FrancophonIA/ELRC3.0 huggingface dataset:
English: On 24 August 2016, Germany referred the matter to the CVMP in order to harmonise the product information for Denagard 45% (and associated names) in the EU.
Croatian: Njemačka je 24. kolovoza 2016. uputila predmet CVMP-u radi usklađivanja informacija o lijeku za VMP Denagard 45 % (i pridružena imena) u EU-u.
English: On 12 April 2017, the European Medicines Agency (the Agency) completed a review of Denagard 45%.
Croatian: Europska agencija za lijekove (Agencija) dovršila je ponovno ocjenjivanje VMPa Denagard 45 %.
English: In addition, the EC requested the Agency to give its opinion, as to whether provisional measures were necessary to protect public health.
Croatian: Pored toga, EK je zatražila mišljenje od Agencije o potrebi uvođenja privremenih mjera radi zaštite javnog zdravlja.
English: The adequacy of these provisional measures will be reviewed as part of the ongoing Article 20.
Croatian: Adekvatnost ovih privremenih mjera ponovno će biti ocijenjena u sklopu provedbe članka 20. koja je u tijeku.
English: This recommendation is without prejudice to the final conclusions of the ongoing procedure under Article 20 of Regulation (EC) No 726/2004.
Croatian: Ova preporuka ne dovodi u pitanje konačne zaključke postupka koji je u tijeku temeljem članaka 20 .Uredbe (EZ) br. 726/20014.
English: The current recommendation relates only to provisional measures recommended by the PRAC for daclizumab based on the preliminary data available at this time.
Croatian: Sadašnja se preporuka odnosi samo na privremenu mjeru koju preporučuje PRAC za daklizumab na temelju trenutačno dostupnih preliminarnih podataka.
English: Therefore, monitoring of serum transaminases levels should continue to be performed at least monthly and more frequently as clinically indicated, further, bilirubin levels should also be tested.
Croatian: Stoga je potrebno nastaviti s provođenjem nadzora razina serumskih transaminaza najmanje jednom mjesečno ili češće ako postoje kliničke indikacije, a pored toga potrebno je testirati i razine bilirubina.
English: Further, the PRAC took into consideration that interrupting treatment in patients whose disease is well-controlled with daclizumab may induce relapses.
Croatian: Nadalje, PRAC je uzeo u obzir činjenicu da bi prekid liječenja kod bolesnika čija je bolest pod nadzorom pomoću daklizumaba mogao izazvati relapse.
English: While liver function monitoring continues to be an important measure to detect liver injury, and likely reduce the incidence of severe cases, it is unclear at this stage whether any alternative monitoring regimen would necessarily prevent further severe cases.
Croatian: Dok praćenje funkcije jetre ostaje važna mjera za otkrivanje oštećenja jetre i vjerojatnog smanjenja učestalosti teških slučajeva, u ovoj je fazi nejasno bi li neki alternativni režim praćenja nužno spriječio daljnje teške slučajeve.
English: In addition, consideration should be given to discontinue treatment if an adequate therapeutic response is not achieved.
Croatian: Pored toga, potrebno je razmotriti prestanak liječenja u slučaju da se ne postigne odgovarajuća terapijska reakcija.
English: In addition 4 cases of serious liver injury were reported from clinical trials, in the first periodic safety update report (PSUR).
Croatian: Pored toga, četiri slučaja teškog oštećenja jetre zabilježena su u kliničkim ispitivanjima, u prvom periodičkom izvješću o neškodljivosti lijeka (PSUR).
English: In the fatal case under review, the finding of normal serum transaminases levels prior to the dose of daclizumab did not prevent the occurrence of liver failure.
Croatian: U fatalnom slučaju koji se provjerava, nalaz normalnih razina serumskih transaminaza prije doze daklizumaba nije spriječio pojavu zatajenja jetre.
English: In view of this and while the magnitude and nature of the risk of liver injury is being further investigated, the PRAC considered that provisional measures are needed to limit the use of daclizumab.
