionate (BDP) and the long-acting beta2-agonist (LABA) formoterol fumarate (FF) which is indicated as regular maintenance treatment of asthma administrated twice daily.
Slovenian: Zdravilo Kantos Master je ustaljena kombinacija odmerkov (FDC) inhalacijskega kortikosteroida (ICS) beklometazon dipropionata (BDP) in dolgo delujočega beta-2-agonista (LABA) formoterol fumarata (FF), ki je indicirana za redno vzdrževalno zdravljenje astme z dajanjem dvakrat na dan.
English: The results demonstrated that MART with Kantos Master was significantly superior to salbutamol in prolonging the time to first severe exacerbations and in reducing the mean yearly rate of severe exacerbations in both subgroups of patients.
Slovenian: Rezultati so pokazali, da je bilo zdravljenje z zdravilom Kantos Master po shemi MART pomembno učinkovitejše od zdravljenja s salbutamolom pri podaljšanju časa do prve hude eksacerbacije in znižanju povprečne letne stopnje hudih eksacerbacij pri obeh podskupinah bolnikov.
English: In the Symbicort MART development program, marked improvements in asthma control have been obtained when part of the dose was given on an as-needed basis.
Slovenian: Med programom razvoja zdravila Symbicort SMART so dosegli opazno izboljšanje v obvladovanju astme, ko so del odmerka dajali po potrebi.
English: The patients enrolled in this study were being treated with a higher mean ICS dose at entry to the study (between 700µg and 1100µg, expressed as labelled or BDP equivalent dose respectively) than during the clinical study (ICS dose in the group taking Kantos Master as reliever and in the group taking salbutamol was respectively about 701.2 µg/day and 488.8 µg/day, always given as part of an ICS-LABA combination).
Slovenian: Bolniki, vključeni v študijo, so bili ob vstopu v študijo zdravljeni z večjim povprečnim odmerkom ICS (med 700 µg in 1100 µg, izraženimi kot označen odmerek oziroma ekvivalenten odmerek BDP) kot med klinično študijo (odmerka ICS v skupini, ki je prejemala zdravilo Kantos Master kot olajševalno zdravljenje, in v skupini, ki je jemala salbutamol, sta bila približno 701,2 µg/dan oziroma 488,8 µg/dan, vedno dana kot del kombinacije ICS in LABA).
English: On 20 January 2012, the MAH submitted a type II variation via the MRP for Kantos Master and associated names (DE/H/0873/001/II/024), to request the inclusion of “Maintenance and reliever therapy taken as regular maintenance treatment and as needed in response to asthma symptoms”.
Slovenian: Imetnik dovoljenja za promet z zdravilom je dne 20. januarja 2012 po postopku medsebojnega priznavanja predložil vlogo za spremembo tipa II za zdravilo Kantos Master in povezana imena (DE/H/0873/001/II/024), s katero je zaprosil za vključitev indikacije „vzdrževalno in olajševalno zdravljenje, ki se uporablja kot redno vzdrževalno zdravljenje in po potrebi glede na simptome astme“.
English: Therefore, the CHMP was of the opinion that the positive effect of Kantos Master on exacerbations was not achieved through a simple increase in daily ICS dose but with the timely delivery of a small dose of BDP together with the bronchodilator, when patient's symptoms worsened.
Slovenian: Zato je CHMP menil, da pozitivni učinek zdravila Kantos Master na eksacerbacije ni bil dosežen z majhnim povečanjem dnevnega odmerka ICS, ampak s pravočasnim dajanjem majhnih odmerkov BDP z bronhodilatatorjem ob poslabšanju simptomov bolnika.
English: In both more severe (defined by FEV1 < 70%) and less severe groups (FEV1 ≥ 70%), Kantos Master in MART was significantly efficacious (similar hazard ratio of 0.65 and 0.61, respectively).
Slovenian: Tako v skupini s hujšo astmo (določeno kot FEV1 < 70 %) kot v skupini z manj hudo astmo (FEV1 ≥ 70 %) je bilo zdravljenje z zdravilom Kantos Master po shemi MART pomembno učinkovito (podobno razmerje tveganja 0,65 oziroma 0,61).
English: Therefore, the CHMP considered that the positive therapeutic effect of MART with Kantos Master has been demonstrated in patients who had a reduction in the daily ICS dose and in patients who did not have any step down treatment (i.e. the subgroup of patients taking up to 500 µg daily at entry and during treatment).
