FrancophonIA/ELRC3.0 huggingface dataset:
English: The efficacy results in the treatment of moderate acne derive from two placebo-controlled studies which are included in section 5.1 “Pharmacodynamic data” of the SmPC.
Danish: Resultaterne vedrørende virkning ved behandling af moderat acne hidrører fra to placebokontrollerede undersøgelser, som er omtalt i afsnit 5.1 “Farmakodynamiske egenskaber” i produktresuméet.
English: After six months of treatment, in comparison with placebo, EE/DRSP showed a statistically and clinically significant reduction of 15.6% (49.3% versus 33.7%) in inflammatory lesions, 18.5% (40.6% versus 22.1%) in non-inflammatory lesions, and 16.5% (44.6% versus 28.1%) in total lesion counts.
Danish: Efter seks måneders behandling med EE/DRSP var der i forhold til placebo en statistisk signifikant og klinisk betydningsfuld reduktion på 15,6 % (49,3 % mod 33,7 %) af inflammatoriske læsioner, 18,5 % (40,6 % mod 22,1 %) af ikke-inflammatoriske læsioner og 16,5 % (44,6 % mod 28,1 %) af det samlede antal læsioner.
English: With the submission of the responses to the CHMP list of questions, the MAH changed the request for the indication and reverted to the indication as follows: “Treatment of moderate acne vulgaris only in women seeking oral contraception”.
Danish: Ved besvarelsen af CHMP's spørgsmål ændrede indehaveren af markedsføringstilladelsen ansøgningen om indikationen og vendte tilbage til følgende indikation: “Behandling af moderat acne vulgaris udelukkende hos kvinder, som ønsker svangerskabsforebyggelse”.
English: The CHMP recognised the efficacy in the overall lesion count reduction.
Danish: Udvalget anerkendte virkningen i form af mindskelse af det samlede antal læsioner.
English: These Member States considered the approval of the variation to constitute a serious risk for public health on the basis that the overall risk-benefit profile for Ethinylestradiol-Drospirenone 24+4 in the proposed indication was considered not acceptable in light of:
Danish: Disse medlemsstater anså godkendelse af ændringsansøgningen for at ville udgøre en alvorlig risiko for den offentlige sundhed, da det overordnede benefit/riskforhold for Ethinylestradiol-Drospirenone til den ansøgte indikation ikke blev anset for acceptabelt på baggrund af:
English: At least four patho-physiologic events take place within acne-infected hair follicles: i) androgenmediated stimulation of sebaceous gland activity, ii) abnormal keratinisation leading to follicular plugging (comedo forming), iii) proliferation of the bacterium Proprioni-bacterium acnes (P. acnes) within the follicle, iv) inflammation.
Danish: I acne-inficerede hårsække optræder mindst fire patofysiologiske processer: i) androgenmedieret stimulation af talgkirtlernes aktivitet, ii) abnorm keratinisering, der medfører tilstopning af talgkirtlerne (komedondannelse), iii) vækst af Proprioni-bacterium acnes (P. acnes) i kirtlerne, og iv) inflammation.
English: • The Committee noted the overall efficacy of EE/DRSP as a treatment for moderate acne vulgaris in reproductive age women was shown in two placebo-controlled studies.
Danish: • Udvalget tog til efterretning, at den overordnede virkning af EE/DRSP til behandling af moderat acne vulgaris hos kvinder i den fødedygtige alder er dokumenteret i to placebokontrollerede undersøgelser.
English: • The Committee considered the known safety profile of EE/DRSP in particular the higher risk associated with VTE in comparison to other available OCs.
Danish: • Udvalget tog den velkendte sikkerhedsprofil af EE/DRSP i betragtning, navnlig den højere risiko for VTE i forhold til andre tilgængelige orale antikonceptiva.
English: • The Committee considered the procedure under Article 6(12) of Commission Regulation (EC) no 1084/2003, for Ethinylestradiol-Drospirenone 24+4 and associated names initiated by Italy and Sweden.
