FrancophonIA/ELRC3.0 huggingface dataset:
English: The MAH discussed fusafungine primarily as an antibiotic.
Danish: Indehaveren af markedsføringstilladelsen omtaler primært fusafungin som et antibiotikum.
English: This was based on a recent Cochrane review (Reveiz, et al, 2015) which concluded that the outcomes achieved by fusafungine was not relevant in clinical practice, and that antibiotics appeared to have no benefits in the treatments of acute laryngitis in adults that may not outweigh the risk of adverse effects and negative consequences for antibiotic resistance patterns.
Danish: Disse betænkeligheder er baseret på det seneste Cochrane-vurdering (Reveiz et al., 2015), der konkluderer, at de resultater, der er opnået med fusafungin, ikke er relevante i klinisk praksis, og at antibiotika-behandling af akut laryngitis ikke synes at have fordele, der opvejer risikoen for bivirkninger og negative effekter på antibiotikas resistensmønstre.
English: With regards to the antimicrobial activity, the MAH submitted several studies presenting the Minimum Inhibitory Concentration (MIC) data for fusafungine for a wide range of clinical isolates (bacterial species and fungi), claiming that there was no significant change in the observed MICs after fusafungine exposure.
Danish: Med hensyn til den antimikrobielle aktivitet har indehaveren af markedsføringstilladelsen fremlagt flere undersøgelser med mindste hæmmende koncentration (MIC)-relaterede data for fusafungin, hvad angår en lang række kliniske isolater (bakteriearter og svampe), og anført, at der ikke ses signifikante ændringer i de observerede MIC-relaterede data efter eksponering for fusafungin.
English: While the anti-bacterial effect of fusafungine is presented by the MAH as beneficial to the antiinflammatory effect, the PRAC is of the view that anti-bacterial effect can be regarded as a potential risk because it cannot be excluded that the medicine might induce antimicrobial resistance and interfere with the throat microbiota.
Danish: Selv om indehaveren af markedsføringstilladelsen beskriver fusafungins antibakterielle effekt som gavnlig for den antiinflammatoriske virkning, er PRAC af den opfattelse, at en antibakteriel effekt kan betragtes som en potentiel risiko, fordi det ikke kan udelukkes, at lægemidlet kan inducere antimikrobiel resistens og interferere med halsens mikroflora.
English: In order to minimize the risk of allergic reactions, the MAH proposed the several risk minimisation measures (RMMs) within the above mentioned variation including an extension of the existing contraindication in children (by restricting the age limit from less than 30 months to less than 12 years of age) and the introduction of a contraindication regarding the use in patients with allergic tendencies and bronchospasm.
Danish: For at minimere risikoen for allergiske reaktioner har indehaveren af markedsføringstilladelsen foreslået en række risikominimerende foranstaltninger i ovennævnte variation, herunder en udvidelse af den eksisterende kontraindikation til også at omfatte lidt større børn (ved at ændre aldersgrænsen fra under 30 måneder til under 12 år) og indførelse af en kontraindikation mod anvendelse hos patienter med allergi og bronkospasmer.
English: However several methodological challenges were noted by the PRAC, the limitations of the studies being inherent to the standards at the time of registration.
Danish: Undersøgelsernes begrænsninger skyldes standarderne på registreringstidspunktet.
English: The PRAC noted that no established susceptibility interpretive criteria (clinical breakpoints) for fusafungine were determined by EUCAST (European Committee for Antibacterial Susceptibility Testing) in Europe or CLSI (Clinical and Laboratory Standards Institution) in the US.
Danish: PRAC bemærker, at EUCAST-komitéen (European Committee on Antibacterial Susceptibility Testing) i Europa eller CLSI-instituttet (Clinical and Laboratory Standards Institute) i USA ikke har fastsat nogen fortolkningskriterier for fusafungin-følsomhed (kliniske breakpoints).
English: The PRAC considered that the risk minimisations measures proposed and discussed during the assessment were not sufficient to reduce the risk.