Slovenian: Zato je CHMP menil, da so bili pozitivni terapevtski učinki zdravljenja z zdravilom Kantos Master po shemi MART dokazani pri bolnikih, ki so prejemali zmanjšani dnevni odmerek inhalacijskih kortikosteroidov, in pri bolnikih, pri katerih niso zmanjšali odmerka (tj. pri podskupini bolnikov, ki je jemala do 500 µg na dan ob vstopu v študijo in med zdravljenjem).
English: The data from the main pivotal study that were submitted with the application to support safety and efficacy of Kantos Master for the maintenance and reliever therapy taken as regular maintenance treatment and as needed in response to asthma symptoms have not demonstrated that the MART treatment regimen was non-inferior to standard of care treatment, as the control group did not actually receive treatment according to standard of care.
Slovenian: 1. podatki glavne ključne študije, ki so bili predloženi skupaj z vlogo v podporo varnosti in učinkovitosti zdravila Kantos Master za vzdrževalno in olajševalno zdravljenje, ki se uporablja kot redno vzdrževalno zdravljenje in po potrebi glede na simptome astme, niso pokazali, da zdravljenje po shemi MART ni slabše od standardnega zdravljenja, saj kontrolna skupina ni dejansko prejemala zdravljenja v skladu s standardno oskrbo;
English: One arm of patients were treated with an entry ICS dose of 500 µg or less and another arm had an entry ICS dose of more than 500 µg.
Slovenian: Bolniki v enem kraku so bili ob vstopu zdravljeni z odmerkom 500 µg ICS ali manj, bolniki v drugem kraku pa z odmerkom, večjim od 500 µg.
English: A further additional analysis of the study CT07 has been conducted in patients with severe asthma as it was considered that if under-treatment with Kantos Master in MART occurred, it should be most evident in this population who requires higher ICS doses to control their asthma.
Slovenian: Nadaljnjo dodatno analizo študije CT07 so izvedli pri bolnikih s hudo astmo, saj so menili, da bi bile posledice morebitnega zdravljenja s premajhnimi odmerki zdravila Kantos Master po shemi MART pri tej populaciji bolnikov najbolj očitne, saj za obvladovanje astme potrebujejo večje odmerke ICS.
English: Although a reduction to the mean ICS dose was observed in patients at entry to the study, the results showed that the mean FEV1 improved in both groups of patients during the run-in period and further improvement were observed during the 48-week treatment period, with a change from baseline to the end of the study of about 100mL in both groups.
Slovenian: Čeprav je bilo pri bolnikih ob vstopu v študijo opaženo zmanjšanje povprečnega odmerka ICS, so rezultati v obeh skupinah pokazali izboljšanje povprečnega FEV1 med uvodnim zdravljenjem in nadaljnje izboljšanje v 48 tednih zdravljenja; sprememba od začetka do konca študije je bila v obeh skupinah približno 100 ml. CHMP je upošteval, da ni bila izvedena primerjava s standardno oskrbo v skladu s smernicami GINA.
English: The similar particle size of the two components also leads to co-deposition in the same regions of the lung, favouring a synergistic interaction.
Slovenian: Ker so delci obeh sestavin podobno veliki, se skupaj nalagajo v istih delih pljuč, kar omogoča sinergijsko delovanje.
English: The CHMP was therefore of the opinion that the effectiveness of Kantos Master in MART was not due to a potential under-treatment of the comparator arm in the study CT07, and that the maintenance administration of Kantos Master at one inhalation twice daily had a clinically significant benefit in these patients.
Slovenian: Zato je CHMP menil, da učinkovitost zdravljenja z zdravilom Kantos Master po shemi MART ni bila povezana z morebitnimi premajhnimi odmerki v primerjalni skupini v študiji CT07 in da je zdravilo Kantos Master kot vzdrževalno zdravljenje z enim vdihom iz inhalatorja dvakrat na dan pri teh bolnikih pokazalo klinično pomembne koristi.
English: This additional analysis further demonstrated that Kantos Master in MART is not associated with under-treatment of patients in case of uncontrolled asthma.
Slovenian: Ta dodatna analiza je nadalje pokazala, da učinkovitost zdravila Kantos Master po shemi MART ni povezana z dajanjem premajhnih odmerkov bolnikom z neurejeno astmo.
English: The daily maintenance dose, in both arms of the study was 200µg of extrafine beclometasone, which is clinically equivalent to 500µg of non extrafine beclometasone.
