FrancophonIA/ELRC3.0 huggingface dataset:
English: The CHMP was therefore of the view that risk minimisation measures (RMMs) should be undertaken in order to address the risks of teratogenicity, embryo-toxicity/spontaneous abortions, impaired male fertility and cancer.
Slovenian: CHMP je zato menil, da je treba sprejeti ukrepe za zmanjšanje tveganja, s katerimi bi zmanjšali tveganja za teratogenost, toksičnost za zarodek/spontani splav, zmanjšano plodnost moških in raka.
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
Slovenian: Rezultati iz ene od študij presnovkov (SL59.0955, M2) so bili zaskrbljujoči: novi podatki o anevgenem delovanju presnovka tiokolhikozida M2, pridobljeni iz predloženih predkliničnih študij, so pokazali, da obstaja sum genotoksičnega potenciala.
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).
Slovenian: CHMP je pregledal pogostnost oddajanja redno posodobljeih poročil o varnosti zdravila za zdravila za sistemsko uporabo, ki vsebujejo tiokolhikozid, in zahteval, da se poročila predložijo vsaka 3 leta (namesto vsakih 13 let, kot je trenutno priporočeno).
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.
Slovenian: • 2 primera z neznanim obdobjem izpostavljenosti: o 1 primer teratogenih učinkov (malformacij), povezanih z izpostavljenostjo v zgodnji nosečnosti, o 1 primer z neznanim razpletom nosečnosti zaradi pomanjkljive dokumentacije.
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.
Slovenian: Vendar pa pri samicah podgan niso opredelili NOAEL za anevgene učinke (LOEL = 25 mg/kg), prav tako pa niso opazili jasnega z odmerkom povezanega učinka, saj so s 3-demetiltiokolhicinom (SL59.0955) pri različnih odmerkih pri samcih in samicah zabeležili zgolj majhne razlike v izpostavljenosti (AUC0-24 in Cmax).
English: • an in vitro micronucleus (MN) test in primary culture of human lymphocytes with the aglycone metabolite (SL59.0955), with centromere staining (Whitwell J., 2012);
Slovenian: • mikronukleusni (MN) preskus in vitro na primarnih kulturah človeških limfocitov z aglikonskim presnovkom (SL59.0955) in z barvanjem centromer (Whitwell J., 2012);
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.
Slovenian: V preskusnih pogojih so raziskali tudi, kakšen je odmerek brez opaženih neželenih učinkov (NOAEL) in najmanjši odmerek, pri katerem je mogoče opaziti neželene učinke (LOAEL); medtem ko so potrdili, da je nerazdvajanje kromosomov končna točka, ki jo je najprimerneje raziskati pri proučevanju strupenih učinkov majhnih odmerkov na vreteno, pa ni bilo mogoče podati zaključkov v zvezi z mejnimi odmerki, pri katerih pride do anevploidije.
English: The corresponding product information sections were updated accordingly.
Slovenian: Zadevna poglavja informacij o zdravilu so bila ustrezno spremenjena.
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.
Slovenian: • 20 primerov zaradi izpostavljenosti med embrionalnim obdobjem, od tega: o dva primera teratogenih učinkov (malformacije), povezanih z izpostavljenostjo v zgodnji nosečnosti (v prvih štirih mesecih nosečnosti je tveganje največje), o štirje primeri, ki so se končali s prekinitvijo nosečnosti (3 spontani splavi in en prostovoljni splav, ki ni bil povezan z zdravstvenim stanjem), o pet primerov z ugodnim razpletom (brez vpliva na novorojenčka), o devet primerov z neznanim razpletom nosečnosti zaradi pomanjkljive dokumentacije;
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),
Slovenian: • 1 primer, ki je bil posledica izpostavljenosti v fetalnem obdobju (tj. primer toksičnih učinkov na plod, ki so povzročili zaplete pri rasti ploda ali zarodka ter histološkem ali funkcionalnem dozorevanju obstoječih organov) (obdobje v drugi četrtini nosečnosti, v katerem se pojavi največje tveganje);
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.