Danish: • Udvalget behandlede den indbringelse, der var indledt af Italien og Sverige i henhold til artikel 6, stk. 12, i Kommissionens forordning (EF) nr. 1084/2003, for Ethinylestradiol-Drospirenone og relaterede navne.
English: Acne is a skin disorder of the sebaceous follicles that presents with lesions that are either inflamed (i.e. papules, pustules and nodules) or non-inflamed (i.e. open- or closed comedones).
Danish: Acne er en hudsygdom i talgkirtlerne, der fremstår med forandringer, som enten er inflammerede (pabler, pustler og noduli) eller ikke inflammerede (åbne eller lukkede komedoner).
English: Therefore, the CHMP concludes that the variation application does not satisfy the criteria for authorisation and recommends the refusal of the variation to the terms of the Marketing Authorisation for all medicinal product(s) referred to in Annex I.
Danish: CHMP konkluderede derfor, at ændringsansøgningen ikke opfylder godkendelseskriterierne, og anbefalede afslag på ansøgningen om ændring af betingelserne i markedsføringstilladelsen for alle de i bilag I omhandlede lægemidler.
English: Venous thromboembolic events (VTEs)
Danish: Venøse tromboemboliske hændelser (VTE)
English: These were regarded as not sufficient to ensure the safe and effective use of EE/DRSP in the specific clinical situation.
Danish: De blev anset for utilstrækkelige til at sikre risikofri og effektiv anvendelse af EE/DRSP i den pågældende kliniske situation.
English: • The Committee found merit on the concerns raised by the Member States regarding the continuation of use of EE/DRSP in the treatment of moderate acne when contraception is no longer needed for which the benefit/risk balance is not acceptable considering the risk of rare but serious adverse events balanced against the limited clinical benefits.
Danish: • Udvalget fandt det berettiget, at nogle medlemsstater havde rejst betænkeligheder vedrørende fortsat anvendelse af EE/DRSP til behandling af moderat acne efter ophør af behovet for antikonception, da benefit/risk-forholdet for en sådan anvendelse ikke er acceptabelt på grund af risikoen for sjældne, men alvorlige bivirkninger sammenholdt med de begrænsede kliniske fordele.
English: The most serious risks associated with its treatment are venous thromboembolic events (VTEs) and breast cancer:
Danish: De alvorligste risici forbundet med behandlingen er venøse tromboemboliske hændelser (VTE) og brystkræft:
English: The VTE associated risk is higher for EE/DRSP oral contraceptives when compared to other combined oral contraceptives.
Danish: Den tilknyttede risiko for VTE er højere for orale antikonceptiva med EE/DRSP end for andre kombinerede orale antikonceptiva.
English: This was corroborated by case-control studies that showed consistent results with a 2 to 3-fold greater risk for drospirenone versus LNGcontaining OCs.
Danish: Dette bekræftes af case-control undersøgelser, der samstemmende har vist 2-3 gange større risiko ved orale antikonceptiva med drospirenon end med LNG.
English: The Committee considered that the risk minimisation measures proposed would not ensure that the use of the product would be limited to treatment of moderate acne only in women seeking oral contraception and could not identify other risk minimisation measures which would reduce such risk.
Danish: Efter udvalgets opfattelse vil de påtænkte foranstaltninger til risikominimering ikke sikre, at produktets anvendelse begrænses til moderat acne hos kvinder med behov for oral antikonception, og udvalget kunne ikke pege på andre risikominimeringsforanstaltninger, der ville nedsætte denne risiko.
English: In support of this indication, two (A25083 and A25152) multicenter, double blind, randomised, placebo controlled studies were performed to evaluate the efficacy and safety of EE/DRSP in women with moderate acne vulgaris.
Danish: Til støtte for den ansøgte indikation blev der udført to dobbeltblindede, randomiserede, placebokontrollerede multicenterundersøgelser (A25083 and A25152) til vurdering af virkningen og sikkerheden af EE/DRSP hos kvinder med moderat acne vulgaris.
English: With regard to the VTE risk associated with EE/DRSP-COCs, the EURAS study (European led study) could not exclude a small difference in VTE risk between drospirenone and other combined OCs.
