FrancophonIA/ELRC3.0 huggingface dataset:
English: However, in all trials there was a higher incidence of malignancies reported in calcitonin treated patients compared to placebo.
Danish: I disse undersøgelser var der imidlertid en højere forekomst af maligniteter, der blev rapporteret hos calcitonin-behandlede patienter, sammenlignet med placebo.
English: The MAH argued that the improvement in bone mineral density (BMD) underestimates fracture efficacy.
Danish: Indehaveren af markedsføringstilladelsen hævdede, at forbedringen i knogletæthed (BMD) undervurderer virkningen på frakturrisikoen.
English: The MAH discussed the low number of post-marketing spontaneous cases of cancer reported with calcitonin.
Danish: Indehaveren af markedsføringstilladelsen henviste til det lave antal spontane indberetninger af cancertilfælde med calcitonin i undersøgelserne efter markedsføring.
English: • In view of the new safety concerns in relation to the risk of cancer in long-term use and the limited efficacy of calcitonin in the treatment of osteoporosis, the Committee is of the opinion that pursuant to Article 116 of Directive 2001/83/EC the benefit-risk balance of the intranasal formulations of calcitonin-containing medicinal products is not positive under normal conditions of use.
Danish: • I lyset af de nye sikkerhedsbetænkeligheder i forhold til cancerrisikoen ved langtidsanvendelse og begrænsede virkning af calcitonin i forbindelse med behandling af osteoporose mener udvalget, at benefit/risk-forholdet for de intranasale formuleringer med lægemidler, der indeholder calcitonin, i henhold til artikel 116 i direktiv 2001/83/EF ikke er positivt under normale anvendelsesbetingelser.
English: The Committee concluded that the benefit-risk balance of calcitonin-containing injectable formulations indicated in the treatment of Paget's disease, hypercalcaemia of malignancy and for the prevention of acute bone loss due to sudden immobilisation, remains positive under normal conditions of use, subject to the restrictions in indication (for Paget's disease), limitation of treatment duration and warnings to be introduced in the product information.
Danish: Udvalget konkluderede, at benefit/risk-forholdet for injektionsformuleringer, der indeholder calcitonin, indiceret til behandling af Pagets sygdom, hypercalcæmi ved malignitet og til forebyggelse af akut knogletab på grund af pludselig immobilisering, forbliver positivt under normale anvendelsesbetingelser, under forudsætning af, at indskrænkning i indikation (for Pagets sygdom), begrænsning af behandlingsperiode og advarsler indføres i produktoplysningerne.
English: The MAH questions the results of the meta-analysis because of the use of fixed-effects models in the presence of heterogeneity.
Danish: Indehaveren af markedsføringstilladelsen drager metaanalysens resultater i tvivl, fordi der er anvendt modeller med faste effekter ved tilstedeværelse af heterogenicitet.
English: Recognising the potential limitations of the clinical trials included in the analysis, the observed increased risk of cancer needs to be balanced against the modest benefit of calcitonin.
Danish: Uanset de potentielle begrænsninger af de kliniske undersøgelser i analysen må den iagttagne øgede cancerrisiko afvejes mod calcitonins beskedne fordel.
English: The scientific points of disagreement presented in the MAHs detailed grounds included efficacy aspects, safety aspects in relation to the risk of cancer (non-clinical, pharmacovigilance, and statistical issues) and overall benefit-risk assessment.
Danish: Indehaveren af markedsføringstilladelsen bestrider i sin detaljerede begrundelse videnskabelige punkter vedrørende virkningen, sikkerhedsaspekter i forhold til cancerrisikoen (dels ikke-kliniske, dels vedrørende lægemiddelovervågning og dels statistiske) og den overordnede benefit/risk vurdering.
English: Based on the totality of the data available on the safety and the efficacy of intranasal calcitonincontaining medicinal products and having noted the opinion of the Ad-Hoc Expert meeting, the CHMP confirmed its initial conclusion that the limited efficacy in this indication needs to be balanced against evidence from clinical trials for an increased risk of cancer with long-term use of calcitonin.
Danish: De foreliggende data om sikkerheden og virkningen af intranasale lægemidler indeholdende calcitonin og konklusionerne fra ad hoc-ekspertmødet bekræftede CHMP's oprindelige konklusion: Den begrænsede virkning til denne indikation må afvejes mod evidensen fra de kliniske undersøgelser om øget cancerrisiko ved langvarig anvendelse af calcitonin.
English: The MAH addressed a number of non-clinical, pharmacovigilance, and statistical issues in relation to the CHMP assessment of the risk of cancer with the use of calcitonin-containing medicinal products.