Slovenian: • odbor je proučil vse razpoložljive podatke iz predkliničnih in kliničnih študij, farmakoepidemioloških študij, objavljene literature in izkušenj v obdobju trženja, ki zadevajo varnost zdravil za sistemsko uporabo, ki vsebujejo tiokolhikozid, v povezavi z genotoksičnostjo;
English: Genotoxicity data on aglycone metabolite SL59.0955 (M2)
Slovenian: Podatki o genotoksičnosti aglikonskega presnovka SL59.0955 (M2)
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.
Slovenian: CHMP meni, da na podlagi kliničnih dokazov iz primerov, ki so jih imetniki dovoljenja za promet z zdravilom zabeležili v zvezi s posledicami anevploidije pri ljudeh, ni mogoče podati dokončnih sklepov.
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.
Slovenian: CHMP je zahteval tudi, da se opravi študija o uporabi zdravila (DUS), namenjena razjasnitvi prakse pri predpisovanju zdravil med običajno klinično uporabo pri reprezentativni skupini zdravstvenih delavcev, ki predpisujejo zdravila, in opredelitvi glavnih razlogov za predpisovanje.
English: On 21 February 2013, the CHMP started a referral procedure for TCC containing medicinal products.
Slovenian: CHMP je napotitveni postopek za zdravila, ki vsebujejo tiokolhikozid, začel dne 21. februarja 2013.
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.
Slovenian: Naknadna analiza mehanizma delovanja z uporabo fluorescenčne hibridizacije in situ (FISH) s sondami DNA za centromere je pokazala, da je bil nastanek mikronukleusov v glavnem posledica anevgenega (številčne nepravilnosti kromosomov) delovanja v vseh pogojih zdravljenja; anevploidijo so nedvoumno potrdili z barvanjem centromer.
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.
Slovenian: Potem ko je bilo že omenjeno klinično preskušanje I. faze s tiokolhikozidom prekinjeno, so podrobneje raziskali genotoksični potencial aglikonskega presnovka SL59.0955 (M2).
English: In females, a positive response was observed at doses of 25, 50, 70 and 100 mg/kg/d based on group mean and individual data.
Slovenian: Pri samicah so glede na skupinsko povprečje in podatke za posamezne živali pri odmerkih 25, 50, 70 in 100 mg/kg/dan zabeležili pozitiven odziv.
English: The CHMP reviewed all available data from pre-clinical and clinical studies, literature and post-marketing experience on aneuploidy for TCC containing medicinal products for systemic use.
Slovenian: CHMP je pregledal vse razpoložljive podatke iz predkliničnih in kliničnih študij, literature in izkušenj v obdobju trženja v zvezi z anevploidijo, povezano z zdravili za sistemsko uporabo, ki vsebujejo tiokolhikozid.
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.
Slovenian: Osnutek omenjenega obrazca za poročanje o nosečnosti mora biti vključen v RMP, poročilo o teh zbranih podatkih pa mora biti predloženo v okviru rednih posodobljenih poročil o varnosti zdravila.
English: This was associated with M1 plasma AUC of 4073 ng.h/mL, which is more than 20 times higher than M1 exposure observed in human after a 8 mg bid oral dose of TCC (175 ng.h/mL at 30 min).
Slovenian: Ta odmerek je povezan s plazemsko AUC presnovka M1 4073 ngh/ml, tj. več kot 20-krat večjo izpostavljenostjo presnovku M1, kot so jo zabeležili pri ljudeh po peroralnem odmerku 8 mg tiokolhikozida dvakrat na dan (175 ngh/ml po 30 minutah).
English: • an in vivo MN test in rat bone marrow following administration of aglycone metabolite (SL59.0955) by oral route in rats with centromere staining and with a full assessment of exposure to SL59.0955 and to 3-O-glucuronidated aglycone metabolite (SL18.0740) to better assess the threshold of exposure (Wase K., October 2012).
Slovenian: • MN preskus in vivo na kostnem mozgu podgan po peroralnem dajanju aglikonskega presnovka (SL59.0955) z obarvanjem centromer in celovito oceno izpostavljenosti presnovkoma SL59.0955 in 3-O-glukuronidnemu aglikonu (SL18.0740) za natančnejšo oceno mejne vrednosti izpostavljenosti (Wase K., oktober 2012).
English: In that respect, the CHMP was of the view that the indication in “Parkinson's disease and druginduced Parkinsonism with special consideration to neurodyslectic syndrome” should be removed as this is a chronic condition which requires longer treatment duration.