Danish: Hvad angår risiko for VTE i forbindelse med kombinerede antikonceptiva med EE/DRSP kunne den europæisk ledede EURAS-undersøgelse ikke udelukke, at der findes en lille forskel i VTE-risiko mellem orale antikonceptiva med drospirenon og andre kombinerede orale antikonceptiva.
English: Based on the above, the Committee is of the opinion that the inclusion of treatment of acne vulgaris in the indication may increase unnecessarily the use of EE/DRSP relatively to safer combined oral contraceptive and that minimisation measures that could ensure an acceptable risk level in this clinical situation could not be identified.
Danish: På dette grundlag er udvalget af den opfattelse, at udvidelse af indikationen med acne vil kunne øge anvendelsen af EE/DRSP unødigt i forhold til sikrere kombinerede orale antikonceptiva, og at der ikke findes risikominimeringsforanstaltninger, der sikrer et acceptabelt risikoniveau i denne kliniske situation.
English: The treatment with EE/DRSP is associated with venous thromboembolic events (VTE) and with breast cancer risks.
Danish: Behandling med EE/DRSP er forbundet med venøse tromboemboliske hændelser (VTE) og brystcancerrisiko.
English: The overall efficacy of EE/DRSP as a treatment for moderate acne vulgaris in reproductive age women was shown in the two placebo-controlled A25083 and A25152 studies.
Danish: Den overordnede virkning af EE/DRSP til behandling af moderat acne vulgaris hos kvinder i den fødedygtige alder blev dokumenteret i de to placebokontrollerede undersøgelser A25083 og A25152.
English: Therefore, it remains of concern the potential for unnecessary exposure to EE/DRSP for prolonged periods for the acne indication alone and that the proposed activities for risk minimisation are insufficient to ensure use of EE/DRSP for the acne indication only by women seeking oral contraception.
Danish: Der er derfor fortsat betænkelighed ved potentialet for unødig langvarig eksponering for EE/DRSP på acneindikationen alene og for, at de påtænkte risikominimeringstiltag er utilstrækkelige til at sikre, at acnebehandling med EE/DRSP udelukkende anvendes af kvinder med behov for oral antikonception.
English: Consequently, the CHMP concluded in accordance with Article 32 (4) of Directive 2001/83/EC that the variation application does not satisfy the criteria for authorisation and recommends the refusal of the variation to the terms of the Marketing Authorisation for Ethinylestradiol-Drospirenone 24+4 and associated names (see Annex I).
Danish: Udvalget bemærkede, at der findes alternativer til behandling af acne alene konkluderede CHMP i overensstemmelse med artikel 32, stk. 4, i direktiv 2001/83/EF, at ændringsansøgningen ikke opfylder kriterierne for godkendelse, og anbefalede afslag på ansøgningen om ændring af betingelserne for markedsføringstilladelsen for Ethinylestradiol-Drospirenone og relaterede navne (se bilag I).
English: The safety profile of the EE/DRSP is known from its use as oral contraception.
Danish: Sikkerhedsprofilen af EE/DRSP er velkendt fra dets anvendelse til peroral antikonception.
English: The magnitude of this relative risk is similar to that found in previous studies of desogestrel/gestodene OCs when compared with LNG-OCs.
Danish: Den relative risiko svarer til den, der er fundet i tidligere undersøgelser af orale antikonceptiva med desogestrel/gestoden i forhold til orale antikonceptiva med LNG.
English: The safety profile of EE/DRSP - COCs in the approved indication is well known.
Danish: Sikkerhedsprofilen af kombinerede orale antikonceptiva med EE/DRSP er velkendt til den godkendte indikation.
English: Statistically significant responses to treatment with EE/DRSP as compared to placebo was seen in all four primary efficacy variables (inflammatory lesion, non-inflammatory lesion, and total lesion counts, and women with a ‘clear' or ‘almost clear' rating on the ISGA scale).
Danish: EE/DRSP resulterede i statistisk signifikant respons i forhold til placebo for alle fire primære virkningsvariable (inflammatorisk læsion, ikke-inflammatorisk læsion, samlet antal læsioner og antal patienter med bedømmelsen af “opklaret” eller “næsten opklaret” på ISGA-skalaen).
