FrancophonIA/ELRC3.0 huggingface dataset:
English: However a follow-up study (in vivo micronucleus test) defined a no-effect level of 39.6 mg/kg.
Croatian: No, kontrolno ispitivanje (in vivo testiranje mikronukleusa) definiralo je razinu bez djelovanja od 39,6 mg/kg.
English: TCC is indicated for the treatment of painful muscular contractures in different settings.
Croatian: TCC je indiciran za liječenje bolnih mišićnih kontraktura u različitim okruženjima.
English: For the purpose of the review of this risk, the MAHs provided an analysis of this genotoxic potential for each systemic route of administration, together with an analysis of possible risk factors, including relevant criteria such as dose and duration of treatment.
Croatian: Za potrebe pregleda ovog rizika, nositelji odobrenja dostavili su analizu genotoksičnog potencijala za svaki sistemski način primjene, zajedno s analizom potencijalnih čimbenika rizika, uključujući relevantni kriterij poput doze i trajanja liječenja.
English: The CHMP considers that the clinical evidence within the cases reported by the MAHs concerning the consequences of aneuploidy in humans does not allow drawing definitive conclusions.
Croatian: CHMP smatra da klinički dokaz sadržan u slučajevima prijavljenima od strane nositelja odobrenja u vezi s posljedicama aneuploidije u ljudi ne omogućuje donošenje konačnih zaključaka.
English: Genotoxic mechanisms, such as aneuploidy, involving cell division and non-DNA targets, are known to occur above a certain threshold of exposure.
Croatian: Poznato je da genotoksični mehanizmi, poput aneuploidije, koji uključuju diobu stanica i ciljeve koji nisu DNK, nastupaju iznad određenog praga izlaganja.
English: However it is still controversial if aneuploidy is a contributing cause or merely a consequence of neoplastic transformation.
Croatian: No, još je uvijek kontroverzno pitanje pridonosi li aneuploidija neoplastičnoj transformaciji ili je jednostavno posljedica iste.
English: Given the treatment conditions with TCC (short-term, potentially aneugenic at maximum doses) effects on male fertility will be low and a rapid recover to normal levels can be expected.
Croatian: Uzimajući u obzir uvjete liječenja sa TCC-om (kratkoročno, potencijalno aneugeno pri maksimalnim dozama) djelovanje na mušku plodnost bit će malo i može se očekivati brzi oporavak normalnih razina.
English: In addition the CHMP reviewed the PSUR frequency for TCC containing medicines for systemic use and requested PSURs to be submitted on a three-yearly basis (instead of a 13-yearly basis as it is currently recommended).
Croatian: Nadalje, CHMP je pregledao učestalost dostavljanja PSUR-ova za lijekove koji sadrže TCC za sistemsku primjenu i zatražio je da se PSUR-ovi dostavljaju na trogodišnjoj bazi (umjesto na 13-godišnjoj bazi kako je to trenutno preporučeno).
English: It was concluded that M1 (SL18.0740) is devoid of mutagenic (gene mutations) and clastogenic (structural chromosome damage) potential, but is able to induce aneuploidy (numerical chromosome damage).
Croatian: Zaključeno je da M1 (SL18.0740) nema mutagenog (mutacije gena) i klastogenog (strukturalnog oštećenja kromosoma) potencijala, no može izazvati aneuploidiju (numeričko oštećenje kromosoma).
English: In addition, the lack of evidence for the correlation between the use of TCC and cancer could be due to the difficulty of establishing a causal relationship between the medicine and the effect, which may occur years after intake.
Croatian: Nadalje, nedostatak dokaza koji bi potkrijepili vezu između primjene TCC-a i raka može biti uzrokovan poteškoćama vezanima uz utvrđivanje kauzalne veze između lijeka i djelovanja, koje može nastupiti godinama nakon unosa.
English: These products should also be contraindicated in women of childbearing potential not using contraception and during lactation.
Croatian: Ovi lijekovi trebaju biti kontraindicirani u žena s reproduktivnim potencijalom koje ne koriste kontracepciju i tijekom laktacije.
English: The CHMP also noted that the limited number of cases of malformations/embryo-foetal toxicities may be due to the fact that, in most of the Member States, the medicine is contraindicated in pregnancy.