Slovenian: Dnevni vzdrževalni odmerek v obeh skupinah je bil 200 µg beklometazona v izredno drobnih delcih, kar je klinično ekvivalentno 500 µg beklometazona, ki ni v izredno drobnih delcih.
English: This treatment approach of using a maintenance dose of a fixed combination of ICS and LABA and additional doses of the same combination in case of symptom worsening instead of a separate short acting beta2-agonist (SABA) is called “Maintenance And Reliever Therapy” (MART).
Slovenian: Način zdravljenja, pri katerem se namesto ločenega kratko delujočega beta-2-agonista (SABA) uporabijo vzdrževalni odmerek fiksne kombinacije ICS in LABA ter dodatni odmerki iste kombinacije v primeru poslabšanja simptomov, se imenuje „vzdrževalno in olajševalno zdravljenje“ (MART).
English: As Kantos Master contain formoterol and beclometasone and in view of the results of the study, the Committee considered the published data to be relevant in the applied regimen.
Slovenian: Na podlagi dejstva, da zdravilo Kantos Master vsebuje formoterol in beklometazon, in ob upoštevanju rezultatov študije je Odbor presodil, da so objavljeni podatki pomembni za uporabljeno shemo;
English: However, the Committee agreed that there was no evidence that patients in the comparator group were under-treated as patients in both group had shown clinical benefit from their maintenance treatment.
Slovenian: Vendar pa se je Odbor strinjal, da ni bilo dokazov, da bi bili bolniki v primerjalni skupini zdravljeni s premajhnimi odmerki, saj je vzdrževalno zdravljenje pokazalo klinično korist za bolnike v obeh skupinah.
English: As Kantos Master contain formoterol and beclometasone, and in view of the results of the submitted study, the Committee considered the published data to be relevant in the applied regimen.
Slovenian: Na podlagi dejstva, da zdravilo Kantos Master vsebuje formoterol in beklometazon, in rezultatov predložene študije je Odbor presodil, da so objavljeni podatki pomembni za uporabljeno shemo.
English: Inhaled beclometasone dipropionate /formoterol extra fine fixed combination in the treatment of asthma: evidence and future perspectives.
Slovenian: Fabbri, L. M., „Inhaled beclometasone dipropionate /formoterol extra fine fixed combination in the treatment of asthma: evidence and future perspectives (Fiksna kombinacija odmerkov inhalacijskega beklometazon dipropionata in formoterola v izredno majhnih delcih za zdravljenje astme: dokazi in perspektive za prihodnost), Expert Opinion Pharmacother.
English: • The Committee is of the opinion that the data of the pivotal study CT07 indicated a significant reduction in the risk of severe exacerbations of asthma and significant longer time to exacerbation can be obtained when Kantos Master dose is given as needed.
Slovenian: • Odbor je menil, da so podatki iz ključne študije CT07 pokazali, da lahko jemanje odmerkov zdravila Kantos Master po potrebi pomembno zmanjša tveganja za pojav hudih eksacerbacij astme in pomembno podaljša čas do eksacerbacij;
English: In order to demonstrate the efficacy of Kantos Master and associated names as maintenance treatment and as needed in response to symptoms of asthma, the MAH submitted data from a phase III pivotal clinical study, randomised, double blind, double dummy, two arms parallel group (Study CT07).
Slovenian: Imetnik dovoljenja za promet z zdravilom je za dokaz učinkovitosti zdravila Kantos Master in povezanih imen kot vzdrževalnega zdravljenja in zdravljenja po potrebi glede na simptome astme predložil podatke iz ključne klinične študije III. faze, ki je bila randomizirana, dvojno slepa, uporabljen je bil dvojni placebo in je imela vzporedno skupino z dvema krakoma (študija CT07).
English: • The Committee reviewed all available data, to support the safety and efficacy of Kantos Master and associated names for “maintenance and reliever therapy taken as regular maintenance treatment and as needed in response to asthma symptoms”.
Slovenian: • Odbor je pregledal vse razpoložljive podatke, predložene v podporo varnosti in učinkovitosti zdravila Kantos Master in povezanih imen za „vzdrževalno in olajševalno zdravljenje, ki se uporablja kot redno vzdrževalno zdravljenje in po potrebi glede na simptome astme“;
English: • The Committee concluded, in view of available data that the benefit/risk of Kantos Master and associated names for “maintenance and reliever therapy taken as regular maintenance treatment and as needed in response to asthma symptoms” is positive.