English: With regard to breast cancer risk, published data showed that the current use of combined OCs is associated with a relative risk (RR) of 1.24 (95 % confidence interval 1.15-1.33).
Danish: For brystcancerrisiko viste publicerede data, at den nuværende anvendelse af kombinerede orale antikonceptiva er forbundet med en relativ risiko (RR) på 1,24 (95 % sikkerhedsinterval 1,15; 1,33).
English: The mean difference observed in total lesion count reduction is of 16% between EE/DRSP and placebo.
Danish: EE/DRSP mindskede det samlede antal læsioner med gennemsnitligt 16 % i forhold til placebo.
English: The overall efficacy assessment of EE/DRSP as a treatment for moderate acne vulgaris in reproductive age women observed during studies A25083 and A25152 demonstrates statistically significant responses to treatment with EE/DRSP as compared to placebo in all four primary efficacy variables (inflammatory lesion, non-inflammatory lesion, and total lesion counts, and women with a ‘clear' or ‘almost clear' rating on the ISGA scale) and the majority of secondary efficacy variables (papules, pustules, closed and open comedones).
Danish: Den samlede vurdering af virkningen af EE/DRSP til behandling af moderat acne vulgaris hos kvinder i den fødedygtige alder i undersøgelse A25083 og A25152 viser statistisk signifikant respons på behandlingen med EE/DRSP i forhold til placebo for alle fire primære virkningsvariable (inflammatorisk læsion, ikke-inflammatorisk læsion, samlet antal læsioner og antal patienter med bedømmelsen “opklaret” eller “næsten opklaret” på ISGA-skalaen).
English: Thus, the potential to restrict the duration of treatment by the proposed risk minimisation program is not considered realistic or sufficiently effective.
Danish: Det påtænkte program til risikominimering anses derfor ikke for at have et realistisk eller tilstrækkeligt potentiale for begrænsning af behandlingsvarigheden.
English: Overall, the safety profile of EE/DRSP oral contraceptives is known from its use as oral contraception and associated with rare but serious adverse events (i.e. VTE and breast cancer).
Danish: Den overordnede sikkerhedsprofil af orale antikonceptiva med EE/DRSP kendes fra anvendelsen som antikonception, idet de er forbundet med sjældne, men alvorlige bivirkninger (VTE og brystcancer).
English: Moreover, women who started OC use before age 20 had a higher risk of breast cancer than those starting later, RR = 1.22 (95 % confidence interval 1.17-1.26; Lancet 1996).
Danish: Kvinder, der begyndte at bruge antikonceptiva inden 20-års alderen, havde desuden større risiko for at få brystcancer end de, der begyndte senere: RR = 1,22 (95 % sikkerhedsinterval 1,17; 1,26) (Lancet
English: This is an important factor when prescribing an oral contraceptive and may preclude EE/DRSP-COCs to be regarded as a first choice for contraception, in clinical practice.
Danish: Dette er en vigtig faktor ved ordination af et oralt antikonceptivum og kan udelukke kombinerede orale antikonceptiva med EE/DRSP som førstevalgs antikonceptiva i klinisk praksis.
English: The most recent review by the Pharmacovigilance Working Party (PhVWP) concluded in January 2012, confirmed that DRSP-containing OCs are associated with a higher VTE risk than levonorgestrel-containing COCs and that the risk may be similar to that for desogestrel/gestodenecontaining COCs.
Danish: I januar 2012 foretog arbejdsgruppen vedrørende lægemiddelovervågning (PhVWP) således en sikkerhedsgennemgang, der bekræftede, at orale antikonceptiva indeholdende DRSP medfører større risiko for VTE end orale antikonceptiva indeholdende levonorgestrel, og at risikoen muligvis er den samme som med orale antikonceptiva indeholdende desogestrel/gestoden.
English: The CHMP considered the MAH proposed measures for risk minimisation not sufficient to ensure the safe and effective use of EE/DRSP in the specific applied clinical situation.