Croatian: S obzirom na navedeno i dok se značaj i priroda rizika od oštećenja jetre dodatno istražuju, PRAC je smatrao da su potrebne privremene mjere radi ograničavanja upotrebe daklizumaba.
English: Since the initial marketing authorisation further serious cases of liver injury have been reported, including a fatal case despite an attempted liver transplant.
Croatian: Od prvog odobrenje za stavljanje u promet zabilježeni su dodatni slučajevi teškog oštećenja jetre, uključujući fatalni slučaj unatoč pokušaju transplantacije jetre.
English: The threshold of transaminases elevation for patients not included in clinical trials, and therefore in which treatment initiation is not recommended, should be corrected from above two times the upper normal limit to above or equal to two times that limit.
Croatian: Prag za povišenje serumskih transaminaza za bolesnike koji nisu uključeni u klinička ispitivanja, pa se stoga kod njih ne preporučuje početak liječenja, potrebno je ispraviti s dva puta više od gornje granice normale na dva puta tu granica ili više.
English: In addition, prompt recognition of signs and symptoms of liver injury is a key component of risk minimisation for liver injury with daclizumab and these should be monitored in all patients.
Croatian: Nadalje, brzo prepoznavanje znakova i simptoma oštećenja jetre ključna je komponenta minimizacije rizika za oštećenje jetre daklizumabom i potrebno ih je nadzirati kod svih bolesnika.
English: • The PRAC considered the procedure under Article 20 of Regulation (EC) No 726/2004 resulting from pharmacovigilance data, in particular regarding the need for provisional measures in accordance with Article 20(3) of Regulation (EC) No 726/2004 for Zinbryta (daclizumab).
Croatian: Uredbe (EZ) br. 726/2004 koji je proizašao iz podataka o farmakovigilanciji, naročito u odnosu na potrebu donošenja privremenih mjera u skladu s člankom 20. stavkom 3. Uredbe (EZ) br. 726/2004 za lijek Zinbryta (daklizumab).
English: Analyses performed in the clinical development program to assess potential interactions of daclizumab with potentially hepatotoxic medications showed no clear evidence of increased risk of liver injury with concomitant hepatotoxic medications.
Croatian: Analize provedene u programu kliničkog razvoja radi procjene mogućih interakcija daklizumaba s potencijalno hepatotoksičnim lijekovima nisu pokazale jasan dokaz povećanog rizika od oštećenja jetre istovremenim uzimanjem drugih hepatotoksičnih lijekova.
English: The Committee, as a consequence, recommends the variation to the terms of the marketing authorisations for Zinbryta (daclizumab).
Croatian: Posljedično tomu, Odbor preporučuje izmjene uvjeta odobrenja za stavljanje u promet lijeka Zinbryta (daklizumab).
English: The efficacy of daclizumab was demonstrated in two pivotal studies in subjects with relapsing remitting multiple sclerosis that led to the indication in relapsing multiple sclerosis.
Croatian: Učinkovitost daklizumaba prikazana je u dva glavna ispitivanja na bolesnicima s relapsima multiple skleroze koji su doveli do indikacije relapsne multiple skleroze.
English: Zinbryta (daclizumab) is a centrally authorised medicinal product indicated in adult patients for the treatment of relapsing forms of multiple sclerosis (RMS).
Croatian: Zinbryta (daklizumab) odobren je lijek indiciran u odraslih bolesnika za liječenje relapsnih oblika multiple skleroze (RMS).
English: Finally, physicians should consider discontinuing daclizumab treatment if an adequate therapeutic response has not been achieved.
Croatian: Konačno, liječnici bi trebali razmotriti prestanak liječenja daklizumabom ako nije postignut odgovarajući terapijski učinak.
English: Patients exhibiting signs and symptoms suggestive of liver injury should be promptly referred to a hepatologist.
Croatian: Bolesnike koji pokazuju znakove i simptome koji upućuju na oštećenje jetre potrebno je odmah uputiti hepatologu.