Danish: Indehaveren af markedsføringstilladelsen tog en række punkter op vedrørende ikke-kliniske data, lægemiddelovervågning og statistiske spørgsmål i relation til CHMP's vurdering af cancerrisikoen ved anvendelse af calcitoninholdige lægemidler.
English: From the meta-analysis of the intranasal calcitonin studies, the data point towards an increase in the risk of cancer in patients treated with intranasal calcitonin compared to placebo.
Danish: Metaanalysen af de intranasale calcitoninundersøgelser peger på øget cancerrisiko i forhold til placebo hos patienter behandlet med intranasalt calcitonin.
English: • Efficacy aspects
Danish: • Aspekter vedrørende virkning
English: The MAH considers that the exclusion of four studies from the meta-analysis in which no cancer cases were observed, lacks basis.
Danish: Indehaveren af markedsføringstilladelsen anser det for ubegrundet, at der i metaanalysen blev udeladt fire undersøgelser, i hvilke der ikke iagttoges cancertilfælde.
English: • Efficacy
Danish: • Virkning
English: The CHMP conclusions in response to these points raised by the MAH are given below.
Danish: Nedenfor følger CHMP's konklusioner til besvarelse af de punkter, der er rejst afindehaveren af markedsføringstilladelsen.
English: The re-examination of the CHMP opinion was related to the benefit-risk balance of the intranasal formulation of calcitonin in the indication “treatment of osteoporosis in order to reduce the risk of vertebral fractures”.
Danish: Den fornyede overvejelse af CHMP's udtalelse vedrørte benefit/risk-forholdet for den intranasale formulering af calcitonin til indikationen “behandling af osteoporose med henblik på reduktion af risikoen for vertebralfrakturer”.
English: The Committee also concluded that the benefit-risk balance of calcitonin-containing intranasal formulation indicated for the treatment of osteoporosis is no longer positive under normal conditions of use and recommends the suspension of the corresponding marketing authorisations.
Danish: Udvalget konkluderede endvidere, at benefit/risk-forholdet for intranasal formulering, der indeholder calcitonin, og som er indiceret til behandling af osteoporose, ikke længere er positivt under normale anvendelsesbetingelser og anbefaler suspendering af de tilsvarende markedsføringstilladelser.
English: The Committee therefore concluded the benefit-risk balance of calcitonin-containing intranasal formulation indicated for the treatment of osteoporosis is no longer positive under normal conditions of use and recommends the suspension of the corresponding marketing authorisations.
Danish: Udvalget konkluderede derfor, at benefit/risk-forholdet for en intranasal formulering indeholdende calcitonin til behandling af osteoporose ikke længere er positivt under normale anvendelsesbetingelser, og anbefaler suspendering af de tilsvarende markedsføringstilladelser.
English: For the lifting of the suspension the MAH(s) should provide new randomised controlled data that will be able to robustly demonstrate that the benefits of calcitonin-containing medicines outweigh their risks in patients with osteoporosis taking into account the increased risk of cancer and cancer mortality associated with long term use of calcitonin.
Danish: For at suspenderingen kan ophæves, skal indehaveren af markedsføringstilladelsen forelægge nye randomiserede, kontrollerede data, der sikkert påviser, at fordelene ved lægemidler indeholdende calcitonin opvejer risiciene hos patienter med osteoporose under hensyntagen til den øgede cancerrisiko og cancerdødelighed ved langvarig anvendelse af calcitonin.
English: For Paget's disease, the evidence of efficacy is based on published literature of a number of small studies, where the treatment duration was in most cases between 3-18 months.
Danish: CHMP accepterede, at nogen evidens for virkning i denne indikation er blevet fremlagt, først og fremmest i undersøgelsen af Tsakalakos et al. For Pagets sygdom er evidensen for virkning baseret på offentliggjort litteratur om et antal små undersøgelser, hvor behandlingsperioden i de fleste tilfælde var 3-18 måneder.
English: Overall conclusion of the re-examination procedure The scope of the re-examination was the benefit/risk of intranasal formulation of calcitonin-containing medicinal products in the indication of “treatment of osteoporosis in order to reduce the risk of vertebral fractures”.
Danish: Samlet konklusion vedrørende den fornyede overvejelse Den fornyede overvejelse vedrørte benefit/risk-forholdet for den intranasale formulering af lægemidler indeholdende calcitonin til indikationen “behandling af osteoporose med henblik på mindskelse af risikoen for vertebralfrakturer”.
English: For the lifting of the suspension the MAH(s) should provide new randomised controlled data that will be able to robustly demonstrate that the benefits of calcitonin-containing medicines outweigh their risks in patients with osteoporosis and taking into account the increased risk of cancer and cancer mortality associated with long term use of calcitonin.
