FrancophonIA/ELRC3.0 huggingface dataset:
English: The main localisation of fibrosis is preferentially pulmonary area and also retroperitoneal and cardiac area.
Croatian: Glavna lokalizacija fibroze je preferencijalno pulmonalno područje, kao i retroperitonealno i srčano područje.
English: Therefore, none of the studies can be considered as conclusively supporting the evidence of efficacy in the indications under assessment.
Croatian: Stoga, niti jedno se ispitivanje ne može smatrati uvjerljivim za potkrjepljivanje dokaza djelotvornosti u indikacijama koje su ocjenjivane.
English: The majority of them had been previously treated with various anti-migraine drugs like dihydroergotamine, pizotifen and propranolol with unsatisfactory effects.
Croatian: Većina njih je prethodno liječena lijekovima protiv migrene, poput dihidroergotamina, pizotifena i propranolola s nezadovoljavajućim učincima.
English: However, provision of information on these events is insufficient to avoid that some patients develop fibrosis and ergotism during treatment.
Croatian: No, odredbe informacija o ovim događajima nisu dostatne da bi se izbjeglo da pojedini bolesnici razviju fibrozu i ergotizam tijekom liječenja.
English: Therefore, the CHMP was of the opinion that it is not possible to rule out the possibility that these actually correspond to the development of ergotism.
Croatian: Stoga, mišljenje je CHMP-a da se ne može isključiti mogućnost da oni u stvari odgovaraju razvoju ergotizma.
English: In these cases, the event occurred after 5 months to 30 years of nicergoline treatment and in patients aged between 59 and 90 years.
Croatian: U ovim slučajevima, događaj je nastupio 5 mjeseci do 30 godina nakon liječenja nicergolinom te u bolesnika od 59 do 90 godina starosti.
English: Moreover, recent cases were identified during the French survey conducted in 2011, which show that the risk minimisation measures currently in place are not sufficient to prevent the development of fibrotic reactions.
Croatian: Nadalje, posljednji slučajevi su identificirani tijekom francuskog istraživanja provedenog 2011. godine, i pokazuju da mjere za smanjivanje rizika, koje su trenutno na snazi, nisu dostatne kako bi se spriječio razvoj fibrotičkih reakcija.
English: Improvements in visual acuity were also reported in Ganescu study (46 patients of various eye conditions) but this study was not comparative.
Croatian: Poboljšanja oštrine vida prijavljena su u Ganescu ispitivanju (46 bolesnika s različitim očnim stanjima), no ovo ispitivanje nije bilo komparativno.
English: The CHMP has considered the totality of the available data on the safety and efficacy of nicergoline.
Croatian: CHMP je razmotrio ukupnost dostupnih podataka o sigurnosti i djelotvornosti nicergolina.
English: The improvement, when documented, was observed between 3 and 10 months after nicergoline discontinuation, without corticoid treatment in four cases.
Croatian: Poboljšanje, ako je dokumentirano, uočeno je između 3 i 10 mjeseci nakon prekida uzimanja nicergolina, bez liječenja kortikoidima u četiri slučaja.
English: Taking into account the limited information presented from these studies (only summary of these studies were provided), the unclear inclusion/exclusion criteria and statistical analyses employed, no conclusion can be drawn from the data provided.
Croatian: Uzimajući u obzir ograničene informacije, koje su prezentirane iz ovih ispitivanja (dostavljeni su samo sažetci ovih ispitivanja), kao i nejasan kriterij uključivanja/isključivanja i primijenjene statističke analize nisu mogli biti doneseni zaključci na temelju dostavljenih podataka.
English: • The Committee considered the overall submitted data provided by the MAHs and the outcome of the scientific advisory group.
Croatian: • Povjerenstvo je razmotrilo sve dostavljene podatke koje su dostavili nositelji odobrenja i zaključak znanstvene savjetodavne grupe.
English: • The Committee is of the opinion that the evidence for clinically significant efficacy of nicergoline in the currently assessed indications is very limited, and therefore the potential benefit for patients in these indications is outweighed by the identified risk.
Croatian: • Povjerenstvo je mišljenja da su dokazi klinički značajne djelotvornosti nicergolina za trenutno ocjenjene indikacije vrlo ograničeni, te stoga identificirani rizici nadmašuju potencijalne koristi za bolesnike u ovim indikacijama.
English: • The Committee considered that a potential causal association between fibrotic reactions or ergotism and nicergoline cannot be excluded.
Croatian: • Povjerenstvo smatra da se ne mogu isključiti potencijalne kauzalne poveznice između fibrotičkih reakcija ili ergotizma i nicergolina.
English: The CHMP noted that an under-notification of the adverse events can also be suspected given that:
Croatian: CHMP je napomenuo da se može posumnjati u premalo prijava nuspojava s obzirom da:
English: Indeed, this publication described the metaanalysis of 13 double-blind, placebo-controlled, randomised studies performed by the Cochrane Collaboration in 2001.
Croatian: Doduše, ova je publikacija opisala meta analizu u 13 dvostruko slijepih, placebom kontroliranih, randomiziranih ispitivanja provedenih 2001. godine od strane Cochrane Collaboration.