English: The RMMs implemented, in particular the monthly liver testing, have not been effective to prevent the fatal case of fulminant hepatic failure.
Croatian: Provedene mjere minimizacije rizika, naročito mjesečno testiranje jetre, nisu bile učinkovite u sprječavanju fatalnog slučaja fulminantnog zatajenja jetre.
English: • The PRAC noted that a fatal case of fulminant liver failure occurred despite adherence to the terms of the marketing authorisation and the risk minimisation measures recommended, including the liver function monitoring.
Croatian: • PRAC je evidentirao da se fatalni slučaj fulminantnog zatajenja jetre dogodio unatoč pridržavanju uvjeta iz odobrenja za stavljanje u promet i preporučenih mjera minimizacije rizika, uključujući praćenje funkcije jetre.
English: The PRAC took under consideration the alternative treatment options for the different stages or manifestations of RMS and that limiting access to daclizumab may deny some patients a treatment option for this disease.
Croatian: PRAC je uzeo u obzir alternativne mogućnosti liječenja za različite faze ili simptome relapsnih oblika multiple skleroze te činjenicu da bi ograničenje pristupa daklizumabu nekim bolesnicima moglo uskratiti mogućnost liječenja ove bolesti.
English: Cases of serious liver injury occurred at any time point between early after treatment initiation to several month after discontinuation and no window of susceptibility to could be defined from cases observed in clinical trials.
Croatian: Slučajevi teškog oštećenja jetre dogodili su se u vremenu između početka liječenja i nekoliko mjeseci nakon prestanka terapije, pri čemu nije bilo moguće odrediti sklonost iz slučajeva promatranih u kliničkim ispitivanjima.
English: On 9 June 2017 the EC therefore triggered a procedure under Article 20 of Regulation (EC) No 726/2004 resulting from pharmacovigilance data, and requested the PRAC to assess the impact of the above concerns on the benefit-risk balance of Zinbryta (daclizumab) and to issue a recommendation on whether the relevant marketing authorisations should be maintained, varied, suspended or revoked.
Croatian: Uredbe (EZ) br. 726/2004 koji je proizašao iz podataka o farmakovigilanciji, te je od PRAC-a zatražila procjenu učinka gore navedenih problema na omjer koristi i rizika za lijek Zinbryta (daklizumab) i izdavanje preporuke o tome trebaju li odgovarajuća odobrenja za stavljanje u promet biti zadržana, izmijenjena, obustavljena ili uskraćena.
English: Transaminases elevations and serious hepatic injury are known risks associated to treatment with Zinbryta (daclizumab) and several risk minimisation measures (RMMs) were implemented in this regard, including monthly liver function monitoring.
Croatian: Povišenja serumskih transaminaza i teško oštećenje jetre poznati su rizici povezani s terapijom lijekom Zinbryta (daklizumab) i u tom je pogledu provedeno nekoliko mjera minimizacije rizika (RMM), uključujući mjesečno praćenje funkcije jetre.
English: During the clinical development, transaminases elevations and serious hepatic injury were identified as important identified risks.
Croatian: Tijekom kliničkog razvoja utvrđeni su povišenja serumskih transaminaza i teško oštećenje jetre kao značajni identificirani rizici.
English: Therefore, while the magnitude and nature of the risk are being reviewed in depth, having considered the seriousness of the risk and that further RMMs that would be effective in preventing with certainty any new severe cases cannot be identified at this stage, the PRAC considered that it is necessary to provisionally limit the use of daclizumab through restriction of the indication and through preventing its use in patients potentially predisposed to liver injury and provide further recommendations to healthcare professionals (HCPs) and patients in the management of this risk.