Croatian: CHMP je također napomenuo da ograničeni broj slučajeva malformacija/embrio-fetalne toksičnosti može nastati zbog činjenice da je lijek kontraindiciran u trudnoći u većini država članica.
English: In addition, the CHMP was of the view that the package size should be restricted according to the new treatment-days scheme recommended (up to 30 tablets or capsules/4 mg pack, up to 14 tablets or capsules/8 mg pack and up to 10 vials/ampoules).
Croatian: Nadalje, CHMP je mišljenja da se veličina pakiranja mora ograničiti u skladu s novom preporučenom shemom dana liječenja (do 30 tableta ili kapsula / 4 mg pakiranje, do 14 tableta ili kapsula / 8 mg pakiranje te do 10 bočica/ampula).
English: A mock-up of the above-mentioned pregnancy reporting form should be provided in the RMP and a report on these collected data should be submitted within PSURs.
Croatian: Reprezentativan uzorak prethodno navedenog obrasca za podnošenje prijava o trudnoći treba se dostaviti u sklopu RMP-a, a izvješće o ovim prikupljenim podacima treba se dostaviti u sklopu PSUR-ova.
English: Postmarketing spontaneous cases were collected based on the reports recorded in two MAHs' global pharmacovigilance databases (cut-off dates of 15 February 2013 and 29 April 2013 respectively).
Croatian: Spontani slučajevi nakon stavljanja lijeka u promet prikupljeni su na temelju prijava zabilježenih u dvije farmakovigilancijske baze podataka nositelja odobrenja (isključni datumi su bili 15. veljače 2013., odnosno 29. travnja 2013.).
English: The aneugenic effect was observed at LOEL corresponding to only 1.6 x human Cmax and 4.1 x AUC (8mg bid, Per Os (PO)).
Croatian: Aneugeni učinak uočen u LOEL odgovara samo 1.6 x ljudskom Cmax i 4.1 x AUC (8 mg dva puta na dan, peroralno (PO)).
English: Furthermore the CHMP requested a drug utilisation study (DUS) to be conducted in order to better characterise prescribing practices for these medicinal products during typical clinical use in representative groups of prescribers and to assess main reasons for prescription.
Croatian: Nadalje, CHMP je zatražio provođenje ispitivanja iskoristivosti lijeka (DUS) kako bi se bolje okarakterizirale prakse propisivanja za ove lijekove tijekom tipične kliničke primjene u reprezentativne grupe propisivača te kako bi se procijenili glavni razlozi za propisivanje.
English: Therefore, on the basis of the above-mentioned available data, the CHMP considered the safety margins and benefit/risk for TCC and SL18.0740 (M1) acceptable.
Croatian: Stoga, na temelju prethodno dostupnih podataka, CHMP smatra da su sigurnosna ograničenja i omjer koristi i rizika za TCC-a i SL18.0740 (M1) prihvatljivi.
English: The CHMP considered that a Direct healthcare professional communication (DHPC) was needed to inform on the outcome of the present review, including the updated indication, the clinical use for these products (short-term) and to highlight the genotoxic risk.
Croatian: CHMP smatra da je izravna komunikacija sa zdravstvenim djelatnicima (pismo liječnicima) potrebna kako bi ih se informiralo o ishodu aktualnog pregleda, uključujući i obnovljenim indikacijama, kliničkoj primjeni za ove proizvode (kratkotrajno) i naglasio genotoksičan rizik.
English: • The Committee concluded that there was a need for further risk minimisation measures such as a drug utilisation study to characterise the prescribing practices during typical clinical use, as well as adequate educational materials to be developed for patients and prescribers.
Croatian: • Povjerenstvo je zaključilo da postoji potreba za daljnjim mjerama smanjivanja rizika poput ispitivanja iskoristivosti lijeka kako bi se okarakterizirala praksa propisivanja tijekom tipične kliničke primjene, kao i primjerenim edukacijskim materijalima koji se moraju razviti za bolesnika i propisivača.
English: After parenteral use, the plasma concentration of M2 is expected to be much lower as the M2 transformation occurs after oral administration mainly by intestinal metabolism.