Slovenian: S tega vidika je CHMP menil, da je treba izbrisati indikacijo “Parkinsonova bolezen in z zdravili povzročen parkinsonizem, še zlasti nevrodislektični sindrom”, saj gre za kronično bolezen, ki zahteva daljše zdravljenje.
English: To address it, the proposed RMM (indication limited to acute conditions, treatment duration limited to seven consecutive days, avoidance of long-term use) were considered appropriate by the CHMP.
Slovenian: CHMP je menil, da so predlagani ukrepi za zmanjšanje tega tveganja (omejitev indikacije na akutna stanja, omejitev trajanja zdravljenja na sedem zaporednih dni, izogibanje dolgotrajni uporabi) ustrezni za zmanjšanje omenjenega tveganja.
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.
Slovenian: MN preskus in vivo na kostnem mozgu podgan je bil po peroralnem dajanju M2 v odmerkih 25, 50, 70, 100 ali 150 mg/kg/dan enkrat dnevno dva zaporedna dneva pri samcih negativen.
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.
Slovenian: Rezultati zgoraj navedenih predkliničnih študij so torej pokazali, da M2 (SL59.0955) spodbuja nastajanje mikronukleusov in vitro ter in vivo, kar je v glavnem posledica anevgenega delovanja v vseh pogojih zdravljenja.
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),
Slovenian: • šest primerov prirojenih nepravilnosti (tj. en primer multiplih malformacij, ki se je končal s splavom, en primer hipoplazije pljuč, en primer palatoshize, en primer spine bifide, en primer
English: In that respect, the CHMP was of the view that the indication in “Parkinson's disease and drug-induced Parkinsonism with special consideration to neurodyslectic syndrome” should be removed as this is an indication for chronic use.
Slovenian: S tega vidika je CHMP menil, da je treba izbrisati indikacijo “Parkinsonova bolezen in z zdravili povzročen parkinsonizem, še zlasti nevrodislektični sindrom”, saj indikacija zahteva kronično uporabo.
English: • Firstly, since the TCC metabolite M2 has been shown to be aneugenic at exposure levels close to human therapeutic exposure, the CHMP considered that the dose should be restricted (to 8 mg bid PO and 4 mg bid by IM) and long-term use avoided.
Slovenian: • Glede na to, da je bilo dokazano, da lahko presnovek tiokolhikozida M2 deluje anevgeno pri stopnjah izpostavljenosti, ki so blizu terapevtski izpostavljenosti človeka, je CHMP menil, da je treba omejiti odmerek (na 8 mg dvakrat na dan skozi usta in 4 mg dvakrat na dan intramuskularno) ter preprečiti dolgotrajno uporabo.
English: New studies were performed in 2011 and 2012 regarding the genotoxicity of the parent compound (TCC), its main circulating metabolite SL18.0740 and the aglycone metabolite SL59.0955.
Slovenian: Leta 2011 in 2012 so opravili nove študije v zvezi z genotoksičnostjo izhodne spojine (tiokolhikozid), njenega glavnega krožečega presnovka SL18.0740 in aglikonskega presnovka SL59.0955.
English: An amendment to the product information was agreed to address this concern.
Slovenian: Spremembe informacij o zdravilu so bile odobrene, da bi se omenjeno tveganje zmanjšalo.
English: Various genetic toxicology studies were conducted on TCC and on its major identified metabolite 3-O-glucuronidated aglycone (SL18.0740), which is the active metabolite.
Slovenian: Opravljenih je bilo več različnih študij genotoksičnosti tiokolhikozida in njegovega glavnega znanega presnovka 3-O-glukuronidnega aglikona (SL18.0740), ki je aktivni presnovek.
English: After discontinuation by a Company of a phase I clinical trial with TCC because of new non-clinical findings, the Italian medicines agency (AIFA) requested one of the Marketing Authorisation Holders (MAH) of TCC to further investigate the genotoxic potential of TCC and in particular of its metabolites; the MAH was requested to perform in vivo and in vitro preclinical studies to address the potential genotoxicity of the metabolites of TCC.