Danish: For ophævelse af suspenderingen skal indehaveren/indehaverne af markedsføringstilladelsen fremlægge nye randomiserede, kontrollerede data, der solidt skal kunne påvise, at fordelene ved lægemidler, der indeholder calcitonin, opvejer risiciene hos patienter med osteoporose, samt vurdere den forøgede cancerrisiko og cancermortalitet, der er forbundet med langtidsanvendelsen af calcitonin.
English: • Prevention of acute bone loss due to sudden immobilisation such as in patients with recent osteoporotic fractures (injectable formulation)
Danish: • Forebyggelse af akut knogletab på grund af pludselig immobilisering, såsom hos patienter med nylige osteoporotiske frakturer (injektionsformulering) Kun begrænset evidens for virkningen for denne indikation er tilgængelig.
English: Considering the limited evidence of efficacy, the risk of cancer associated with the use of calcitonin, and the long term duration of treatment required for this indication, the benefit risk balance for the intranasal formulation of calcitonin for the treatment of osteoporosis in order to reduce the risk of vertebral fractures, which is the only indication for this pharmaceutical form, is considered to be negative.
Danish: I betragtning af den begrænsede evidens for virkning, risikoen for cancer, der er relateret til anvendelsen af calcitonin, og den langsigtede behandlingsperiode, der er nødvendig til denne indikation, vurderes benefit/risk-forholdet til at være negativt for den intranasale formulering af calcitonin til behandling af osteoporose for at reducere risikoen for vertebralfrakturer, som er den eneste indikation for denne farmaceutiske form.
English: Grounds for the suspension of the marketing authorisation for the intranasal calcitonincontaining medicinal products Whereas
Danish: Årsager til suspendering af markedsføringstilladelsen for intranasale lægemidler, der indeholder calcitonin Følgende noteres:
English: Considering the limited evidence of efficacy, the risk of cancer with the use of calcitonin, and the long term duration of treatment required for this indication, the benefit risk balance for the intranasal formulation of calcitonin for the treatment of osteoporosis in order to reduce the risk of vertebral fractures, which is the only indication for this pharmaceutical form, is considered to be negative.
Danish: I betragtning af den begrænsede dokumentation for virkning, cancerrisikoen ved anvendelse af calcitonin og den lange behandlingsvarighed, der kræves ved denne indikation, anses benefit/riskforholdet for at være negativt for den intranasale formulering af calcitonin til behandling er osteoporose med henblik på mindskelse af risikoen for vertebrale frakturer, som er den eneste indikation for denne lægemiddelform.
English: Efficacy of calcitonin for this indication is supported by established use of calcitonin in clinical practice.
Danish: • Behandling af hypercalcæmi ved malignitet (injektionsformulering) Calcitonins virkning for denne indikation understøttes af etableret anvendelse af calcitonin i klinisk praksis.
English: Grounds for the variation to the terms of the marketing authorisation for the injectable calcitonin-containing medicinal products
Danish: Årsager til ændring af betingelserne i markedsføringstilladelsen for injektionslægemidler, der indeholder calcitonin Følgende noteres:
English: However the CHMP was of the view that regardless of whether OR or RR are used, the signal is apparent, which can even be partly assessed by even looking at crude rates.
Danish: Indehaveren af markedsføringstilladelsen påpeger desuden, at der er anvendt et punktestimat for OR, der giver større sandsynlighed for et signifikant resultat end den tilsvarende RR. CHMP var imidlertid den opfattelse, at anset om der anvendes OR eller RR, er signalet tydeligt, hvad der endda delvis ses blot ved at betragte de samlede frekvenser.
English: o for the prevention of acute bone loss due to sudden immobilisation such as in patients with recent osteoporotic fractures, the benefit-risk balance remains positive provided that the duration of use is restricted to 2 weeks, not exceeding 4 weeks in any case.
Danish: Behandlingsperioden kan udvides med op til højst 6 måneder under ekstraordinære omstændigheder, og regelmæssig genbehandling kan overvejes o til forebyggelse af akut knogletab på grund af pludselig immobilisering, såsom hos patienter med nylig osteoporotiske frakturer, forbliver benefit/risk-forholdet positivt under forudsætning af, at anvendelsens varighed indskrænkes til 2 uger og ikke overstiger 4 uger i nogen af tilfældene o ved behandling af hypercalcæmi ved malignitet forbliver benefit/risk-forholdet positivt under forudsætning af, at behandlingsperioden begrænses til den kortest mulige tid og ved brug af den mindste effektive dosis.