Croatian: Nakon parenteralne primjene, očekivano je da će koncentracija M2 u plazmi biti mnogo niža s obzirom da pretvaranje M2 nastupa nakon peroralne primjene uglavnom potaknuto intestinalnim metabolizmom.
English: The preclinical development of TCC was mainly performed during the 1980s, and then complemented in the 1990s to be compliant with the European guidelines on the non-clinical documentation for mixed marketing authorisation applications (CPMP/SWP/799/95) and to investigate a new active metabolite SL18.0740 (M1) identified at that time.
Croatian: Predklinički razvoj TCC-a proveden je uglavnom tijekom 1980.-ih, a zatim je završen u 1990.-ima kako bi udovoljavao Europskim smjernicama o nekliničkoj dokumentaciji za kombinirane zahtjeve za odobrenja za stavljanje lijeka u promet (CPMP/SWP/799/95) i kako bi se istražio novi aktivni metabolit SL18.0740 (M1) koji je identificiran u to vrijeme.
English: A relevant summary is presented hereinafter.
Croatian: Niže u tekstu naveden je relevantan sažetak.
English: However, whether the exposure to M2 would be below a threshold of aneugenicity (including a sufficient safety margin) is unknown since M2 has not been analysed in the available clinical kinetic studies.
Croatian: No, nije poznato da li bi izlaganje M2 bilo niže od praga aneugenosti (uključujući dostatno sigurnosno ograničenje) s obzirom da M2 nije analiziran u dostupnim kliničkim kinetičkim ispitivanjima.
English: Taking the totality of data into account, the CHMP considered that causality cannot be excluded and that aneuploidy should be considered as a cancer risk factor on theoretical grounds.
Croatian: Uzimajući u obzir ukupnost podataka, CHMP smatra da se uzročna veza ne može isključiti te da se zbog teorijskih razloga aneuploidija mora uzeti u obzir kao čimbenik rizika od raka.
English: • and 2 cases with unknown exposure period: o 1 case of teratogenic effects (malformations) associated with exposure in early pregnancy, o 1 case with an unknown evolution of the pregnancy due to lack of documentation.
Croatian: • i 2 slučaja s nepoznatim razdobljem izlaganja: o 1 slučaj teratogenskog djelovanja (malformacija) povezanog s izlaganjem u ranoj trudnoći, o 1 slučaj s nepoznatom evolucijom trudnoće zbog nedostatka dokumentacije.
English: • The Committee considered that thiocolchicoside containing medicinal products for systemic use remain an effective adjuvant treatment of painful muscle contractures in acute spinal pathology.
Croatian: • Povjerenstvo je smatralo da lijekovi koji sadrže tiokolhikozid za sistemsku primjenu ostaju djelotvorna adjuvantna terapija bolnih mišićnih kontraktura u akutnoj spinalnoj patologiji.
English: A risk management plan (RMP) will be submitted to national competent authorities in accordance with agreed timelines and periodic safety update reports (PSURs) will be submitted every 3 years.
Croatian: Plan upravljanja rizicima dostavlja se nacionalnim nadležnim tijelima u skladu s rasporedom, a povremena izvješća o neškodljivosti lijeka (PSUR-ovi) dostavljaju se svake 3 godine.
English: In view of the above, on 15 February 2013, Italy requested the CHMP, under Article 31 of Directive 2001/83/EC, to assess the above concerns regarding aneuploidy and its impact on the benefit-risk balance for TCC containing medicinal products for systemic use.
Croatian: U svjetlu prethodno navedenog, dana 15. veljače 2013. godine, Italija je u skladu sa člankom 31. Direktive 2001/83/EZ zatražila od CHMP-a da ocjeni prethodno navedenu zabrinutost u vezi s aneuploidijom i njezinim utjecajem na omjer koristi i rizika za lijekove koji sadrže TCC-a za sistemsku primjenu.
English: No case was registered for neonatal effects related to exposure occurred in late pregnancy or during childbirth.
Croatian: Nema prijavljenih slučajeva neonatalnog djelovanja povezanog s izlaganjem nastalim u kasnoj trudnoći ili tijekom poroda.
