FrancophonIA/ELRC3.0 huggingface dataset:
English: However, it is noted that the CHMP is a scientific committee and that while it operates within the legal framework, it cannot discuss the specific merits of procedural and legal aspects of administrative procedures laid down in the legislation.
Danish: Det må imidlertid bemærkes, at Udvalget for Humanmedicinske Lægemidler er et videnskabeligt udvalg, som, skønt det arbejder inden for lovmæssige rammer, ikke kan drøfte den nærmere berettigelse af de proceduremæssige og retlige aspekter af de administrative procedurer, lovgivningen fastlægger.
English: • Detailed grounds for re-examination submitted by the applicant
Danish: • Ansøgerens detaljerede begrundelse for fornyet overvejelse
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.
Danish: Ansøgeren gav udtryk for sin uenighed omkring visse proceduremæssige aspekter af den gensidige anerkendelsesprocedure, CMDh-proceduren og indbringelsesproceduren i henhold til artikel 29, stk. 4, i direktiv 2001/83/EF.
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.
Danish: • ansøgeren har ikke tilfredsstillende godtgjort, at en potentielt lavere eller højere eksponering for furosemid vil være uden betydning for virkningen eller sikkerheden,
English: The non-clinical overview referred to 29 publications up to year 2010 describing pharmacodynamics, general pharmacology, pharmacokinetic and toxicology studies.
Danish: Den ikke-kliniske sammenfatning henviste til 29 publikationer op til år 2010 med beskrivelse af undersøgelser af farmakodynamik, generel farmakologi, farmakokinetik og toksikologi.
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.
Danish: Den betænkelighed, der blev rejst af Polen og Litauen, kunne ikke afklares ved indbringelsen for CMD(h), og sagen blev derfor indbragt for Udvalget for Humanmedicinske Lægemidler.
English: Furosemide is a loop diuretic which acts along the entire nephron with the exception of the distal exchange site.
Danish: Furosemid er et loop-diuretikum, der virker i hele nefronets længde bortset fra det distale udvekslingsområde.
English: Considering the foreseeable high variability of the product, the main risk with furosemide would be a lack of efficacy.
Danish: I betragtning af den forventelige høje variabilitet af produktet ville hovedrisikoen med furosemid være manglende virkning.
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.
Danish: Det vedgås, at fremstillingsmetoden er fyldestgørende beskrevet, men en pålidelig fremstillingsproces er kun grundlag for yderligere undersøgelser af virkningen og sikkerheden af det ansøgte produkt og kan ikke godtages som bevis for ækvivalens med et godkendt produkt.
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.
Danish: Ansøgningen om markedsføringstilladelse via den decentrale procedure for Furosemide Vitabalans blev indgivet i henhold til artikel 10, litra a), i direktiv 2001/83/EF, som vedrører en almindelig anerkendt anvendelse.
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.
Danish: Den kliniske del af dossieret henviste til 77 publikationer op til år 2009, som underbygger virkningen af furosemid til behandling af ødem ved kongestiv hjerteinsufficiens, levercirrose og nyresygdom, herunder nefrotisk syndrom, og let til moderat hypertension.
English: The group considered that manufacturing methods or dissolution data could not predict how the product would behave in vivo.
Danish: Gruppens opfattelse var, at fremstillingsmetoder eller opløselighedsdata ikke kan bruges til forudsigelse af, hvordan produktet vil opføre sig in vivo.
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.
Danish: Proceduremæssige og retlige hensyn er således uden for Udvalgets beføjelser, hvorfor den fornyede overvejelse af indbringelsesproceduren i henhold til artikel 29, stk. 4, i direktiv 2001/83/EF alene omfattede de videnskabelige punkter, der henvises til i begrundelsen for den fornyede overvejelse.
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.
Danish: Derudover bemærkes, at der i henhold til “Guideline on the Definition of a Potential Serious Risk to Public Health” kan antages at foreligge potentiel alvorlig risiko for den offentlige sundhed i forbindelse med et givet lægemiddel, hvis de fremlagte data til støtte for den terapeutiske virkning ikke giver holdbar begrundelse for den påberåbte virkning, og/eller hvis de kliniske sikkerhedsdata ikke giver tilstrækkeligt grundlag for at konkludere, at alle potentielle sikkerhedsproblemer er løst på passende og tilstrækkelig måde.