Slovenian: Italijanska agencija za zdravila (AIFA) je potem, ko je farmacevtska družba zaradi novih predkliničnih ugotovitev prekinila klinično preskušanje I. faze s tiokolhikozidom, zahtevala, da eden od imetnikov dovoljenja za promet s tiokolhikozidom podrobneje razišče, kakšen je genotoksični potencial tiokolhikozida in še zlasti njegovih presnovkov; od imetnika dovoljenja za promet so zahtevali, da opravi predklinične študije in vivo ter in vitro, da se ugotovi morebitna genotoksičnost presnovkov tiokolhikozida.
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.
Slovenian: Vendar pa se lahko zaradi tveganj zdravila za sistemsko uporabo, ki vsebujejo tiokolhikozid, uporabljajo samo pri bolnikih z akutnimi stanji, starejših od 16 let, zdravljenje pa lahko traja največ 7 (peroralna uporaba) oziroma 5 (intramuskularna uporaba) zaporednih dni.
English: TCC is indicated for the treatment of painful muscular contractures in different settings.
Slovenian: Tiokolhikozid je indiciran za zdravljenje bolečega krčenja mišic v različnih primerih.
English: Genotoxicity data on TCC and its main circulating metabolite SL18.0740 (M1)
Slovenian: Podatki o genotoksičnosti tiokolhikozida in njegovega glavnega krožečega presnovka SL18.0740 (M1)
English: The Committee, as consequence, concluded that the benefit-risk balance of thiocolchicoside containing medicinal products for systemic use as adjuvant treatment of painful muscle contractures in acute spinal pathology in adults and adolescents from 16 years onwardsremains favourable, subject to the restrictions, warnings, other changes to the product information, additional pharmacovigilance activities and risk minimisation measures agreed.
Slovenian: Posledično je CHMP zaključil, da je razmerje med tveganji in koristmi zdravil za sistemsko uporabo, ki vsebujejo tiokolhikozid in so indicirana za adjuvantno zdravljenje bolečega krčenja mišic pri akutni patologiji hrbtenice pri odraslih in mladostnikih, starejših od 16 let, še naprej ugodno pod pogojem, da se upoštevajo dogovorjene omejitve, opozorila in druge spremembe informacij o zdravilu, dodatne dejavnosti farmakovigilance ter ukrepi za zmanjšanje tveganja.
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.
Slovenian: Vendar pa se je več zadržkov zaradi tovrstne anevploidije pojavilo v zvezi z možnim tveganjem za nepravilnosti ploda kot v zvezi z neplodnostjo pri moških kot tako.
English: Having noted the above, the CHMP concluded that the benefit-risk balance of TCC containing medicinal products indicated as adjuvant treatment of painful muscle contractures in acute spinal pathology in adults and adolescents from 16 years onwards remains favourable subject to the restrictions, warnings, other changes to the product information, additional pharmacovigilance activities and RMMs agreed.
Slovenian: Ob upoštevanju vsega navedenega je CHMP zaključil, da je razmerje med tveganji in koristmi zdravil, ki vsebujejo tiokolhikozid in so indicirana za adjuvantno zdravljenje bolečega krčenja mišic pri akutni patologiji hrbtenice pri odraslih in mladostnikih, starejših od 16 let, še naprej ugodno pod pogojem, da se upoštevajo dogovorjene omejitve, opozorila in druge spremembe informacij o zdravilu, dodatne dejavnosti farmakovigilance ter ukrepi za zmanjšanje tveganja.
English: Pre-clinical studies
Slovenian: Predklinične študije
English: Based on common use in acute settings, other recommendations for the posology were included as the limitation of the treatment duration to 7 days in case of oral administration and to 5 days in case of IM administration; a reference to the maximum dose allowed was also recommended .Finally a 12 hours interval between 2 consecutive administrations was requested in view of the elimination half-life of the M2 metabolite.
Slovenian: Glede na pogosto uporabo v akutnih primerih so vključili tudi druga priporočila glede odmerjanja, in sicer omejitev trajanja zdravljenja na 7 dni v primeru peroralne uporabe in na 5 dni v primeru intramuskularne uporabe; priporočili so tudi, da se navede največji dovoljeni odmerek.
English: Clinical trials and post marketing spontaneous reports were submitted by the MAHs.
Slovenian: Imetniki dovoljenja za promet z zdravilom so predložili klinična preskušanja in spontana poročila iz obdobja trženja.