Croatian: Stoga, dok se značaj i priroda rizika temeljito ocjenjuju, uzimajući u obzir ozbiljnost rizika i činjenicu da dodatne mjere minimizacije rizika koje bi bile učinkovite u sigurnom sprječavanju novih ozbiljnih slučajeva u ovoj fazi nije moguće utvrditi, PRAC smatra da je potrebno privremeno ograničiti upotrebu daklizumaba kroz ograničenje indikacije i kroz prevenciju njegove upotrebe kod bolesnika koji imaju moguću sklonost oštećenju jetre te pružiti dodatne preporuke zdravstvenim radnicima (HCP) i bolesnicima o upravljanju rizikom.
English: The above provisional measures should be reflected in the product information of daclizumab and communicated to HCPs via a dedicated letter.
Croatian: Gore navedene privremene mjere trebale bi biti prikazane u informacijama o daklizumabu i dostavljene zdravstvenim radnicima pisanim putem.
English: In view of the above, the Committee considers that the benefit-risk balance of Zinbryta (daclizumab) remains favourable subject to the agreed provisional amendments to the product information.
Croatian: S obzirom na gore navedeno, Odbor smatra da omjer koristi i rizika za lijek Zinbryta (daklizumab) ostaje povoljan uz uvjet dogovorenih privremenih izmjena informacija o lijeku.
English: However, in view of the seriousness of the reactions reported, leading in one case to a fatal outcome despite adherence to the recommended RMMs, the EC considered that the impact of the risk of liver injury on the benefit-risk balance of the medicinal product and the adequacy of the related RMMs should be reviewed.
Croatian: Međutim, s obzirom na ozbiljnost zabilježenih reakcija, koje su u jednom slučaju dovele do fatalnog ishoda unatoč pridržavanju preporuka RMM-a, EK smatra da je potrebno ponovno ispitati učinak rizika od oštećenja jetre na omjer koristi i rizika lijeka i adekvatnost povezanih mjera minimizacije rizika.
English: On 7 June 2017, the European Commission (EC) was informed of a fatal case of fulminant liver failure in a patient treated with daclizumab in an ongoing observational study, despite monthly liver function testing performed in accordance with recommendations in the product information.
Croatian: Europska komisija (EK) je obaviještena o slučaju fatalnog fulminantnog zatajenja jetre kod bolesnika liječenog daklizumabom u opservacijskoj studiji koja je u tijeku, unatoč mjesečnom testiranju funkcije jetre provedene u skladu s preporukama u informacijama o lijeku.
English: The PRAC considered the preliminary new safety data from a recent fatal case of fulminant liver failure and from cases of serious liver injury that occurred since the marketing authorisation, in the context of the data generated during the clinical development of daclizumab.
Croatian: PRAC je uzeo u obzir nove preliminarne sigurnosne podatke iz nedavnog slučaja fatalnog slučaja fulminantnog zatajenja jetre i iz slučajeva teškog oštećenje jetre koji su pojavili nakon odobrenja za stavljanje u promet, u kontekstu podataka ostvarenih tijekom kliničkog razvoja daklizumaba.
English: This was also noted in serious cases that occurred since the marketing authorisation, including the fatal case, therefore while the role of concomitant hepatotoxic medication is not fully elucidated, concomitant use with daclizumab should be cautious.
Croatian: To je također zabilježeno kod teških slučajeva koji su se dogodili nakon izdavanja odobrenja za stavljanje u promet, uključujući fatalni slučaj, pa je stoga potreban oprez kod istovremenog uzimanja s daklizumabom dok se potpuno ne razjasni uloga istovremeno uzimanih hepatotoksičnih lijekova.
English: Caution should also be used when medicinal products of known hepatotoxic potential are used concomitantly.
Croatian: Potreban je oprez kod istovremenog uzimanja lijekova koji su poznati kao potencijalno hepatotoksični.
English: HCPs and patients should be informed of the post-marketing fatal case of fulminant liver failure, the common risk of hepatitis and the updated frequency of serious cases of hepatic injury in the light of the new cases.
Croatian: Zdravstveni radnici i bolesnici trebaju biti informirani o fatalnom slučaju fulminantnog zatajenja jetre, općem riziku od hepatitisa i najnovijoj učestalosti slučajeva teškog oštećenja jetre u svjetlu novih slučajeva.