English: Annex II Scientific conclusions and grounds for variation to the terms of the marketing authorisations
Croatian: Znanstveni zaključci i razlozi za izmjenu uvjeta odobrenja za stavljanje lijeka u promet
English: In the in vivo MN test in rat bone marrow, after M2 oral administration once daily for two consecutive days at doses of 25, 50, 70, 100 or 150 mg/kg/d, the rats bone marrow micronucleus test was found negative in males.
Croatian: U testu in vivo MN u koštanoj srži štakora, nakon peroralne primjene M2 jednom dnevno tijekom dva uzastopna dana u dozama od 25, 50, 70, 100 ili 150 mg/kg/d, test mikronukleusa koštane srži štakora bio je negativan u mužjaka.
English: Grounds for the maintenance of the marketing authorisations
Croatian: Razlozi za zadržavanje odobrenja za stavljanje lijeka u promet
English: Under the assay conditions, the No Observed Adverse Effect Level (NOAEL) and lowest-observedadverse-effect level (LOAEL) were also considered but while acknowledging that chromosome non disjunction (CND) is the most appropriate end-point to investigate when looking for low-dose effects of spindle poisons, conclusion on the search for threshold doses for aneuploidy induction was not possible to draw.
Croatian: U uvjetima eseja uzete su u obzir i vrijednosti razine bez uočenih nuspojava (NOAEL) i najniža razina s uočenim nuspojavama (LOAEL), no iako je priznavanje da je nerazdvajanje kromosoma (CND) najprimjerenija krajnja točka za istraživanje prilikom traženja djelovanja male doze otrova koji prekidaju diobeno vreteno, nije bilo moguće donijeti zaključak o rezultatima istraživanja granične doze za izazivanje aneuploidije.
English: • The Committee considered also that thiocolchicoside containing medicinal products for systemic use should be contraindicated during the entire pregnancy period.
Croatian: • Povjerenstvo je smatralo da lijekovi koji sadrže tiokolhikozid za sistemsku primjenu trebaju biti kontraindicirani tijekom cijelog razdoblja trudnoće.
English: Thiocolchicoside (TCC) is a semi-synthetic sulfurated colchicoside derivative with a muscle relaxant pharmacological activity.
Croatian: Tiokolhikozid (TCC) je polusintetski derivat kolhikozida tretiranog sumporom s farmakološkim djelovanjem mišićnog relaksansa.
English: Since no relevant genetic toxicology studies were previously performed with the aglycone metabolite SL59.0955, complementary studies (chromosome damage assays) were performed in order to investigate the genotoxic profile of this metabolite and its ability to induce aneuploidy in nonclinical in vitro (up to 600 µg/mL) and in vivo (up to 150 mg/kg):
Croatian: S obzirom da prethodno nisu provedena relevantna ispitivanja genetske toksikologije s metabolitom aglikona SL59.0955, provedena su komplementarna ispitivanja (određivanja oštećenja kromosoma) kako bi se utvrdio genotoksičan profil ovog metabolita i njegova sposobnost izazivanja aneuploidije u nekliničkom in vitro (do 600 µg/mL) i in vivo (do 150 mg/kg):
English: • six cases of congenital abnormalities (i.e. one multiple malformations leading to abortion, one pulmonary hypoplasia, one cleft palate, one spina bifida, one Poland's syndrome, one patent ductus arteriosus),
Croatian: • šest slučajeva kongenitalnih abnormalnosti (odnosno jedan slučaj višestrukih malformacija koje su rezultirale pobačajem, jednom pulmonalnom hipoplazijom, jednim rascjepom nepca, jednim križnim rascjepom, jednim Polandovim sindromom, jednim prohodnim ductus arteriozusom),
English: The results obtained from one of the metabolites' studies (metabolite SL59.0955, M2) led to concerns: new data on the aneugenic effect of the M2 metabolite of TCC generated from the submitted preclinical studies indicated a signal of genotoxic potential
Croatian: Rezultati dobiveni jednim od ispitivanja metabolita (metabolit SL59.0955, M2) uzrokovali su zabrinutost: novi podaci o aneugenom djelovanju M2 metabolita TCC-a generiranog iz dostavljenih predkliničkih ispitivanja signaliziraju genotoksični potencijal.
English: Subsequent safety assessments focusing on genotoxic potential were issued in 20012 and 20033 .