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
Danish: Efter vedtagelsen af Udvalget for Humanmedicinske Lægemidlers udtalelse og anbefalinger på Udvalgets møde i oktober 2012 blev der den 12. november 2012 indgivet en anmodning om fornyet overvejelse fra indehaveren af markedsføringstilladelsen, Vitabalans Oy.
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.
Danish: Ansøgningen for Furosemide Vitabalans er derfor baseret på offentligt tilgængelige bibliografiske oplysninger, idet resultaterne af prækliniske og kliniske undersøgelser kan erstattes af en udførlig videnskabelig bibliografi (oplysninger, der er offentligt tilgængelige), hvis det kan påvises, at det aktive indholdsstof i et lægemiddel har haft almindelig anerkendt anvendelse på det medicinske område i Fællesskabet i mindst ti år og er effektivt og tilstrækkelig sikkert.
English: Indeed, furosemide is an active substance with low solubility and low permeability (BCS class IV) which does not support an extrapolation based on pharmaceutical data.
Danish: Furosemid har således lav opløselighed med lav permeabilitet (BCS klasse IV), hvilket ikke støtter en ekstrapolation på grundlag af farmaceutiske data.
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:
Danish: Ansøgeren gav udtryk for uenighed med Udvalget for Humanmedicinske Lægemidlers udtalelse og rettede sin videnskabelige begrundelse mod følgende punkter, som ifølge ansøgeren savner en forklaring i form af en klar begrundelse eller evidens:
English: A judgement must be made whether the product studied can be considered as similar to the product for which application for marketing authorisation has been made in spite of existing differences”.
Danish: Det skal vurderes, om det produkt, der er undersøgt, kan anses for at svare til det produkt, som der er ansøgt om markedsføringstilladelse for, på trods af de eksisterende forskelle.”
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.
Danish: En faktor med betydning for den farmakokinetiske variabilitet af furosemid er netop absorptionsprocessen, der afhænger af dette stofs iboende egenskaber i form af lav opløselighed og lav permeabilitet i forbindelse med ukendte effekter fra formuleringen.
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.
Danish: Udvalget for Humanmedicinske Lægemidler er af den opfattelse, at der skal være påvist sammenlignelig biotilgængelighed af det ansøgte produkt og et produkt omhandlet i den forelagte litteratur, for at der kan påberåbes samme indikation.
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.
Danish: Udvalget for Humanmedicinske Lægemidler konkluderede derfor, at virkningen af Furosemide Vitabalans ikke er påvist ved de ansøgte indikationer, og at dette udgør en potentiel alvorlig risiko for den offentlige sundhed.
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.
Danish: I tilfælde af stærkt varierende lægemiddelstoffer som i det ansøgte produkt anses det også for nødvendigt at undersøge de farmakokinetiske egenskaber for at udelukke alle andre potentielle produktrelaterede forskelle.
English: To support the efficacy and safety of Furosemide Vitabalans, the applicant only referred to published studies.
Danish: Til underbygning af virkningen og sikkerheden af Furosemide Vitabalans henviste ansøgeren udelukkende til publicerede undersøgelser.
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.
Danish: Del II.1., litra d), af bilag I til direktiv 2001/83/EF fastslår, at “de ikke-kliniske og/eller kliniske oversigter skal forklare relevansen af alle forelagte data, som vedrører et lægemiddel, der er forskelligt fra det lægemiddel, der påtænkes markedsført.
English: An ad-hoc expert meeting was convened on 13 February 2013 at the request of the applicant.
Danish: På anmodning af ansøgeren blev der desuden den 13. februar 2013 afholdt et ad hoc-ekspertmøde.
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:
Danish: For at påvise relevansen af den bibliografi, der anvendes til støtte for ansøgningen om Furosemide Vitabalans, henviste indehaveren af markedsføringstilladelsen til:
English: • how the applied furosemide 40 mg product would cause a potential serious risk to public health
Danish: • hvordan det ansøgte produkt indeholdende furosemid, 40 mg, ville medføre mulig alvorlig risi ko for den offentlige sundhed
English: • Pharmacokinetics data
Danish: • Farmakokinetiske data
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.