English: o for the treatment of Paget's disease the benefit-risk balance remains positive provided that the duration of use is restricted to 3 months and only in patients who do not respond to alternative treatments or for whom such treatments are not suitable, for example those with severe renal impairment.
Danish: • Udvalget betragtede derfor benefit/risk-forholdet for injektionslægemidler, der indeholder calcitonin, under normale anvendelsesbetingelser i hver af de autoriserede indikationer og konkluderede, at: o til behandling af Pagets sygdom forbliver benefit/risk-forholdet positivt, forudsat at varigheden af anvendelsen er indskrænket til 3 måneder og kun til patienter, der ikke reagerer på andre behandlinger, eller for hvem sådanne behandlinger ikke er egnede, for eksempel dem med svær nyreinsufficiens.
English: The company also provided information from a variety of supportive studies.
Danish: Virksomheden fremlagde også oplysninger fra en række underbyggende studier.
English: As for every medicine, this included studies showing that the medicine was of acceptable quality.
Danish: Som for alle lægemidler omfattede disse studier, der viste, at lægemidlet var af acceptabel kvalitet.
English: Two medicines are bioequivalent when they produce the same levels of the active substance in the body.
Danish: To lægemidler er bioækvivalente, når de giver de samme niveauer af det aktive stof i kroppen.
English: This reduces the risk of blood vessels becoming blocked.
Danish: Dette mindsker risikoen for, at blodkarrene bliver blokeret.
English: Further information on Xromi can be found on the Agency's website: ema.europa.eu/medicines/human/EPAR/xromi .
Danish: Yderligere information vedrørende Xromi findes på agenturets websted under: ema.europa.eu/medicines/human/EPAR/xromi.
English: This means that it is similar to a ‘reference medicine' containing the same active substance, but is given as a liquid to be swallowed rather than as capsules and is authorised for different uses.
Danish: Det betyder, at det er identisk med et "referencelægemiddel", som indeholder det samme aktive stof, men som gives som en væske til at drikke i stedet for som kapsler, og som er godkendt til forskellige anvendelser.
English: It must not be used in pregnancy, and breast-feeding must be stopped while taking the medicine.
Danish: Det må ikke anvendes under graviditet, og amningen skal afbrydes, så længe lægemidlet anvendes.
English: As for all medicines, data on the use of Xromi are continuously monitored.
Danish: Som for alle lægemidler bliver data vedrørende brugen af Xromi løbende overvåget.
English: Other information about Xromi
Danish: Andre oplysninger om Xromi
English: What measures are being taken to ensure the safe and effective use of Xromi?
Danish: Hvilke foranstaltninger træffes der for at sikre risikofri og effektiv anvendelse af Xromi?
English: Patients should drink water after a dose of Xromi to ensure the full dose reaches the stomach.
Danish: Patienter bør drikke vand efter indtagelsen af Xromi for at sikre, at hele dosen når ned i maven.
English: Xromi must also not be used in patients taking medicines to treat HIV infection.
Danish: Xromi må heller ikke anvendes til patienter, der får lægemidler til behandling af hiv-infektion.
English: Therefore the European Medicines Agency decided that Xromi's benefits are greater than its risks and it can be authorised for use in the EU.
Danish: Det Europæiske Lægemiddelagentur konkluderede derfor, at fordelene ved Xromi opvejer risiciene, og at det kan godkendes til anvendelse i EU.
English: The company that markets Xromi will put in place an educational programme for doctors and patients about the correct use of the medicine and preventing harm, including guidance on use of the appropriate syringe for dosing and the need for regular blood testing.
Danish: Virksomheden, der markedsfører Xromi, vil indføre et uddannelsesprogram for læger og patienter om korrekt brug af lægemidlet og forebyggelse af skader, herunder vejledning om brug af den rette injektionssprøjte til doseringen og behovet for regelmæssige blodprøver.
English: This included information from 4 main studies in sickle cell disease, including 3 studies involving 384 adults and children in whom hydroxycarbamide was shown to substantially reduce the risk of severe, painful blockages of blood supply (called vaso-occlusive crises) compared with a dummy treatment, and a fourth study involving 121 children that showed hydroxycarbamide to be at least as effective as standard treatment using blood transfusions in reducing blood vessel damage in the brain and the risk of stroke.
Danish: Dette omfattede oplysninger fra 4 hovedstudier af seglcellesygdom, herunder 3 studier med 384 voksne og børn, hvor hydroxycarbamid viste sig at reducere risikoen for alvorlige og smertefulde blokeringer af blodforsyningen (kaldet vaso-okklusive kriser) i betydelig grad i forhold til en virkningsløs behandling, og et fjerde studie med 121 børn, der viste, at hydroxycarbamid er mindst lige så effektivt som standardbehandling med blodtransfusioner til at reducere skader på blodkar i hjernen og risiko for slagtilfælde.
