FrancophonIA/ELRC3.0 huggingface dataset:
English: For the suspension to be lifted, the Marketing Authorisation Holders should provide convincing data to identify a patient population in which the benefits of meprobamate clearly outweigh its identified risks (see Annex III of the Opinion).
Danish: For at opnå ophævelse af suspenderingen skal indehaverne af markedsføringstilladelserne fremlægge overbevisende data, der gør det muligt at udpege en patientpopulation, hos hvem fordelene ved meprobamat klart overstiger de fundne risici (se bilag III til denne udtalelse).
English: Seven comas had a fatal outcome.
Danish: Syv tilfælde af koma fik dødelig udgang.
English: In particular, restriction to hospital-use only was not considered practical, given the nature of the indications and the duration of treatment.
Danish: Navnlig blev begrænsningen af udleveringen til hospitalsbrug ikke anset for praktisk mulig på baggrund af indikationer og behandlingsvarighed for produktet.
English: Some MAHs nonetheless proposed minor amendments to the product information, in particular with regard to treatment duration.
Danish: Nogle indehavere af markedsføringstilladelse foreslog dog mindre ændringer af produktinformationen, navnlig behandlingsvarigheden.
English: Regarding the meprobamate/aceprometazine combination products, the second Lille CPRV analysis identified 365 medically confirmed cases during the study period, of which 277 (76%) were recorded as serious (corresponding to 894 adverse events) while 88 were recorded as non-serious (corresponding to 153 adverse events).
Danish: For kombinationsprodukter med meprobamat/aceprometazin fandtes i den anden analyse fra CPRV i Lille 365 lægeligt bekræftede tilfælde i undersøgelsesperioden, hvoraf de 277 (76 %) var registreret som alvorlige (svarende til 894 bivirkninger), mens 88 var registreret som ikke-alvorlige (svarende til 153 bivirkninger).
English: There were also reports of consciousness disorders (36 cases), falls (30 cases), hypotension (26 cases) and confusion and disorientation (20 cases).
Danish: Der var desuden indberetninger om bevidsthedsforstyrrelser (36 tilfælde), fald (30 tilfælde), hypotension (26 tilfælde) og konfusion og desorientering (20 tilfælde).
English: The CHMP noted that despite the 10% decrease in the proportion of elderly patient during the current study period, elderly patients remained the main affected age group (40% of patients over 65 years of age and 32% of patients over 75 years of age).
Danish: CHMP bemærkede, at der havde været en nedgang på 10 % i andelen af ældre patienter i den aktuelle undersøgelsesperiode, men at ældre patienter fortsat var den vigtigste berørte gruppe (40 % af patienter over 65 år og 32 % af patienter over 75 år).
English: 6 cases of inhalation pneumopathy and 3 cases of addiction/withdrawal were reported.
Danish: Der var indberettet seks tilfælde af inhalationsbetinget lungesygdom og tre tilfælde af afhængighed/abstinenser.
English: A number of indications are approved across Europe, including aid for alcohol withdrawal, treatment of anxiety states, treatment of muscle tension, cramps or spastic state of voluntary muscles, symptomatic treatment of digestive functional disorders, treatment of migraine attacks and treatment of occasional insomnia.
Danish: En række indikationer er godkendt i Europa: behandling af alkoholabstinenser, behandling af angsttilstande, behandling af muskelspændinger, kramper eller spastisk tilstand af voluntære muskler, symptomatisk behandling af funktionelle fordøjelsesforstyrrelser, behandling af migræneanfald og behandling af lejlighedsvist søvnbesvær.
English: The analysis concluded that the reporting rate for meprobamate/aceprometazine did not decrease following the implementation of the risk minimisation measures.
Danish: I analysen konkluderedes, at indberetningsfrekvensen for meprobamat/aceprometazin ikke aftog efter gennemførelsen af risikominimeringsforanstaltningerne.
English: While the CHMP noted the minor decrease in the number of elderly patients, it raised concerns over the high proportion of elderly patients using the product.
Danish: CHMP noterede sig det lille fald i antallet af ældre patienter, men udtrykte betænkelighed ved den høje andel af ældre patienter, der anvendte produktet.
English: 30 fatal cases were recorded during the study period, of which 27 were associated with the use of psychotropic drugs and 20 were recorded as overdoses.
Danish: I undersøgelsesperioden blev der registreret 30 tilfælde med dødelig udgang, hvoraf 27 var relateret til anvendelse af psykoaktive lægemidler, og 20 var registreret som tilfælde af overdosering.
English: The most frequently encountered serious adverse events were comas (11 cases), consciousness disorders (16 cases), confusion states (15 cases) and intoxications (33 cases, including deliberate, accidental or nonspecified).