English: • The PRAC reviewed the preliminary data provided by the marketing authorisation holder on cases of serious liver injury reported since the initial marketing authorisation, in the context of available safety data from clinical trials submitted in support of the initial marketing authorisation in relation to the overall risk of liver injury with daclizumab.
Croatian: • PRAC je ponovno pregledao preliminarne podatke koje je dostavio nositelj odobrenja za stavljanje u promet o slučajevima teškog oštećenja jetre zabilježenih od dobivanja odobrenja za stavljanje u promet, u kontekstu dostupnih sigurnosnih podataka iz kliničkih ispitivanja dostavljenih kao dodatak inicijalnom odobrenju za stavljanje u promet vezano uz opći rizik od oštećenja jetre daklizumabom.
English: The PRAC noted that the hepatic findings observed during the clinical development program had led at time of the initial marketing authorisation to the inclusion of a warning in the product information that treatment of patients with pre-existing severe hepatic impairment is not appropriate and that those with pre-existing mild or moderate hepatic impairment should be monitored.
Croatian: PRAC je zabilježio da su nalazi oštećenja jetre primijećeni tijekom programa kliničkog razvoja u vrijeme početnog odobrenja za stavljanje u promet doveli do uključivanja upozorenja u informacije o lijeku o tome da liječenje bolesnika s prethodnim oštećenjem jetre nije prikladno te da osobe s prethodnim blagim ili srednjim oštećenjem jetre trebaju biti pod nadzorom.
English: However, a number of serious hepatic events in patients in daclizumab groups occurred in the setting of concomitant drugs with known hepatotoxic potential, including one fatal autoimmune hepatitis and one non-fatal hepatic failure assessed by an adjudication committee as probable Hy's Law (indicative of a risk of drug-induced severe liver injury).
Croatian: Međutim, broj slučajeva teškog oštećenja jetre kod bolesnika kod kojih je primjenjivan daklizumab dogodio se istovremenim uzimanjem drugih lijekova koji su poznati kao potencijalno hepatotoksični, uključujući jedan fatalni autoimuni hepatitis i jedno zatajenje jetre koje nije bilo fatalno, koje je odbor za odlučivanje procijenio kao mogući „Hyjev zakon” (ukazuje na rizik od teškog oštećenja jetre induciranog lijekovima).
English: • In addition, the PRAC recommended, as provisional measures to further minimise the risk of liver injury, to strengthen the current warnings to take due account that all patients should be monitored for signs and symptoms of hepatic injury and that liver functions testing should be performed at least monthly, to promptly refer patients to an hepatologist in case of signs or symptoms suggestive of such injury and that treatment initiation is not recommended in patients with other autoimmune conditions.
Croatian: • Pored toga, kao privremene mjere radi dodatne minimizacije rizika od oštećenja jetre, PRAC je preporučio pojačanje postojećih upozorenja kako bi se vodilo računa o tome da je sve bolesnike potrebno nadzirati radi uočavanja znakova i simptoma oštećenja jetre te provoditi testiranje funkcija jetre najmanje jednom mjesečno te ih hitno uputiti hepatologu u slučaju znakova ili simptoma koji upućuju na takvo oštećenje, kao i da se početak liječenja ne preporučuje u bolesnika s drugim autoimunim problemima.
English: • The PRAC recommended as provisional measure amendment to the indication of daclizumab to restrict its use to adult patients with highly active relapsing disease despite a previous treatment with at least one disease modifying therapy (DMT) or, with rapidly evolving severe relapsing multiple sclerosis who are unsuitable for treatment with other DMTs.
Croatian: • PRAC je kao privremenu mjeru preporučio izmjenu indikacije za daklizumab radi ograničavanja njegove upotrebe kod bolesnika s visoko aktivnom relapsnom bolešću unatoč prethodnom liječenju najmanje jednom terapijom koja modificira tijek bolesti (DMT), ili kod bolesnika s relapsnom multiplom sklerozom koja se brzo razvija i kod kojih nije prikladno liječenje drugim lijekovima koji modificiraju tijek bolesti.