Danish: PRAC mener, at de foreslåede og drøftede risikominimerende foranstaltninger ikke er tilstrækkelige til at reducere risikoen.
English: In addition to the data from clinical trials, the PRAC reviewed data from spontaneous reports provided by the MAH.
Danish: Ud over dataene fra kliniske undersøgelser har PRAC gennemgået dataene fra spontane indberetninger fra indehaveren af markedsføringstilladelsen.
English: • The PRAC considered that the available efficacy data, including data which became available since the initial marketing authorisation, and concluded that the evidence for beneficial effects of fusafungine in all approved indications is weak and such effects are not clinically meaningful.
Danish: • På baggrund af de tilgængelige effektdata, herunder data, der er blevet tilgængelige efter den oprindelige markedsføringstilladelse, konkluderer PRAC, at evidensen for fusafungins gavnlige virkninger i alle de godkendte indikationer er svag, og at disse virkninger ikke giver klinisk mening.
English: The PRAC noted that there have been 6 fatal cases reported post-marketing since the first MA of fusafungine.
Danish: PRAC bemærker, at der siden den første markedsføringstilladelse for fusafungin er rapporteret om 6 tilfælde med dødelig udgang.
English: Overall, based on the above and the views expressed by the experts of the CHMP SAG in AntiInfectives, the PRAC considered that the available efficacy data, including data which became available since the initial marketing authorisation, showed only limited efficacy of local fusafungine in its approved indications which does not translate into evidence of a benefit for patients in the current context of the therapeutic strategy and knowledge acquired in diseases in the upper respiratory airways.
Danish: På baggrund af ovenstående og udtalelserne fra eksperterne i CHMP's videnskabelige rådgivende gruppe inden for antiinfektiva mener PRAC generelt, at de tilgængelige effektdata, herunder data, der er blevet tilgængelige efter udstedelsen af den oprindelige markedsføringstilladelse, kun viser en begrænset effekt ved lokal fusafungin i de godkendte indikationer, som ikke giver tilstrækkelig evidens for en gavnlig effekt hos patienterne i betragtning af den aktuelle behandlingsstrategi og viden inden for sygdomme i de øvre luftveje.
English: • angioedema - 3.8% (7.7%).
Danish: • angioødem - 3,8 % (7,7 %).
English: Overall, based on data from spontaneous reports and safety information available from other sources, the PRAC considers that fusafungine use is associated with serious cases of allergic reactions, potentially with short time to onset, which may be fatal.
Danish: På grundlag af data fra spontane indberetninger og sikkerhedsoplysninger fra andre kilder vurderer PRAC generelt, at brug af fusafungin er forbundet med alvorlige tilfælde af allergiske reaktioner med potentielt kort tid til debut og potentiel dødelig udgang.
English: The serious and fatal cases concern patients of different age-ranges; the contraindications for patients under 12 years of age and patients with a history of allergy will not prevent severe or life-threatening events.
Danish: Kontraindikationerne for patienter under 12 år og patienter med allergi i anamnesen vil ikke forhindre alvorlige eller livstruende hændelser.
English: Later in the procedure, the MAH re-defined fusafungine as a primarily anti-inflammatory medicine for symptomatic relief of acute (and predominantly viral) rhinopharyngitis.
Danish: Senere i proceduren redefinerer indehaveren af markedsføringstilladelsen fusafungin som et primært antiinflammatorisk lægemiddel til symptomlindring ved akut (og fortrinsvis viral) rhinofaryngitis.
English: The PDCO questioned the place of this product in the treatment armamentarium of viral upper respiratory illnesses and concluded that information on limited beneficial effect in the literature, did not point towards a different clinical interest of fusafungine across the various paediatric age sub-groups.
Danish: Det Pædiatriske Udvalg sætter spørgsmålstegn ved produktets plads blandt midlerne til behandling af virale sygdomme i de øvre luftveje og konkluderer, at de oplysninger, man finder i i litteraturen om begrænset gavnlig effekt, ikke peger i retning af, at fusafungin har forskellig klinisk interesse i de forskellige pædiatriske aldersopdelte undergrupper.