Danish: De hyppigst optrædende alvorlige bivirkninger var koma (11 tilfælde), bevidsthedsforstyrrelser (16 tilfælde), konfusionstilstande (15 tilfælde) og forgiftninger (33 tilfælde, herunder forsætlige, accidentelle og uspecificerede).
English: Finally, the CHMP noted a non-fatal case of coma, following severe liver failure, in a cirrhotic patient.
Danish: Endelig bemærkede CHMP et ikke-dødeligt tilfælde af koma efter svært leversvigt hos en patient med cirrhose.
English: The measures were also inadequate to address the risk of pharmacodependence and of serious withdrawal symptoms.
Danish: Foranstaltningerne var desuden utilstrækkelige til at imødegå risikoen for lægemiddelafhængighed og alvorlige abstinenssymptomer.
English: 7 fatalities associated with meprobamate were reported during the study period (including 2 due to overdoses).
Danish: 7 dødsfald med relation til meprobamat indberettedes i løbet af undersøgelsesperioden (herunder to som følge af overdosering).
English: The risks of serious withdrawal symptoms were also acknowledged by the MAH during the oral explanation.
Danish: Risiciene for alvorlige abstinenssymptomer blev desuden erkendt af indehaveren af markedsføringstilladelsen under den mundtlige redegørelse.
English: Finally, the CHMP also noted a clinical epidemiological study by Kovacs et al, 2002, which reported 25 cases of accidental overdoses with meprobamate.
Danish: Endelig bemærkede CHMP en klinisk epidemiologisk undersøgelse udført af Kovacs et al, 2002, hvor der blev beskrevet 25 tilfælde af accidentel overdosering med meprobamat.
English: The CHMP was of the opinion that the identified risks persist, despite the implemented risk minimisation measures, particularly in patients over the age of 65, who are at high risk of falls and confusion.
Danish: Det var CHMP's opfattelse, at de påviste risici fortsat er til stede trods de gennemførte risikominimeringsforanstaltninger, navnlig for patienter over 65 år, som har høj risiko for fald og konfusion.
English: In summary, the CHMP noted the 52 fatal cases identified (including 30 cases of overdoses) in the two French pharmacovigilance analyses, for which an association with meprobamate was considered possible.
Danish: Sammenfattende bemærkede CHMP de 52 tilfælde med dødelig udgang (herunder 30 tilfælde af overdosering) i de to franske analyser efter markedsføring, som blev anset for at have mulig sammenhæng med meprobamat.
English: The CHMP was concerned by the identified risk of pharmacodependence, including in cases under normal conditions of use, as suggested by the 17 reported cases of pharmacodependence and withdrawal symptoms (13 serious and 4 non-serious).
Danish: CHMP var betænkelig ved den påviste risiko for lægemiddelafhængighed, også under normale anvendelsesbetingelser, således som de 17 indberettede tilfælde af lægemiddelafhængighed og abstinenssymptomer (13 alvorlige og 4 ikke-alvorlige) tyder på.
English: Other frequent SOCs were psychiatric disorders, skin and subcutaneous tissue disorders, and haematologic and lymphatic disorders (6-9% each).
Danish: Andre ofte forekommende SOC var psykiske forstyrrelser, hud og subkutane væv samt blod- og lymfesystemet (6-9 % for hver kategori).
English: One MAH suggested that further to the treatment duration restriction already implemented in France, the only way to reduce the number of voluntary overdose cases would be to restrict the use of the product to hospital-use only.
Danish: En indehaver af markedsføringstilladelse fremførte, at ud over den allerede gennemførte begrænsning af behandlingsvarigheden i Frankrig ville den eneste mulighed for at mindske antallet af tilfælde med forsætlig overdosering være, at udlevering af produktet blev forbeholdt sygehuse.
English: The first analysis reviewed meprobamate-only products, indicated as withdrawal aid for alcoholdependent subjects, with a treatment duration of 1 to 3 weeks, with a maximum of 12 weeks.
Danish: Den første analyse gennemgik enkeltstofpræparater med meprobamat indiceret til alkoholafvænning med en behandlingsvarighed på 1-3 uger, maksimalt 12 uger.
English: The CHMP therefore concluded that accidental overdoses are a serious risk with meprobamate.
Danish: CHMP konkluderede derfor, at accidentel overdosering er en alvorlig risiko i forbindelse med meprobamat.
English: In summary, the CHMP assessed the totality of the available data, including responses submitted by the MAHs in writing and during an oral explanation, as well as the nationally-conducted French pharmacovigilance assessments.