English: In view of the restricted indication and contraindication in patients with pre-existing hepatic disease or hepatic impairment, the PRAC recommended that physicians should re-evaluate promptly whether daclizumab continues to be an appropriate treatment option for each of their patients currently treated with this medicinal product, taking into account the provisional measures recommended by the PRAC.
Croatian: S obzirom na ograničenu indikaciju i kontraindikaciju kod bolesnika s prethodnom bolešću ili oštećenjem jetre, PRAC je liječnicima preporučio da odmah ponovno ocijene ostaje li daklizumab prikladna mogućnost liječenja za svakog od svojih bolesnika koji trenutno primaju terapiju ovim lijekom, uzimajući u obzir privremene mjere koje preporučuje PRAC.
English: Notable for this fatal case was the occurrence of rapid fulminant liver failure in the setting of recommended liver function monitoring and concomitant use of another medicinal product known to be associated with hepatotoxicity.
Croatian: Za fatalni slučaj značajna je pojava brzog fulminantnog zatajenja jetre u okviru preporučenog praćenja funkcije jetre i istovremenog uzimanja drugog lijeka povezanog s hepatotoksičnošću.
English: Considering the lack of clinical data in patients with pre-existent significant hepatic diseases as these were excluded from clinical trials, the new serious hepatic cases, and that a mild elevation of serum transaminases was reported prior to treatment initiation in the patient who died of fulminant liver failure, the PRAC recommended as a provisional measure that daclizumab should be contraindicated in all patients with pre-existing hepatic disease or hepatic impairment, while the pattern of hepatotoxicity and possible mechanism of action is further investigated.
Croatian: Uzimajući u obzir nedostatak kliničkih podataka kod bolesnika s prethodnim teškim bolestima jetre, budući da su oni bili isključeni iz kliničkih ispitivanja, nove slučajeve teškog oštećenja jetre, kao i činjenicu da je blago povišenje serumskih transaminaza zabilježeno prije početka liječenja kod bolesnika koji je preminuo od fatalnog fulminantnog zatajenja jetre, PRAC je preporučio privremenu mjeru kontraindiciranja daklizumaba kod svih bolesnika s prethodnom bolešću ili oštećenjem jetre, dok se uzorak hepatotoksičnosti i mogući mehanizam djelovanja dodatno ne istraže.
English: The majority of findings were asymptomatic transaminases elevations, however a low incidence of serious liver events and a rare incidence of fatal liver failure (autoimmune hepatitis) were acknowledged as important risks with daclizumab.
Croatian: Većina nalaza bila su asimptomatska povišenja serumskih transaminaza, međutim, slaba učestalost slučajeva teškog oštećenja jetre i rijetka učestalost fatalnog oštećenja jetre (autoimuni hepatitis) zabilježeni su kao značajni rizici kod daklizumaba.
English: Thus, considering the serious risk of hepatic injury along with the benefit that daclizumab may bring to RMS patients, the PRAC recommended that the use of daclizumab should be provisionally restricted to adult patients with highly active RMS despite a full and adequate course of treatment with at least one disease modifying therapy (DMT) or, with rapidly evolving severe relapsing multiple sclerosis who are unsuitable for treatment with other DMTs.
Croatian: Prema tome, uzimajući u obzir ozbiljan rizik oštećenja jetre uz korist koju daklizumab može donijeti bolesnicima s relapsnim oblicima multiple skleroze, PRAC je preporučio da se upotreba daklizumaba privremeno ograniči kod odraslih bolesnika s vrlo aktivnim relapsnim oblicima multiple skleroze unatoč potpunom i adekvatnom liječenju najmanje jednom terapijom koja modificira tijek bolesti (DMT), ili kod bolesnika s relapsnom multiplom sklerozom koja se brzo razvija i kod kojih nije prikladno liječenje drugom terapijom koja modificira tijek bolesti.