English: The MAH submitted in vitro data regarding the anti-inflammatory activity of fusafungine suggesting that the mechanism of action of anti-inflammatory activity of fusafungine is complex (such as inhibition of release of ICAM-1, IL-1β, IL-6, IL-8, and TNF-α by human alveolar macrophages).
Danish: Indehaveren af markedsføringstilladelsen har fremlagt in vitro-data om fusafungins antiinflammatoriske aktivitet og anført, at virkningsmekanismen for fusafungins antiinflammatoriske aktivitet er kompleks (f.eks. humane alveolærmakrofagers hæmning af frigivelsen af ICAM-1, IL-1β, IL-6, IL-8 og TNF-α).
English: This was also based on the fact that, in the current state of knowledge, the studies available in support of the efficacy data for fusafungine may not completely fulfil requirements to demonstrate efficacy in particular with regards to infections sustained by Streptococcus pyogenes or Streptococcus viridans.
Danish: Betænkelighederne er også baseret på det forhold, at undersøgelserne til understøttelse af effektdataene for fusafungin med den nuværende viden måske ikke helt opfylder kravene til påvisning af lægemidlets effekt, navnlig hvad angår infektioner med Streptococcus pyogenes og Streptococcus viridans.
English: In addition, the PRAC also noted uncertainties relating to the putative mechanisms of action of the antibacterial and anti-inflammatory effects and the occurrence of antimicrobial resistance cannot be excluded.
Danish: Derudover har PRAC også bemærket, at der er visse usikkerhedsmomenter vedrørende de formodede virkningsmekanismer for den antibakterielle og antiinflammatoriske effekt, og forekomsten af antimikrobiel resistens kan ikke udelukkes.
English: In addition, in the Cochrane review by Reveiz et al. (2015), fusafungine or fusafungine plus clarithromycin in acute laryngitis in adults were more effective than no treatment only at day five, but no differences were found at days 8 and 28.
Danish: I Cochrane-vurderingen (Reveiz et al., 2015) var fusafungin eller fusafungin plus clarithromycin ved akut laryngitis hos voksne kun mere effektivt end ingen behandling efter fem dage.
English: • Furthermore, the PRAC could not identify any potential measure or condition, the fulfilment of which would demonstrate a positive benefit/risk balance for fusafungine in any of the current indications.
Danish: • Derudover har PRAC ikke kunnet identificere mulige foranstaltninger eller omstændigheder, der kan påvise et positivt benefit/risk-forhold for fusafungin, og dette gælder alle de aktuelle indikationer.
English: The PRAC acknowledged that specific information on the efficacy of fusafungine in documented infections sustained by streptococcus pyogenes or viridans could not be provided.
Danish: PRAC anerkender, at der ikke har kunnet fremlægges specifikke oplysninger om fusafungins virkning ved dokumenterede infektioner med Streptococcus pyogenes og Streptococcus viridans.
English: In line with the PDCO position, the PRAC concluded that the efficacy data of fusafungine-containing medicinal products for oromucosal and nasal use in the paediatric population is limited.
Danish: I overensstemmelse med Det Pædiatriske Udvalgs udtalelse konkluderer PRAC, at effektdataene for fusafungin-holdige lægemidler til anvendelse i mundhulen og næsen hos den pædiatriske population er begrænsede.
English: Based on the safety data from post marketing data, the PRAC is of the view that the risk minimisation measures proposed by the MAH would not be able to adequately reduce the risks of serious adverse reactions considering that the severity of hypersensitivity reactions cannot be predicted.
Danish: På baggrund af sikkerhedsdataene fra indberetninger efter markedsføring er PRAC af den opfattelse, at de risikominimerende foranstaltninger, som indehaveren af markedsføringstilladelsen har foreslået, ikke vil kunne reducere risiciene for alvorlige bivirkninger tilstrækkeligt i betragtning af, at overfølsomhedsreaktionernes sværhedsgrad ikke kan forudsiges.