Danish: Som tidligere nævnt fastslår bilag I til direktiv 2001/83/EF, at de ikke-kliniske og/eller kliniske oversigter skal forklare relevansen af alle forelagte data, som vedrører et lægemiddel, der er forskelligt fra det lægemiddel, der påtænkes markedsført.
English: A scientifically valid approach such as the demonstration of comparable pharmacokinetics was considered necessary to bridge Furosemide Vitabalans to a similar product.
Danish: Det blev anset for nødvendigt med en videnskabeligt begrundet tilgang, såsom påvisning af sammenlignelig farmakokinetik, for at bygge bro fra Furosemide Vitabalans til et lignende produkt.
English: During the decentralised procedure, Poland and Lithuania were of the opinion that bibliographic data on pharmacokinetics of furosemide, presented in the marketing authorisation dossier cannot be applied to Furosemide Vitabalans and should be regarded as not sufficient.
Danish: Ved den decentrale procedure var Polen og Litauen af den opfattelse, at den bibliografiske oversigt over farmakokinetiske data for furosemid, der ledsager ansøgningen, ikke kan anvendes på Furosemide Vitabalans og bør anses for utilstrækkelig.
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.
Danish: De manglende data om produktets biotilgængelighed kan tænkes at medføre uforudsigelige afvigelser i den farmakodynamiske respons med behandlingssvigt eller toksiske effekter til følge.
English: • Clinical data
Danish: • Kliniske data
English: It was considered necessary to have in vivo data especially with a drug exhibiting such wide range of pharmacokinetic values.
Danish: Det blev anset for nødvendigt med in vivo-data, navnlig for et lægemiddelstof med så stærkt varierende farmakokinetiske værdier.
English: • Pharmaceutical data
Danish: • Farmaceutiske data
English: • why the safety and efficacy of the applied furosemide 40 mg product would be effectively different than in other furosemide 40 mg products
Danish: • hvorfor sikkerheden og virkningen er det ansøgte produkt indeholdende furosemid, 40 mg, re elt ville være anderledes end for andre produkter indeholdende furosemid, 40 mg
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.
Danish: Furosemid har udbredt klinisk anvendelse, og under den decentrale procedure er der forelagt en række publikationer til støtte for dets virkning og sikkerhed.
English: The pharmacokinetic parameters available in the literature are not sufficient to claim that Furosemide Vitabalans would have a similar bioavailability.
Danish: De farmakokinetiske parametre i litteraturen giver ikke tilstrækkeligt grundlag for at hævde, at Furosemide Vitabalans vil have tilsvarende biotilgængelighed.
English: Furthermore, in vitro data cannot be sole proof that the clinical data from the submitted studies are applicable to Furosemide Vitabalans.
Danish: Desuden kan in vitrodata ikke godtages som eneste bevis for, at de kliniske data fra de forelagte undersøgelser kan finde anvendelse på Furosemide Vitabalans.
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.
Danish: mg, ville være forskellige fra de i litteraturen beskrevne farmakokinetiske parametre for andre furosemidprodukter, i hvilket omfang de måtte forventes at være forskellige, og hvordan en sådan forskel ville medføre en konkret alvorlig risiko for den offentlige sundhed.
English: • The provided data do not show that Furosemide Vitabalans is similar to the products described in the submitted literature.
Danish: • de forelagte data viser ikke, at Furosemide Vitabalans svarer til de produkter, der er anvendt i den forelagte bibliografiske oversigt.
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.
Danish: På baggrund af, at furosemid har så forskellige egenskaber, blev det desuden anset for nødvendigt at forelægge in vivo-data til karakterisering af produktets farmakokinetik sammen med en begrundelse, der gør det muligt at bygge bro til de publicerede data.
English: A judgement must be made whether the product studied can be considered as similar to the products, for which application for a marketing authorisation has been made in spite of the existing differences.
Danish: Det skal vurderes, om det produkt, der er undersøgt, kan anses for at svare til det produkt, der er ansøgt om markedsføringstilladelse for, på trods af de eksisterende forskelle.
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.
Danish: Den undersøgelse, ansøgeren har forelagt til støtte for sikkerheden af furosemid (Dormans et al.1), anså Udvalget for Humanmedicinske Lægemidler ikke for relevant, da furosemid i undersøgelsen blev anvendt intravenøst, mens Furosemide Vitabalans påtænkes anvendt oralt som en 40 mg tablet.