Danish: De risikominimeringsforanstaltninger, der er foreslået af indehaveren af markedsføringstilladelsen, blev af CHMP ikke anset for tilstrækkelige til at sikre risikofri og effektiv anvendelse af EE/DRSP i den særlige kliniske situation, som ansøgningen vedrørte.
English: The MAH submitted a risk minimisation program to ensure the safe use of EE/DRSP COCs and to limit possible off-label use following authorisation of the applied indication.
Danish: Indehaveren af markedsføringstilladelsen forelagde et program, der skulle sikre risikofri anvendelse af kombinerede perorale antikonceptiva med EE/DRSP og begrænse eventuel ikke-godkendt anvendelse efter at den ansøgte indikation er godkendt.
English: Furthermore the MAH failed to show that once the need for oral contraception seizes to exist, the patients will be switched to other acne treatments.
Danish: Indehaveren af markedsføringstilladelsen har endvidere ikke kunnet påvise, at patienterne vil blive sat over på andre acnemidler, når behovet for oral antikonception ophører.
English: Overall, the safety profile of EE/DRSP oral contraceptives is known and associated with serious adverse events (i.e. VTE and breast cancer).
Danish: Den overordnede sikkerhedsprofil af orale antikonceptiva af typen EE/DRSP er velkendt og er forbundet med alvorlige bivirkninger (VTE og brystcancer).
English: The CHMP considered the MAH proposed measures for risk minimisation to ensure the safe use of EE/DRSP COCs and to limit possible off-label use following authorisation of the applied indication.
Danish: CHMP vurderede de af indehaveren af markedsføringstilladelsen påtænkte foranstaltninger, der skulle sikre risikofri anvendelse af perorale kontraceptiva med EE/DRSP og begrænse eventuel ikke godkendt anvendelse, efter at den ansøgte indikation er godkendt.
English: In addition, the dual need for treatment of acne while the patient will also need oral contraception will exist at time of prescribing.
Danish: På ordinationstidspunktet vil patienten have behov for både acnebehandling og oral antikonception.
English: Considering all the above and the fact that acne is a very common condition in young women, the Committee raised concerns that a beneficial effect noted by the patient from use of EE/DRSP would reduce the motivation to stop the intake when the need for contraception ceases and, therefore, it would not be possible to ensure that the use of the medicinal product would be limited to the treatment of moderate acne vulgaris only in women seeking oral contraception.
Danish: I betragtning af alt det ovennævnte og den store udbredelse af acne blandt unge kvinder var der i udvalget bekymring for, at en gavnlig effekt af EE/DRSP kan mindske patientens motivation til at ophøre med indtagelsen ved ophør af behovet for antikonception.
English: This is of concern as the risk of venous thromboembolism for drospirenone-containing OCs is higher (approximately 2-fold) than for levonorgestrel-containing OCs.
Danish: Dette medførte betænkelighed, da risikoen for venøs tromboembolisme for orale antikonceptiva indeholdende drospirenon er cirka dobbelt så stor som for orale antikonceptiva indeholdende levonorgestrel.
English: In addition, and in order to monitor the effectiveness of the educational program with the consequent monitoring of the EE/DRSP-COCs prescribing practices in Europe, two drug utilization studies were proposed.
Danish: Derudover planlagdes to undersøgelser af lægemiddelanvendelse til overvågning af oplysningsprogrammets virkning gennem registrering af ordinationspraksis for kombinerede perorale antikonceptiva med EE/DRSP i Europa.
English: General tools (e.g. lectures, conferences, symposia) targeting health care providers were proposed as educational material for prescribers by emphasising on the benefit/risk of EE/DRSP use in targeted population and discourage off-label use as well as to highlight to the patients that treatment of moderate acne with EE/DRSP is limited to patients who indeed require hormonal contraception.
Danish: Heri skulle der lægges vægt på benefit/risk-forholdet for anvendelse af EE/DRSP hos målpopulationen, undgåelse af ikke-godkendt brug og information af patienterne om, at behandling af moderat acne med EE/DRSP udelukkende er til patienter med behov for hormonel antikonception.