Slovenian: • Odbor je na podlagi razpoložljivih podatkov zaključil, da je razmerje med tveganji in koristmi zdravila Kantos Master in povezanih imen za „vzdrževalno in olajševalno zdravljenje, ki se uporablja kot redno vzdrževalno zdravljenje in po potrebi glede na simptome astme“, pozitivno;
English: The results of the study have shown that the risk of experiencing a severe asthma exacerbation was reduced by 36% (CI: 18% - 51%) in the group taking Kantos Master as reliever compared to the
Slovenian: Rezultati študije so pokazali, da se je tveganje za pojav hude eksacerbacije astme zmanjšalo za 36 % (CI: 18 %-51 %) v skupini, ki je prejemala zdravilo Kantos Master kot olajševalno zdravljenje, v primerjavi s skupino, ki je prejemala salbutamol, in da je bila razlika med skupinama statistično pomembna (p < 0,001).
English: The CHMP considered that the data provided by the MAH are sufficient to support the use of Kantos Master and associated names in the maintenance and reliever therapy (MART) taken as regular maintenance treatment and as needed in response to asthma symptom.
Slovenian: CHMP je menil, da so podatki, ki jih je predložil imetnik dovoljenja za promet z zdravilom, zadostni za utemeljitev uporabe zdravila Kantos Master in povezanih imen za vzdrževalno in olajševalno zdravljenje (MART), ki se uporablja kot redno vzdrževalno zdravljenje in po potrebi glede na simptome astme.
English: This suggested that the ICS-LABA maintenance therapy was adequate to control both lung function and symptoms.
Slovenian: To kaže na to, da je vzdrževalno zdravljenje z inhalacijskim kortikosteroidom in dolgo delujočim beta-2-agonistom zadostovalo tako za obvladovanje delovanja pljuč kot simptomov.
English: The primary endpoint is a clinically important measure of the long-term asthma control, and was clearly in favour of Kantos MART in comparison with Kantos plus SABA treatment.
Slovenian: Primarni cilj je klinično pomembna stopnja dolgoročnega obvladovanja astme, ki je bila nedvomno v korist zdravljenja z zdravilom Kantos po shemi MART v primerjavi z zdravljenjem z zdravilom Kantos skupaj s kratko delujočim beta-2-agonistom.
English: Grounds for the variation to the terms of the marketing authorisations
Slovenian: Podlaga za spremembo pogojev dovoljenj za promet z zdravilom Ob upoštevanju naslednjega:
English: Whereas
Slovenian: Sklep
English: • The Committee took note of literature data where the principle of MART is substantiated with the use of an ICS and LABA.
Slovenian: • Odbor je upošteval podatke iz literature, ki shemo MART utemeljujejo z uporabo inhalacijskega kortikosteroida in dolgo delujočega beta-2-agonista.
English: For instance, in the SMILE study2, the dose of budesonide (400µg/day) was in line with the ICS dose administrated in the study CT07 (500µg BDP non-extrafine equivalent).
Slovenian: Dodatni podatki iz literature kažejo na to, da zamenjava visokega odmerka z zmernim vzdrževalnim odmerkom ICS ni vplivala na rezultate zdravljenja po shemi MART. Na primer, v študiji SMILE 2 je bila velikost odmerka budezonida (400 µg/dan) enaka velikosti odmerka ICS v študiji CT07 (ekvivalentnega 500 µg BDP, ki ni v izjemno drobnih delcih).
English: The CHMP also took note of literature data where the principle of MART is substantiated with the use of an ICS and LABA.
Slovenian: CHMP je upošteval tudi podatke iz literature, ki shemo MART utemeljujejo z uporabo inhalacijskega kortikosteroida in dolgo delujočega beta-2-agonista.
English: Rabe KF, Atienza T, Magyar P, Larsson P, Jorup C, Lalloo UG.
Slovenian: Rabe, K. F., Atienza, T., Magyar, P., Larsson, P., Jorup, C., Lalloo, U. G., „Effect of budesonide in combination with formoterol for reliever therapy in asthma exacerbations: a randomised controlled, double-blind study“ (Učinek budezonida v kombinaciji s formoterolom za olajševalno zdravljenje eksacerbacij astme: randomizirana, kontrolirana, dvojno slepa študija), Lancet, 2006, št. 368, str. 744-753.
English: To further demonstrate that the patients in the MART treatment arm were not overtreated or undertreated and to support the results of the study CT07, the MAH conducted post hoc analysis of data and made reference to additional supportive data.