English: The PRAC therefore concluded that the benefit-risk balance of fusafungine-containing medicinal products for oromucosal and nasal use is not favourable.
Danish: PRAC konkluderer derfor, at benefit/risk-forholdet for fusafungin-holdige lægemidler til anvendelse i mundhulen og næsen ikke er gunstigt.
English: The SAG agreed that notwithstanding some evidence supports the antibiotic and anti-inflammatory effects of fusafungine, the evidence from clinical trials was weak.
Danish: Den videnskabelige rådgivende gruppe mener også, at selv om der foreligger nogen evidens for fusafungins antibiotiske og antiinflammatoriske effekt, er evidensen fra kliniske undersøgelser svag.
English: The PRAC considered also the views expressed by experts such as the CHMP Scientific Advisory Group (SAG) in Anti-Infectives and the Paediatric Committee (PDCO).
Danish: PRAC har også taget højde for ekspertudtalelser fra f.eks. CHMP's videnskabelige rådgivende gruppe inden for antiinfektiva og Det Pædiatriske Udvalg.
English: Moreover, the available efficacy data showed only limited efficacy in support of the claimed indications of local fusafungine in rhinopharyngitis which does not translate in evidence of a benefit for patients in the current context of the therapeutic clinical practice.
Danish: Desuden har de tilgængelige effektdata ved anvendelse af lokal fusafungin ved rhinofaryngitis kun vist en begrænset virkning i de godkendte indikationer, som ikke giver tilstrækkelig evidens for en gavnlig effekt for patienterne ved den aktuelle behandling i klinisk praksis.
English: Based on the above data, the uncertainties relating to the mechanisms of action of the antiinflammatory and antibacterial effects were noted by the PRAC.
Danish: På baggrund af ovenstående data har PRAC bemærket usikkerhedsmomenterne vedrørende virkningsmekanismerne for antiinflammatorisk og antibakteriel effekt.
English: With regards to paediatric data, the advice of the Paediatric Committee (PDCO) was requested by the PRAC.
Danish: Hvad angår pædiatriske data, har PRAC bedt om en udtalelse fra Det Pædiatriske Udvalg.
English: Whilst acknowledging that patients with a medical history of allergy are at higher risk of developing allergic reaction, the PRAC also considered that serious allergic reactions including life-threatening even fatal ones also occurred in patients with no medical history of allergy.
Danish: PRAC anerkender, at patienter med allergi i anamnesen har større risiko for at udvikle allergiske reaktioner, men tager tillige højde for, at alvorlige allergiske reaktioner, herunder livstruende og endog fatale tilfælde, også er set hos patienter, der ikke tidligere har haft allergi.
English: When treating upper respiratory tract infections, the aetiology of which is mainly viral, with antibiotics, the risk for selecting antimicrobial resistance cannot be excluded.
Danish: Når man behandler infektioner i de øvre luftveje, hvis ætiologi primært er viral, med antibiotika, kan risikoen for selekteret antimikrobiel resistens ikke udelukkes.
English: Although some efficacy was shown at day 4, the PRAC is of the view that the endpoints were not clinically meaningful; at day 7 no differences were identified and the product was not superior to placebo.
Danish: På dag 7 er der ikke identificeret nogen forskelle, og produktet havde ikke en større virkning end placebo.
English: • bronchospasm - 3.9% (8.1%),
Danish: • bronkospasmer - 3,9 % (8,1 %)
English: • The PRAC noted that serious, life-threatening hypersensitivity (including allergic) reactions have been reported with fusafungine for oromucosal and nasal use, including fatal cases, with short time to onset (even at first dose).
Danish: • PRAC bemærker, at der er rapporteret om alvorlige, livstruende allergiske reaktioner ved brug af fusafungin til anvendelse i mundhulen og næsen, herunder fatale tilfælde, med kort tid til debut (allerede efter første dosis).