Danish: Sammenfattende vurderede CHMP alle de foreliggende data, herunder de af indehaverne af markedsføringstilladelserne afgivne besvarelser, dels skriftligt, dels ved den mundtlige redegørelse, samt de nationalt udførte franske vurderinger af lægemiddelovervågning.
English: The second analysis reviewed a combination product containing meprobamate together with aceprometazine, indicated in the treatment of occasional insomnia, with a treatment duration of 2 to 5 days.
Danish: Den anden analyse gennemgik et kombinationsprodukt indeholdende meprobamat kombineret med aceprometazin til indikationen lejlighedsvist søvnbesvær med en behandlingsperiode på 2-5 dage.
English: Consequently, the CHMP recommended to the European Commission the suspension of the Marketing Authorisations of meprobamate-containing medicinal products listed in Annex I of the Opinion in all concerned EU Member States, to be effective within 15 months of the adoption of the European Commission Decision, in order to ensure the safe termination of treatment or switching of patients already being treated with meprobamate.
Danish: anbefalede CHMP Europa-Kommissionen at suspendere markedsføringstilladelserne for de i bilag 1 til denne udtalelse nævnte lægemidler indeholdende meprobamat i samtlige berørte EU medlemsstater med virkning 15 måneder fra vedtagelsen af Europa-Kommissionens afgørelse for at sikre risikofrit behandlingsophør eller behandlingsskift for patienter, der aktuelt er i behandling med meprobamat.
English: Elderly patients constitute a considerable proportion of patients and use in this population is of concern, especially considering the increased risk of adverse events due to interactions with concomitant medication.
Danish: Ældre patienter udgør en betydelig andel af patienterne, og anvendelse hos denne population vækker betænkelighed, navnlig i betragtning af den øgede bivirkningsrisiko gennem interaktioner med anden samtidig medicinering.
English: The CHMP also reviewed spontaneous case reports submitted to the Eudravigilance database and identified 18 cases of accidental overdoses, of which 17 were fatal.
Danish: CHMP gennemgik desuden spontane case-rapporter, der var indsendt til Eudravigilance-databasen, og bemærkede 18 tilfælde af accidentel overdosering, heraf 17 med dødelig udgang.
English: However, the CHMP was of the opinion that this may have increased the risks of adverse events with meprobamate due to interactions and therefore it cannot be excluded that meprobamate may have had a contributory role.
Danish: CHMP fandt imidlertid, at dette kan have medført øget risiko for bivirkninger af meprobamat som følge af interaktioner, hvorfor det ikke kan udelukkes, at meprobamat har bidraget.
English: Based on the same Eudravigilance dataset, the CHMP also noted 11 cases of withdrawal symptoms, of which one was fatal.
Danish: På grundlag af samme Eudravigilance-datasæt bemærkede CHMP desuden 11 tilfælde af abstinenssymptomer, heraf ét med dødelig udgang.
English: Giving due consideration to the serious risk of withdrawal symptoms, the CHMP recommended that the withdrawal of meprobamate from the market should be implemented over a 15 month period, in order to ensure the safe termination of treatment or switching of patients already being treated with meprobamate.
Danish: Med behørigt hensyn til den alvorlige risiko for abstinenssymptomer anbefalede CHMP, at tilbagetrækningen af meprobamat fra markedet gennemføres over en periode på 15 måneder for at sikre risikofrit ophør af behandling eller overgang til anden behandling for patienter i behandling med meprobamat.
English: The CHMP noted that the available data on the efficacy of meprobamate is limited in some indications and non-existent in others.
Danish: CHMP konstaterede, at de foreliggende data om virkningen af meprobamat for visse indikationers vedkommende er begrænsede, og for andres vedkommende ikke-eksisterende.
English: • The Committee raised concerns regarding the considerable proportion of elderly patients and regarding use in this population, especially considering the increased risk of adverse events due to interactions with concomitant medication.
Danish: • udvalget rejste betænkeligheder ved den betydelige andel af ældre patienter og anvendelsen hos denne population, navnlig på baggrund af den øgede risiko for bivirkninger gennem interaktioner med anden samtidig medicinering,
English: Two recent pharmacovigilance analyses of data from spontaneous reports, conducted by the Lille CRPV (Centre régional de pharmacovigilance) and finalised in 2011, did not identify any significant impact of the implemented risk minimisation measures and noted the lack of clinical data on the benefit of these products.
Danish: To nylige lægemiddelovervågningsanalyser af data fra spontane indberetninger, som blev udført af CRPV (Centre régional de pharmacovigilance) i Lille og afsluttet i 2011, viste ikke nævneværdig virkning af risikominimeringsforanstaltningerne, men påpegede, at der manglende kliniske data vedrørende produkternes fordele.