Slovenian: Imetnik dovoljenja za promet z zdravilom je izvedel post hoc analizo podatkov in navedel tudi dodatne spremljajoče podatke, s katerimi je želel dokazati, da bolniki v skupini, ki je prejemala zdravljenje po shemi MART, niso jemali prevelikih ali premajhnih odmerkov, in na ta način podprl študijo CT07.
English: The aim of the MART approach is to reduce the rate of asthma exacerbations by “early intervention”, i.e. by giving additional doses of ICS plus FF in response to an increase in symptoms (2011 GINA Guidelines1).
Slovenian: Cilj zdravljenja po shemi MART je zmanjšati pogostnost eksacerbacij astme z „zgodnjim ukrepanjem“, tj. z dajanjem dodatnih odmerkov ICS v kombinaciji s formoterol fumaratom, kadar so simptomi pogostejši (smernice GINA 20111).V študiji CT07 so primerjali učinkovitost zdravila Kantos Master in povezanih imen, ki so jih dajali kot vzdrževalno in olajševalno zdravljenje, ter zdravila Kantos Master, ki so ga dajali kot vzdrževalno zdravljenje skupaj s salbutamolom (kratko delujočim beta-2
English: Background
Slovenian: Osnovne informacije
English: The study CT07 compared the efficacy of Kantos Master and associated names given as both maintenance and reliever therapy and Kantos Master given as maintenance therapy with salbutamol (short acting beta2 -agonist SABA) as reliever therapy in partially controlled or uncontrolled asthmatics, over a 48 weeks treatment.
Slovenian: agonistom - SABA) kot olajševalnim zdravljenjem bolnikom z delno urejeno ali neurejeno astmo v obdobju 48 tednov.
English: Package size l t o r
Slovenian: Velikost pakiranja o ā
English: 20 October 2015 EMA/499012/2015
Slovenian: oktober 2015 EMA/499012/2015
English: This means that, although there is insufficient evidence from clinical trials, the effectiveness of these herbal medicines is plausible and there is evidence that they have been used safely in this way for at least 30 years (including at least 15 years within the EU).
Slovenian: To pomeni, da je kljub nezadostnim dokazom iz kliničnih preskušanj učinkovitost teh zdravil rastlinskega izvora verjetna in da obstajajo dokazi, da so se na navedene načine varno uporabljala že vsaj 30 let (najmanj 15 let tudi v EU).
English: While the skin preparations can be used by people of all ages, the medicines to be taken by mouth are not recommended in children and adolescent (under 18 years of age).
Slovenian: Medtem ko lahko pripravke, ki se nanašajo na kožo, uporabljajo ljudje vseh starosti, se zdravila, ki se jemljejo peroralno (uživajo skozi usta), ne priporočajo pri otrocih in mladostnikih (mlajših od 18 let).
English: After cooling, the essential oil separates from the water and can be collected.
Slovenian: Po ohlajanju se eterično olje loči od vode in ga je mogoče posneti.
English: Caraway oil EMA/499012/2015
Slovenian: EMA/499012/2015
English: The HMPC noted the insufficient clinical data on the effects of caraway oil in patients, but took into account the well documented use of this herbal medicine for the above-mentioned use.
Slovenian: Odbor HMPC je izpostavil nezadostne klinične podatke o učinkih eteričnega olja navadne kumine pri bolnikih, vendar je upošteval dobro dokumentirano uporabo tega zdravila rastlinskega izvora za zgoraj navedene težave.
English: This summary is not intended to provide practical advice on how to use medicines containing caraway oil.
Slovenian: Povzetek ni namenjen zagotavljanju praktičnih nasvetov o uporabi zdravil, ki vsebujejo eterično olje navadne kumine.
English: If symptoms last for more than 2 weeks during the use of caraway oil medicines, the patient should consult a doctor or qualified healthcare practitioner.
Slovenian: Če pri uporabi zdravil, ki vsebujejo eterično olje navadne kumine, simptomi trajajo več kot dva tedna, se mora bolnik posvetovati z zdravnikom ali usposobljenim zdravstvenim delavcem.
English: This is a summary of the scientific conclusions reached by the Committee on Herbal Medicinal Products (HMPC) on the medicinal uses of caraway oil.
Slovenian: To je povzetek znanstvenih zaključkov Odbora za zdravila rastlinskega izvora (HMPC) v zvezi z medicinsko uporabo eteričnega olja navadne kumine.