English: The advice of the CHMP Scientific Advisory Group (SAG) in Anti-Infectives was requested by the PRAC.
Danish: PRAC har anmodet CHMP's videnskabelige rådgivende gruppe inden for antiinfektiva om en udtalelse.
English: The PRAC could not identify any potential measure or condition, the fulfilment of which would demonstrate a positive benefit risk balance for fusafungine in any of the current indications.
Danish: PRAC har ikke kunnet identificere mulige foranstaltninger eller omstændigheder, der kan påvise et positivt benefit/risk-forhold for fusafungin, og dette gælder alle de aktuelle indikationer.
English: The MAH submitted studies regarding rhinopharyngitis, rhinosinusitis, pharyngitis, laryngitis, status after tonsillectomy and URTI in general.
Danish: Indehaveren af markedsføringstilladelsen har fremlagt undersøgelser af rhinofaryngitis, rhinosinuitis, faryngitis, laryngitis, status efter tonsillektomi og infektioner i de øvre luftveje generelt.
English: • The PRAC reviewed the totality of the data submitted in support of the safety and efficacy of fusafungine-containing products for oromucosal and nasal use including submissions from the marketing authorisation holders and views expressed by experts such as the CHMP Scientific Advisory Group (SAG) in Anti-Infectives and the Paediatric Committee (PDCO).
Danish: • PRAC har gennemgået alle de data, der er indsendt til understøttelse af sikkerheden ved og virkningen af fusafungin-holdige produkter til anvendelse i mundhulen og næsen, herunder indberetninger fra indehavere af markedsføringstilladelser og ekspertudtalelser fra f.eks.
English: In the context of signal detection activities, the Marketing Authorization Holder (MAH) of fusafunginecontaining medicinal products for oromucosal and nasal use noted an increased reporting rate of all adverse drug reactions (ADRs) including allergic reactions.
Danish: I forbindelse med den løbende registrering af uønskede hændelser har indehaveren af markedsføringstilladelsen til fusafungin-holdige lægemidler til anvendelse i mundhulen og næsen bemærket et øget antal indberetninger af alle typer bivirkninger, herunder allergiske reaktioner.
English: The PRAC is of the opinion that when treating upper respiratory tract infections, the aetiology of which is mainly viral, with antibiotics the risk for selecting antimicrobial resistance cannot be excluded.
Danish: PRAC mener, at når man behandler infektioner i de øvre luftveje, hvis ætiologi primært er viral, med antibiotika, kan risikoen for selekteret antimikrobiel resistens ikke udelukkes.
English: • The PRAC considered that the risk minimisations measures discussed during the assessment, including further restriction of the indication and additional contra-indications, limitation of treatment duration, addition of special warning and precautions for use, limitation of excipients, Direct Health Care Professional communication and restriction to prescription only, would not sufficiently reduce the risk of serious hypersensitivity (including allergic) reactions.
Danish: • PRAC mener, at de risikominimerende foranstaltninger, der er drøftet under vurderingsforløbet, herunder yderligere begrænsning i indikationen og tilføjelse af flere kontraindikationer, begrænsning af behandlingsvarigheden, tilføjelse af en advarsel under særlige advarsler og forsigtighedsregler vedrørende brugen, begrænsning af hjælpestofferne, kommunikationsmateriale til sundhedspersoner og indførelse af receptpligt, ikke i tilstrækkelig grad vil reducere risikoen for alvorlige overfølsomheds- og allergiske reaktioner.
English: • cough - 10.6% (3.1%),
Danish: • hoste - 10,6 % (3,1 %)
English: The author's conclusion that the outcomes achieved by fusafungine are not relevant in clinical practice is supported by the PRAC.
Danish: PRAC tilslutter sig forfatterens konklusion om, at de opnåede resultater ved behandlingen med fusafungin ikke har nogen relevans i klinisk praksis.