English: Meprobamate is considered to have a relatively narrow therapeutic index, with a steep dose-response curve, resulting in an increased risk of unintentional overdoses with serious and potentially fatal adverse events, including coma, profound hypotension, hypothermia, respiratory arrest and cardiogenic shock.
Danish: Meprobamat anses for at have et relativt smalt terapeutisk indeks med en stejl dosis-responskurve, hvilket medfører øget risiko for accidentel overdosering med alvorlige og potentielt dødelige bivirkninger, herunder koma, dyb hypotension, hypotermi, respirationsstop og kardiogent shock.
English: • The CHMP therefore concluded that the risk-benefit balance of meprobamate-containing medicinal products for oral use is not positive under normal conditions of use.
Danish: • CHMP konkluderede derfor, at benefit/risk-forholdet for lægemidler indeholdende meprobamat ikke er positivt under normale anvendelsesbetingelser,
English: • The CHMP considered that the available data showed only very limited clinical efficacy of meprobamate in its approved indications.
Danish: • CHMP fandt, at de foreliggende data kun viser meget begrænset klinisk virkning af meprobamat til de godkendte indikationer,
English: Therefore, in order to assess the safety profile of meprobamate, mainly neurological and psychiatric adverse events, including pharmacodependence and serious withdrawal symptoms under normal conditions of use, particularly in the elderly, the CHMP reviewed the data from the two pharmacovigilance analyses of safety data on meprobamate conducted by the Lille CRPV, which were the basis of the Afssaps decision to suspend the marketing authorisations for the products concerned.
Danish: For at vurdere sikkerhedsprofilen af meprobamat, især neurologiske og psykiatriske bivirkninger, herunder lægemiddelafhængighed og alvorlige abstinenssymptomer under normale anvendelsesbetingelser, navnlig hos ældre, gennemgik CHMP data fra de to lægemiddelovervågningsanalyser af sikkerhedsdata for det aktive stof, der var udført af CRPV i Lille og var grundlag for Afssaps's beslutning om at suspendere markedsføringstilladelserne for de berørte produkter.
English: The CHMP also noted that the available medical practice guidelines for anxiety disorder, alcohol withdrawal and migraine do not recommend meprobamate.
Danish: CHMP bemærkede desuden, at de foreliggende retningslinjer for behandling af angsttilstande, alkoholabstinenser og migræne ikke indeholder en anbefaling af at anvende meprobamat.
English: The CHMP also acknowledged the potential confounding effect of co-medication as patients were co-medicated in almost all cases, particularly with psychotropic drugs.
Danish: CHMP anerkendte i øvrigt den potentielle konfunderende effekt af comedicinering i næsten alle tilfældene, især med psykoaktive midler.
English: The CHMP reviewed the available data submitted by the MAHs but considered that this limited data was insufficient to conclude on the safety of meprobamate and the predictability of any associated risks.
Danish: CHMP gennemgik de foreliggende data, der var indsendt af indehaverne af markedsføringstilladelserne, men fandt disse begrænsede data utilstrækkelige til at drage konklusioner om sikkerheden af meprobamat og forudsigeligheden af eventuelle tilknyttede risici.
English: Regarding meprobamate-only products, the first Lille CPRV analysis identified 119 medically confirmed cases following the implementation of the risk minimisation measures, which was similar to the data for the period prior to the implementation, despite an assumed reduction in patient exposure, based on sales data.
Danish: For enkeltstofprodukter indeholdende meprobamat fandtes 119 lægeligt bekræftede tilfælde i den første analyse udført af CPRV i Lille efter gennemførelsen af risikominimeringsforanstaltningerne, hvilket svarede til perioden inden gennemførelsen, skønt salgstallene lod formode, at patienteksponeringen var faldet.
English: Following a number of French national safety and efficacy reviews and pharmacovigilance analyses of meprobamate, the French National Competent Authority (Afssaps) implemented risk minimisation measures to reduce the identified risks of meprobamate and initiated national pharmacovigilance analyses to assess the impact of these measures.
Danish: Efter at der var foretaget en række nationale franske gennemgange af sikkerhed og virkning samt lægemiddelovervågningsanalyser af meprobamat, indførte de franske kompetente myndigheder (Afssaps) risikominimeringsforanstaltninger med henblik på de konstaterede risici ved meprobamat og iværksatte nationale lægemiddelovervågningsanalyser til vurdering af foranstaltningernes virkning.
English: Meprobamate is a carbamate derivative, acting as a central nervous system depressant with anxietyrelieving, sedative and muscle relaxant activity.