Croatian: U 2001.2 i 2003.3 godini izdane su naknadne sigurnosne ocjene koje su se usredotočile na genotoksični potencijal.
English: • 1 case due to exposure during the foetal period (i.e. a case of foetotoxic effects that resulted in foetal or neonatal type of achieving growth impact, or histological or functional maturation of organs in place (the period during which the greatest risk begins in the second quarter of pregnancy),
Croatian: • 1 slučaj zbog izlaganja tijekom fetalnog razdoblja (odnosno slučaj fetotoksičnog djelovanja koje rezultira fetalnim ili neonatalnim tipom postizanja učinka rasta ili histološkim odnosno funkcionalnim sazrijevanjem organa u mjestu (razdoblje tijekom kojeg počinje najveći rizik u drugom kvartalu trudnoće),
English: • 20 cases due to exposure during the embryonic period, of which: o two cases of teratogenic effects (malformations) associated with exposure in early pregnancy (the first quarter is the period during which the risk is the greatest), o four cases resulting in discontinuation of the pregnancy (3 spontaneous abortions and one voluntary abortion not due to medical reason), o five cases with a favourable evolution (no effect on the new born), o nine cases with an unknown evolution of the pregnancy due to lack of documentation.
Croatian: • 20 slučajeva zbog izlaganja tijekom stadija embrija, od kojih su: o dva slučaja teratogenskog djelovanja (malformacija) povezanog s izlaganjem u ranoj trudnoći (prvi kvartal je razdoblje tijekom kojeg je rizik najveći), o četiri slučaja rezultirala su prekidom trudnoće (3 spontana pobačaja i jedan dobrovoljan pobačaj koji nije bio proveden zbog medicinskih razloga), o pet slučajeva s povoljnom evolucijom (bez učinka za novorođenče), o devet slučajeva s nepoznatom evolucijom trudnoće zbog nedostatka dokumentacije.
English: To address the risks of teratogenicity and embryo-toxicity/spontaneous abortions the CHMP agreed on contraindicating TCC during the entire pregnancy period, during lactation, and in women of childbearing potential not using contraception.
Croatian: Kako bi se uklonio rizik od teratogenosti i embrionalne toksičnosti/spontanih pobačaja, CHMP je suglasan s kontraindiciranjem TCC-a tijekom cijelog razdoblja trudnoće, tijekom laktacije i u žena s reproduktivnim potencijalom koje ne koriste kontracepciju.
English: However, more concern was raised in relation to the potential risk of foetal anomalies due to elevated sperm aneuploidy rather than to the male infertility per se.
Croatian: No, veću zabrinutost je izazvao potencijalni rizik od fetalnih anomalija zbog povećane aneuploidije kromosoma spermija nego neplodnost u muškaraca kao takva.
English: Genotoxicity data on aglycone metabolite SL59.0955 (M2)
Croatian: Podaci o genotoksičnosti metabolita aglikona SL59.0955 (M2)
English: Continuous monitoring of any safety signal correlated with aneuploidy (i.e. teratogenicity, embryo-foetal toxicity / spontaneous abortion, impaired male fertility and cancer) and pregnancy reporting to collect structured data on accidental exposure to the drug should be performed.
Croatian: Potrebno je provoditi kontinuirano praćenje svih sigurnosnih signala povezanih s aneuploidijom (odnosno teratogenost, embrio-fetalna toksičnost / spontani pobačaj, poremećena plodnost u muškaraca i rak) i prijave trudnoća kako bi se prikupili strukturirani podaci o slučajnom izlaganju lijeku.
English: But no NOAEL for aneugenic effects was identified in rat females (LOEL = 25 mg/kg) and no clear dose related effect was observed because only slight difference in exposure (AUC0-24 and Cmax) with 3demethylthiocolchicine (SL59.0955) were observed between the different doses in males and females.
Croatian: No NOAEL za aneugeno djelovanje nije identificiran u ženki štakora (LOEL = 25 mg/kg) te nije uočeno učinak jasno povezan s dozom jer je uočena samo neznatna razlika u izlaganju (AUC0-24 i Cmax) s 3-demetiltiokolhikinom (SL59.0955) između različitih doza u mužjaka i ženki.