English: Because hydroxycarbamide is a well-established substance that has been used for many years in the EU the company provided information from the published literature on the benefits and risks of hydroxycarbamide in its approved uses.
Danish: Da hydroxycarbamid er et veletableret stof, der har været anvendt i mange år i EU, fremlagde virksomheden oplysninger fra den offentliggjorte litteratur om fordelene og risiciene ved hydroxycarbamid i de godkendte anvendelser.
English: Xromi is available as a liquid to be swallowed containing hydroxycarbamide 100 mg/mL, and doses are based on the patient's body weight.
Danish: Xromi fås som en væske til at drikke, der indeholder hydroxycarbamid 100 mg/ml, og doserne er baseret på patientens kropsvægt.
English: Side effects reported with Xromi are carefully evaluated and any necessary action taken to protect patients.
Danish: De indberettede bivirkninger ved Xromi vurderes omhyggeligt, og der træffes de nødvendige forholdsregler for at beskytte patienterne.
English: Xromi (hydroxycarbamide)
Danish: Xromi (hydroxycarbamid)
English: For more information about using Xromi, see the package leaflet or contact your doctor or pharmacist.
Danish: Hvis du ønsker mere information om anvendelsen af Xromi, kan du læse indlægssedlen eller kontakte lægen eller apotekspersonalet.
English: The most common side effects with Xromi (which may affect more than 1 in 10 people) are bone marrow suppression (reduced ability to produce blood cells) and reduced fertility in men due to oligospermia (low sperm counts) or azoospermia (absence of sperm).
Danish: De hyppigste bivirkninger ved Xromi (som kan forekomme hos mere end 1 ud af 10 personer) er undertrykkelse af knoglemarven (nedsat evne til at producere blodceller) og nedsat fertilitet hos mænd som følge af oligospermi (lavt spermtal) eller azospermi (fravær af sæd).
English: Xromi is a ‘hybrid medicine'.
Danish: Xromi er et "hybridlægemiddel".
English: Hydroxycarbamide, which used to be known as hydroxyurea, has been used for many years to treat sickle cell disease, and has been authorised in EU countries for several decades as Hydrea for use in some types of cancer.
Danish: Hydroxycarbamid, der har været kendt som hydroxyurea, har i mange år været anvendt til behandling af seglcellesygdom og har i flere årtier været tilladt i EU-lande som Hydrea til brug ved visse former for kræft.
English: The active substance in Xromi, hydroxycarbamide, blocks the growth and reproduction of some cells, such as blood cells.
Danish: Det aktive stof i Xromi, hydroxycarbamid, blokerer væksten og reproduktionen af visse celler, f.eks. blodceller.
English: An overview of Xromi and why it is authorised in the EU
Danish: Oversigt over Xromi, og hvorfor det er godkendt i EU
English: What is Xromi and what is it used for?
Danish: Hvad er Xromi, og hvad anvendes det til?
English: The company provided updated information showing the benefits of hydroxcarbamide in preventing complications of sickle cell disease in patients over 2 years of age.
Danish: Virksomheden fremlagde opdaterede oplysninger, der viste fordelene ved hydroxycarbamid til forebyggelse af seglcellesygdom hos patienter over 2 år.
English: Although the way that it works in this disease is not fully understood, hydroxycarbamide can reduce the numbers of cells that are circulating in the blood, as well as prevent red blood cells changing shape in patients with sickle cell disease.
Danish: Selv om det ikke helt vides, hvordan det virker på denne sygdom, kan hydroxycarbamid reducere antallet af celler, der cirkulerer i blodet, og forhindre røde blodlegemer i at ændre form hos patienter med seglcellesygdom.
English: Xromi is used to prevent so-called vaso-occlusive complications - problems that happen when blood vessels become blocked by the abnormal red blood cells, restricting the flow of blood to parts of the body.
Danish: Xromi anvendes til at forebygge såkaldte vaso-okklusive komplikationer - problemer, der opstår, når blodkarrene bliver blokeret af de abnorme røde blodlegemer, hvilket begrænser strømmen af blod til dele af kroppen.
English: Why is Xromi authorised in the EU?
Danish: Hvorfor blev Xromi godkendt i EU?
English: Xromi must not be used in people who have severe problems with their kidneys or liver, or who have dangerously low blood cell counts.
Danish: Xromi må ikke anvendes til personer med svære nyre- eller leverproblemer, eller som har faretruende lave blodcelletal.