English: The CHMP was therefore of the view that the available data allow to confirm a clear aneugenic effect of the thiocolchicoside metabolite M2 at concentrations which are 4 fold the human exposure in plasma after oral 8 mg TCC treatment bid (recommended dose) and starting from 25 mg/kg dose.The submitted data did not allow establishing a NOEL for aneuploidy, thus not excluding the potential for a human risk.
Slovenian: CHMP je zato menil, da je na podlagi razpoložljivih podatkov mogoče potrditi, da ima presnovek tiokolhikozida M2 nedvomno anevgeni učinek pri koncentracijah, ki so 4-krat večje od plazemske izpostavljenosti pri človeku po zdravljenju s peroralnim odmerkom 8 mg tiokolhikozida dvakrat na dan (priporočeni odmerek) in se začnejo pri odmerku 25 mg/kg.
English: Finally educational material for prescribers and for patients highlighting the risks and warnings of genotoxicity reactions will also be submitted to national competent authorities within the RMP.
Slovenian: Poleg tega se bo v okviru RMP pristojnim nacionalnim organom predložilo izobraževalno gradivo za zdravstvene delavce, ki predpisujejo zdravilo, in bolnike, da se jih seznani s tveganji in opozorili v zvezi z genotoksičnimi neželenimi učinki.
English: Widely used by prescribers in the concerned Member States (see Annex I), the benefits of TCC containing medicinal products are recognised in clinical practice.
Slovenian: Koristi zdravil, ki vsebujejo tiokolhikozid, so priznane v klinični praksi, saj zdravstveni delavci v zadevnih državah članicah (glejte Prilogo I) ta zdravila pogosto predpisujejo.
English: In addition, three-yearly PSURs should be submitted by all MAHs of these products.
Slovenian: Poleg tega morajo vsi imetniki dovoljenj za promet s temi zdravili predložiti 3-letna redno posodobljena poročila o varnosti zdravila.
English: Amendments to the warnings and pregnancy and lactation sections of the product information were also endorsed.
Slovenian: Potrdili so tudi spremembe poglavja povzetka glavnih značilnosti zdravila z opozorili in poglavij o nosečnosti ter dojenju.
English: No cases of cancer, congenital abnormalities, spontaneous abortion and impaired male fertility were retrieved from a review of clinical trials and literature.
Slovenian: V pregledu kliničnih preskušanj in literature niso zasledili primerov raka, prirojenih nepravilnosti, spontanega splava in zmanjšane plodnosti moških.
English: • Carcinogenicity and impaired fertility are categorised as important potential risks.Concerning the risk of male infertility: elevated sperm chromosome aneuploidy is known to be associated with male infertility.
Slovenian: Glede tveganja za neplodnost pri moških: znano je, da je anevploidija, ki povzroči povečano število kromosomov v semenčicah, povezana z neplodnostjo moških.
English: The duration of treatment must not exceed 2 weeks.
Slovenian: Trajanje zdravljenja ne sme presegati 2 tednov.
English: If a longer duration of use is required, other pharmaceutical forms are available.
Slovenian: Če je potreben daljši čas uporabe, so na voljo druge farmacevtske oblike.
English: [Solution for injection (i.m.)]
Slovenian: [Raztopina za injiciranje (i.m.)]
English: [The currently approved indications should be deleted and replaced by the following:]
Slovenian: [Trenutno odobrene indikacije se izbriše in nadomesti s sledečimi:]
English: Very common: Transaminases increased.
Slovenian: Zelo pogosti: zvišanje transaminaz.
English: The summary of product characteristics and package leaflet may need to be subsequently updated by the national competent authorities, in liaison with the reference Member State, if appropriate
Slovenian: Povzetek glavnih značilnosti zdravila in navodilo za uporabo bo morda posledično potrebno posodobiti s pristojnimi nacionalnimi organi, v povezavi z referenčno državo članico, kjer je to primerno.
English: For single dose application in adults with postoperative pain.
Slovenian: Za enkratno odmerjanje pri odraslih s pooperativno bolečino.
English: A. Summary of Product Characteristics (SmPC) <This medicinal product is subject to additional monitoring.
Slovenian: A. Povzetek glavnih značilnosti zdravila (SmPC) < Za to zdravilo se izvaja dodatno spremljanje varnosti.