English: Nicergoline was also given to 17 patients with migraines for prevention of attacks (Prusinski, Wiad.Lek, 1984).
Croatian: Nicergolin primijenjen je također u 17 bolesnika s migrenama za prevenciju napadaja (Prusinski, Wiad.Lek, 1984).
English: • Fibrosis is also a slow and insidious reaction that occurs after a long period of treatment and with delayed diagnosis
Croatian: • je fibroza također spor i neprimjetan odgovor koji nastupa nakon dugog razdoblja liječenja i s kasnom dijagnozom.
English: Most of the studies that became available after the granting of the initial marketing authorisation were very old and of poor methodological quality, notably non-randomised and with a low number of patients.
Croatian: Većina ispitivanja, koja je postala dostupna nakon izdavanja prvotnog odobrenja za stavljanje lijeka u promet, bila je vrlo stara i slabe metodološke kvalitete, te ponajprije nisu bila randomizirana i obuhvaćala su mali broj bolesnika.
English: Dementia and dementia related indications are excluded from the scope of this referral procedure.
Croatian: Demencija i s demencijom povezane indikacije isključene su iz predmeta postupka upućivanja.
English: As a result, the reliability and the clinical relevance of the studies is questionable.
Croatian: Rezultat toga je upitnost pouzdanosti i kliničke relevantnosti ispitivanja.
English: In conclusion, the CHMP was of the opinion that a couple of studies have some positive findings in the populations tested but considering the inadequate methodology, the reliability and the clinical relevance of the results is questionable.
Croatian: Zaključno, mišljenje je CHMP-a da nekoliko ispitivanja sadrži pozitivne nalaze u testiranoj populaciji, no uzimajući u obzir neprimjerenu metodologiju, upitna je pouzdanost i klinička relevantnost rezultata.
English: The MAHs considers that the most comprehensive review of nicergoline efficacy was completed in a meta-analysis performed in 2008 by Winblad et al.
Croatian: Nositelji odobrenja smatraju da je najsloženiji pregled djelotvornosti nicergolina proveden u meta analizi provedenoj 2008. godine od strane Winblad et al.
English: Four cases of fibrotic events were excluded from the analysis.
Croatian: Iz analize isključena su četiri slučaja fibrotičkih događaja.
English: The CHMP was therefore requested to give its opinion on whether the marketing authorisations for ergot derivatives containing medicinal products should be maintained, varied, suspended or withdrawn in relation to the below mentioned indications:
Croatian: Stoga je zatraženo od CHMP-a da donese svoje mišljenje trebaju li se odobrenja za stavljanje u promet lijekova koji sadrže derivate ergota zadržati, izmijeniti, suspendirati ili ukinuti s obzirom na niže navedene indikacije:
English: Therefore, the group was of the opinion that there is not a clearly defined population, which unsatisfactorily responds to standard migraine prophylaxis treatment, where there is a therapeutic need for this substance as alternative/last line treatment.
Croatian: Stoga, mišljenje je grupe da ne postoji jasno definirana populacija, koja nezadovoljavajuće odgovara na standardno liječenje profilakse migrene, kada postoji terapijska potreba za ovom tvari kao alternativno liječenje / posljednja opcija.
English: Overall, the study designs were adequate (randomised, double-blind, placebo-controlled), diagnoses were established according classification criteria at the time of the studies, primary efficacy scales were defined a priori (MMSE, SCAG, ADAS-Cog).
Croatian: Načelno, dizajni ispitivanja bili su primjereni (randomizirana, dvostruko slijepa, placebom kontrolirana), dijagnoze su postavljene sukladno kriterijima klasifikacije u trenutku ispitivanja, skale primarne djelotvornosti definirane su a priori (MMSE, SCAG, ADAS-Cog).
English: From the approved indications of the nicergoline containing medicinal products the ones that are in the scope of this referral procedure and are approved in at least one Member State are the following (specific wording of the indication may vary from product to product):
Croatian: Od odobrenih indikacija za lijekove koji sadrže nicergolin, sljedeće su indikacije predmetom ovog postupka upućivanja i odobrene su od barem jedne države (točna formulacija indikacije može varirati od proizvoda do proizvoda):
English: Among the 21 remaining cases, an association between nicergoline and the fibrotic event or potential fibrotic event could not be excluded.
Croatian: U slučaju preostalog 21 slučaja nije se mogla isključiti veza između nicergolina i fibrotičkog događaja ili potencijalnog fibrotičkog događaja.
English: Therefore, despite the positive conclusions of the authors regarding the progression of visual acuity under a treatment with nicergoline, the CHMP considered that, in the absence of a comparison to a placebo control, no reliable conclusion can be drawn from these clinical results which referred to heterogeneous data based on small series of patients of various eye conditions.
Croatian: Stoga, usprkos pozitivnim zaključcima autora u vezi s progresijom oštrine vida u slučaju liječenja nicergolinom, CHMP smatra da se, u odsutnosti usporedbe s placebo kontrolom grupom, ne mogu donijeti pouzdani zaključci za ove kliničke rezultate, koji se odnose na heterogene podatke na temelju malih serija bolesnika s različitim očnim stanjima.