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.
Danish: Udvalget for Humanmedicinske Lægemidler fandt, at de meget forskellige farmakokinetiske værdier for forskellige produkter indeholdende 40 mg furosemid ikke var bevis for, at de farmakokinetiske parametre for Furosemide Vitabalans vil ligge inden for samme område.
English: Diuretic efficacy of high dose furosemide pharmacokinetics and pharmacodynamics in health and diseasean update.
Danish: 1 Dormans et al.: Diuretic efficacy of high dose <A> pharmacokinetics and pharmacodynamics in health and disease - an update.
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.
Danish: Det kan nemlig ikke udelukkes, at formuleringen af det ansøgte produkt vil have andre farmakokinetiske egenskaber end de furosemidprodukter, der er omhandlet i den forelagte litteratur.
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.
Danish: Det af ansøgeren forelagte dossier indeholdt ingen in vivo kliniske data til godtgørelse af, at den farmakokinetiske profil af Furosemide Vitabalans svarer til de furosemidprodukter, der er omhandlet i den forelagte litteratur.
English: • The Committee considered the notification of the referral triggered by Estonia under Article 29(4)
Danish: • udvalget behandlede anmeldelsen af den indbringelse, der var indledt af Estland i henhold til arti kel 29, stk. 4, i direktiv 2001/83/EF.
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).
Danish: Som svar på Udvalget for Humanmedicinske Lægemidlers spørgsmål henviste ansøgeren desuden til publicerede farmakokinetiske data for tabletformuleringer svarende til Furosemide Vitabalans samt andre formuleringer (f.eks. 20 mg tabletter).
English: Furthermore, the applicant provided a set of dissolution profiles comparing Furosemide Vitabalans with nine other furosemide 40 mg tablets.
Danish: Ansøgeren forelagde endvidere en sammenligning af opløselighedsprofiler for Furosemide Vitabalans og ni andre tabletter indeholdende furosemid, 40 mg.
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.
Danish: Ansøgerens påstand om, at traditionelle fremstillingsmetoder samt hjælpestoffer med udbredt anvendelse er tilstrækkelige til at danne bro mellem Furosemide Vitabalans og andre furosemidprodukter, kan ikke godtages.
English: Additional data would be needed to support the relevance of the bibliographic data to demonstrate the safety and efficacy of Furosemide Vitabalans.
Danish: Det ville kræve supplerende data at underbygge relevansen af den bibliografiske oversigt til påvisning af sikkerheden og virkningen af Furosemide Vitabalans .
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.
Danish: Det kan derfor ikke konkluderes, at Furosemide Vitabalans vil have samme virkning og sikkerhed som de furosemidprodukter, der er omhandlet i den forelagte litteratur.
English: Therefore, the literature data submitted by the applicant to support the safety and efficacy of furosemide did not provide sufficient evidence that the pharmacokinetics of Furosemide Vitabalans allow its safe and effective use in the same dosage and indications applied for.
Danish: Derfor er den bibliografiske oversigt, der er forelagt af ansøgeren til støtte for virkningen og sikkerheden af furosemid, ikke tilstrækkelig evidens for, at farmakokinetikken af Furosemide Vitabalans tillader sikker og virkningsfuld anvendelse ved den ansøgte dosering og de ansøgte indikationer.
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.
Danish: Ad hoc-ekspertgruppen fandt, at den publicerede litteratur og de opløsningsdata, der var fremlagt af ansøgeren, ikke var tilstrækkelige til at godtgøre sikkerheden og virkningen af Furosemide Vitabalans.
English: • CHMP conclusion on grounds for re-examination
Danish: • Udvalget for Humanmedicinske Lægemidlers konklusion vedrørende begrundelsen for fornyet overvejelse
English: The applicant's arguments saying that there is no correlation between the absorbed amount of furosemide and the diuresis, and that controlled-released and immediate-released formulation produce almost as much diuresis, was not considered as sufficient to prove the efficacy of Furosemide Vitabalans.
Danish: Ansøgerens argumentation om, at der ikke er korrelation mellem den absorberede mængde af furosemid og diuresen, og at formuleringer med kontrolleret udløsning og umiddelbar udløsning frembringer næsten samme diurese, blev ikke anset for tilstrækkelige til at bevise virkningen af Furosemide Vitabalans .