Danish: Meprobamat, der er et derivat af carbamat, er et CNS-deprimerende middel med anxiolytisk, sedativ og muskelafslappende virkning.
English: In addition, Afssaps was particularly concerned by adverse events in elderly patients.
Danish: Derudover var der i Afssaps 101 særlig betænkelighed ved bivirkninger hos ældre patienter.
English: During the study period, the main adverse events occurred generally in the SOCs nervous system disorders (34%), procedure-related lesions/intoxications and complications (8%) and general disorders (8%).
Danish: I undersøgelsesperioden forekom de vigtigste rapporterede bivirkninger hovedsagelig i systemorganklasserne (SOC) nervesystemet (34 %) og procedurebetingede skader/forgiftninger og almene symptomer (8 %).
English: The CHMP also noted the pharmacovigilance analyses of the impact of the risk minimisation measures for meprobamate and meprobamate/aceprometazine implemented in France, which did not result in a significant nor sufficient reduction of the incidence of adverse reactions associated with meprobamate, including in cases of normal conditions of use.
Danish: CHMP noterede sig desuden lægemiddelovervågningsanalyserne af virkningen af de risikominimeringsforanstaltninger for meprobamat og meprobamat/aceprometazin, der var gennemført i Frankrig uden at medføre nævneværdig eller tilstrækkelig reduktion af incidensen af bivirkninger med sammenhæng med meprobamat, heller ikke under normale anvendelsesbetingelser.
English: One MAH considered the benefit-risk of meprobamate to be negative in the alcohol withdrawal indication and proposed to remove the indication where authorised.
Danish: Én indehaver af markedsføringstilladelse anså benefit/risk-forholdet for meprobamat for at være negativt ved indikationen alkoholabstinenser og ville slette denne indikation, hvor den er godkendt.
English: Meprobamate can cause physical and psychological dependence and a potentially life-threatening abstinence syndrome with delirium on abrupt withdrawal, in particular after prolonged use, with pharmacological effects similar to those of alcohol and barbiturates, including within the normal dosage and treatment duration, due to the nature of the product.
Danish: Meprobamat kan medføre fysisk og psykisk afhængighed og et potentielt livstruende abstinenssyndrom med delirium ved pludselig seponering, navnlig efter langvarig brug, og med farmakologiske virkninger svarende til virkningerne af alkohol og barbiturater.
English: The CHMP noted that the majority of MAHs responded that they considered the benefit-risk of their products to be positive and that routine pharmacovigilance activities were sufficient to address the identified safety concerns.
Danish: CHMP konstaterede, at størstedelen af indehaverne af markedsføringstilladelserne svarede, at de anså benefit/risk-forholdet for deres produkter for positivt, og at de fundne sikkerhedsmæssige betænkeligheder ville kunne imødekommes tilfredsstillende ved sædvanlig lægemiddelovervågning.
English: The CHMP concluded that no risk minimisations measures could be identified that would adequately reduce the identified risks associated with the use of meprobamate to a clinically acceptable level, especially with regard to elderly patients and the risk of pharmacodependence.
Danish: CHMP konkluderede, at der ikke kan udpeges risikominimeringsforanstaltninger, der vil mindske de konstaterede risici ved brugen af meprobamat til et klinisk acceptabelt niveau, navnlig vedrørende ældre patienter og risikoen for lægemiddelafhængighed.
English: Meprobamate may induce generalized tonic-clonic attacks in the predisposed which may be a drawback during alcohol withdrawal, a condition characterized by an increased susceptibility to convulsions.
Danish: Meprobamat kan fremkalde generaliserede tonisk-kloniske attakker hos prædisponerede personer, hvilket kan være uheldigt ved alkoholabstinenser karakteriseret af øget krampetendens.
English: This analysis assessed the impact of the implementation of the 2009 risk minimisation measures (restriction of the indications, reduction of pack size and circulation of a DHPC) on their risk profile.
Danish: Denne analyse vurderede virkningen på produkternes risikoprofil af gennemførelsen af risikominimeringsforanstaltningerne i 2009 (indskrænkning af indikationerne, begrænsning af pakningsstørrelsen og udsendelse af en DHPC).
English: The CHMP was of the opinion that patients who are being treated for alcohol withdrawal are at risk of serious adverse reactions, given that liver function is likely to be affected in most patients with chronic alcohol problems.
Danish: CHMP var af den opfattelse, at patienter, der behandles for alkoholabstinenser, risikerer alvorlige bivirkninger på baggrund af, at leverfunktionen må forventes at være nedsat hos de fleste patienter med kroniske alkoholproblemer.