English: The in vitro MN test in human lymphocytes showed that M2 induced micronuclei in cultured human peripheral blood lymphocytes in all treatment conditions.
Croatian: Testom in vitro MN u ljudskih limfocita utvrđeno je da M2 izaziva mikronukleuse u kultiviranim ljudskim perifernim krvnim limfocitima u svim uvjetima liječenja.
English: Subsequent mechanistic analysis via the use of fluorescence in situ hybridization (FISH) with pan centromeric DNA probes demonstrated that micronuclei were predominantly generated via an aneugenic (numerical chromosome abnormality) mechanism under all treatment conditions; aneuploidy was clearly confirmed by centromere staining.
Croatian: Naknadna mehanistička analiza putem primjene fluorescentne svjetlosti in situ hibridizacija (FISH) s pancentromernim probama DNK-a pokazala je da su mikronukleusi uglavnom prevladavali u aneugenom (numerička abnormalnost kromosoma) mehanizmu u svim stanjima liječenja; aneuploidija jasno je potvrđena bojanjem centromere.
English: However, having considered the risks, thiocolchicoside containing medicinal products for systemic use should only be administered to patients over 16 years of age in acute conditions, with treatment duration limited to 7 (oral) and 5 (IM) consecutive days.
Croatian: No, uzimajući u obzir rizike, lijekovi koji sadrže tiokolhikozid za sistemsku primjenu smiju se davati samo bolesnicima starijima od 16 godina u slučaju akutnih stanja, pri čemu je trajanje liječenja ograničeno na 7 (peroralno) i 5 (intramuskularno) uzastopnih dana.
English: In the two in vitro and in vivo preclinical studies conducted, the findings (increase in the incidence of micronucleated cells) were observed at concentrations/exposures close to the exposures measured in human at therapeutic doses.
Croatian: U dva provedena in vitro i in vivo predklinička ispitivanja, nalazi (povećanje u incidenciji mikronukleatidnih stanica) uočeni su u koncentracijama/izlaganjima u blizini izlaganja izmjerenih u ljudi pri terapijskim dozama.
English: • The Committee considered all available data from pre-clinical, clinical studies, pharmacoepidemiological studies, published literature, post-marketing experience on the safety of thiocolchicoside containing medicinal products for systemic use with regards to its genotoxicity.
Croatian: • Povjerenstvo je razmotrilo sve dostupne podatke iz predkliničkih ispitivanja, kliničkih ispitivanja, farmakoepidemioloških ispitivanja, objavljene literature, iskustva nakon stavljanja lijeka u promet o sigurnosti lijekova koji sadrže tiokolhikozid za sistemsku primjenu s obzirom na njegovu genotoksičnost.
English: Aneuploidy (variation in the number of chromosomes and loss of heterozygosity) is recognised as a potential risk factor for cancer when impacting somatic cells, and teratogenicity, embryotoxicity/spontaneous abortions and impaired male fertility when impacting germ cells1.
Croatian: Aneuploidija (varijacija u broju kromosoma i gubitak heterozigotnosti) prepoznata je kao potencijalan čimbenik rizika od raka u slučaju kada utječe na somatske stanice, i teratogenosti, toksičnost embrija/spontanih pobačaja te poremećaja plodnosti u muškaraca kada utječe na zametne stanice1.
English: In conclusion, the results of the above pre-clinical studies showed that M2 (SL59.0955) induced micronuclei in vitro and in vivo, generated via a predominantly aneugenic mechanism under all treatment conditions.
Croatian: Zaključno, rezultati prethodno navedenih kliničkih ispitivanja pokazuju da su mikronukleusi inducirani M2 (SL59.0955) in vitro i in vivo generirani putem uglavnom aneugenog mehanizma u svim uvjetima liječenja.
English: After discontinuation of the above-mentioned phase I clinical trial with TCC, the genotoxic potential of the aglycone metabolite SL59.0955 (M2) was further investigated.
Croatian: Nakon prekida prethodno spomenute faze I kliničkog ispitivanja sa TCC-om dalje je istražen genotoksični potencijal metabolita aglikona SL59.0955 (M2).
English: The study protocol should be provided within the RMP.
Croatian: Protokol ispitivanja mora se dostaviti u sklopu RMPa.