English: Its efficacy was presented by the MAH derived from its bacteriostatic properties.
Danish: Indehaveren af markedsføringstilladelsen beskriver virkningen som baseret på stoffets bakteriostatiske egenskaber.
English: Its bacteriostatic properties were presented as an additional activity by the MAH.
Danish: Indehaveren af markedsføringstilladelsen beskriver stoffets bakteriostatiske egenskaber som en supplerende aktivitet.
English: • The PRAC is of the view, after having reviewed the available data that fusafungine, in the context of a mild disease of self-limited nature, is associated with an increased risk of serious hypersensitivity (including allergic) adverse reactions including anaphylactic reactions which can be life threatening and fatal.
Danish: • Efter at have gennemgået de tilgængelige data mener PRAC, at fusafungin er forbundet med en øget risiko for alvorlige overfølsomheds- og allergiske reaktioner, herunder anafylaktiske reaktioner, der kan være livstruende og have dødelig udgang, selv om indikationen er en mild, selvbegrænsende sygdom.
English: The MAH provided: - 5 clinical studies in adults including 3 pivotal studies in acute rhinopharyngitis (Chabolle, 19991, Eccles 20002 and Bouter, 20023) and 2 supportive randomized, double-blind, placebo controlled studies in rhinosinusitis (Cuénant 19884, Mösges 2002) and, - one study in children (a double-blind, placebo-controlled, randomized, in 515 children, aged 8-12 years, with acute rhinopharyngitis, Januszewicz 2002).
Danish: - 5 kliniske undersøgelser af voksne, herunder 3 centrale undersøgelser af akut rhinofaryngitis (Chabolle 19991, Eccles 20002 og Bouter 20023) og 2 understøttende randomiserede, dobbeltblindede, placebo-kontrollerede undersøgelser af rhinosinuitis (Cuénant 19884, Mösges 2002) og,
English: The PRAC was of the view that the risk minimisation measures proposed by the MAH will not sufficiently reduce the risks of serious adverse reactions.
Danish: PRAC er af den opfattelse, at de risikominimerende foranstaltninger, som indehaveren af markedsføringstilladelsen har foreslået, ikke i tilstrækkelig grad vil reducere risikoen for alvorlige bivirkninger.
English: The PRAC considered that the use of fusafungine-containing medicinal products for oromucosal and nasal use is associated with serious hypersensitivity (including allergic) reactions including fatal cases, with short time to onset.
Danish: PRAC vurderer, at brug af fusafungin-holdige lægemidler i mundhulen og næsen er forbundet med alvorlige allergiske reaktioner med kort tid til debut, herunder tilfælde med dødelig udgang.
English: • rash - 4.7% (2.1%),
Danish: • udslæt - 4,7 % (2,1 %)
English: The PRAC considered all the available data submitted with regards to the mechanism of action of fusafungine.
Danish: PRAC har gennemgået alle de tilgængelige data, der er indsendt, hvad angår fusafungins virkningsmekanisme.
English: During the assessment, the PRAC also noted that the MAH stated that available data no longer support tonsillitis and laryngitis indications; the MAH also confirmed that all the available data have been provided and that they will not be able to provide any further data to demonstrate the clinical safety and benefit of fusafungine in the management of diseases of the upper respiratory airways.
Danish: Indehaveren af markedsføringstilladelsen har også bekræftet, at alle tilgængelige data er fremlagt, og at der ikke vil kunne fremlægges supplerende data til påvisning af fusafungins kliniske sikkerhed og gavnlige effekt ved behandling af sygdomme i de øvre luftveje.
English: In addition, although there is insufficient evidence to conclude on potential risk of inducing bacterial resistance, the risk of cross-resistance cannot be excluded.
Danish: Endvidere kan risikoen for krydsresistens ikke udelukkes, selv om der ikke foreligger tilstrækkelig evidens til at drage konklusioner med hensyn til en potentiel risiko for bakterieresistens.