English: Moreover, when data were analysed by age at first use, women who started OC use before age 20 had a higher risk of breast cancer than those starting later, RR = 1.22 (95 % confidence interval 1.17-1.26; Lancet 1996).
Danish: For aldersfordelingen ved førstegangsanvendelse fremgik det endvidere, at brystcancerrisikoen var større hos kvinder, der var begyndt at bruge orale antikonceptiva inden 20-års alderen, end for dem, der begyndte senere, med RR = 1,22 (95 % sikkerhedsinterval 1,17; 1,26) (Lancet 1996).
English: a) the known greater risk of venous thromboembolic events (VTE) for DRSP-COCs in comparison with levonorgestrel (LNG)-COCs;
Danish: Baggrunden var navnlig, at kombinerede antikonceptiva med drospirenon (DRSP-COC) medfører større risiko for venøse tromboemboliske hændelser (VTE) end kombinerede antikonceptiva med levonorgestrel (LNG-COC).
English: With regard to breast cancer risk, the largest meta-analysis to date, including 53297 women with breast cancer and 100239 controls, showed that current use of combined OCs was associated with a relative risk (RR) of 1.24 (95 % confidence interval 1.15-1.33).
Danish: Den hidtil største metaanalyse af brystcancerrisiko omfattede 53 297 kvinder med brystkræft og 100 239 kontrolpersoner.
English: The CHMP was requested to give its opinion on whether the overall risk-benefit profile for Ethinylestradiol-Drospirenone 24+4 in the proposed indication was considered acceptable, particularly in light of the known greater risk of venous thromboembolic events (VTE) for DRSP-COCs in comparison with levonorgestrel (LNG)COCs, and initiated the procedure in July 2011.
Danish: CHMP blev anmodet om at afgive en udtalelse om, hvorvidt det overordnede benefit/risk-forhold for Ethinylestradiol-Drospirenone til den ansøgte indikation anses for acceptabelt.
English: b) the potential use of the product for women who are not comprised in the target population.
Danish: a) den kendte større risiko for venøse tromboemboliske hændelser med kombinerede orale antikonceptiva indeholdende DRSP end for tilsvarende præparater indeholdende levonorgestrel b) den potentielle anvendelse af produktet til kvinder, der ikke er tilhører målpopulationen.
English: ¾ The specific indication approved.
Danish: ¾ Den specifikke godkendte indikation.
English: CONDITIONS OR RESTRICTIONS WITH REGARD TO THE SAFE AND EFFECTIVE USE OF THE MEDICINAL PRODUCT TO BE IMPLEMENTED BY THE MEMBER STATES
Danish: Betingelser eller begrænsninger med hensyn til en sikker og effektiv anvendelse af lægemidlet pålagt
English: ¾ The lack of clinical data to support the combination with theophylline and that such combination is not recommended.
Danish: ¾ Manglen på kliniske data til at understøtte kombination med theophyllin og at en sådan kombination derfor ikke anbefales.
English: • The Marketing Authorisation Holder (MAH) should ensure that, at launch, all Healthcare Professionals who are expected to prescribe Daliresp are provided with an Educational pack.
Danish: • Indehaveren af markedsføringstilladelsen (MAH) skal sikre, at alle sundhedsprofessionelle, der forventes at ordinere Daliresp, er forsynet med en uddannelsespakke ved lanceringen.
English: ¾ The need to inform patients about the risks of Daliresp and the precautions for safe use.
Danish: ¾ Nødvendigheden af, at informere patienter om risici ved Daliresp og forholdsregler for sikker brug.
English: ¾ The potential risk of malignant tumours and the lack of experience in patients with past history of cancer.
Danish: ¾ Den potentielle risiko for maligne tumorer og den manglende erfaring hos patienter med en tidligere kræftsygdom.
English: Daliresp should not be initiated or should be stopped in patients with cancers (except basal cell carcinoma).
Danish: Dalirespbehandling bør ikke påbegyndes eller bør stoppes hos patienter med kræft (bortset fra basalcellekarcinom).