English: Regarding ergotism, there were no cases identified in the MAH's safety database reporting the preferred term ergotism associated with nicergoline.
Croatian: Vezano uz ergotizam, ne postoje slučajevi identificirani u sigurnosnoj bazi nositelja odobrenja kojima se prijavljuje preferirani pojam ergotizma povezan s nicergolinom.
English: Regarding cases of pulmonary reactions, the emerging number of cases and the improvement observed after nicergoline discontinuation in 10 cases with no confounding factor is in favour of a causal role of nicergoline, especially in 5 cases in which improvement was also confirmed by radiography or scanner.
Croatian: Vezano uz slučajeve pulmonalnih reakcija, rastući broj slučajeva i poboljšanje uočen nakon prekida uzimanja nicergolina u 10 slučajeva bez čimbenika zabune ide u prilog kauzalnoj ulozi nicergolina, posebice u 5 slučajeva, u kojima je poboljšanje potvrđeno radiografijom ili skenerom.
English: The marketing authorisation holders (MAHs) submitted all available efficacy data from clinical trials and observational studies, including data that became available since the granting of the initial marketing authorisation.
Croatian: Nositelji odobrenja za stavljanje lijeka u promet (nositelji odobrenja) dostavili su sve dostupne podatke o djelotvornosti iz kliničkih istraživanja i opservacijskih ispitivanja, uključujući i podatke koji su postali dostupni od trenutka izdavanja prvotnog odobrenja za stavljanje lijeka u promet.
English: In addition, given that fibrosis is a serious life threatening reaction, observed after long duration of treatment with nicergoline (a drug used in indications requiring long duration of treatment), this has an impact on the benefit-risk profile of the products.
Croatian: Nadalje s obzirom da je fibroza ozbiljna reakcija opasna po život, uočena nakon dugotrajnog liječenja nicergolinom (lijek koji se koristi za indikacije koje zahtijevaju dugotrajno liječenje), ovo ima učinak na profil omjera koristi i rizika lijekova.
English: The MAHs also submitted their own overviews and critical summaries of all spontaneous reports of fibrotic reactions (cardiac with or without pulmonary arterial hypertension, pulmonary, pleural, peritoneal, retroperitoneal, etc) and ergotism with their ergot derivatives-containing medicinal products.
Croatian: Nositelji odobrenja dostavili su, također, i svoje vlastite preglede i kritičke sažetke svih spontanih prijava fibrotičkih reakcija (srčanih s ili bez pulmonalne arterijske hipertenzije, pulmonalnih, pleuralnih, peritonealnih, retroperitonealnih, itd.) i ergotizma povezanih sa njihovim lijekovima koji sadrže derivat ergota.
English: Regarding peritoneal and cardiac fibrosis, the CHMP was of the view that the causal role of nicergoline cannot be excluded.
Croatian: Vezano uz peritonelane i srčane fibroze, mišljenje je CHMP-a da se ne može isključiti kauzalna uloga nicergolina.
English: Grounds for the suspension/variation to the terms of the marketing authorisations
Croatian: Razlozi za suspenziju/varijaciju uvjeta odobrenja za stavljanje lijeka u promet
English: The group highlighted that the claimed indication is not used anymore in the clinical practice and that from a clinical viewpoint there is no evidence at present that there is a therapeutic need for this active substance in the treatment of cognitive and neurosensorial impairment in the elderly.
Croatian: Grupa je naglasila da se dodijeljena indikacija više ne koristi u kliničkoj praksi, te da sa kliničkog stajališta u sadašnjosti nema dokaza za postojanje terapijske potrebe za ovom djelatnom tvari u liječenju kognitivnog i neurosenzoričkog oštećenja u starijih osoba.
English: Nicergoline is a semisynthetic ergoline derivative that seems to have an action: (i) as an α1adrenoceptor antagonist, it induces vasodilation and increases arterial blood flow; (ii) it enhances cholinergic and catecholaminergic neurotransmitter function; (iii) it inhibits platelet aggregation; (iv) it promotes metabolic activity, resulting in increased utilization of oxygen and glucose; and (v) it has neurotrophic and antioxidant properties.
Croatian: Nicergolin je polusintetički derivat ergolina za koji se čini da djeluje: (i.) kao antagonist α1adrenoceptora, koji potiče vazodilataciju i povećava protok arterijske krvi; (ii.) povećava funkciju kolinergijskih i katekolaminergijskih neurotransmitora; (iii.) sprječava agregaciju trombocita; (iv.) potiče metaboličku aktivnost, što rezultira povećanom iskoristivošću kisika i glukoze; i (v.) ima neurotrofna i antioksidantna svojstva.
English: The studies submitted have assessed nicergoline for oral or parenteral use and had heterogeneous efficacy endpoints such as: sensitivity to cold, peripheral blood flow, walking distance, pain, quality of life.
Croatian: Dostavljena ispitivanja ocijenila su nicergolin za oralnu i parenteralnu uporabu i imala su završne točke heterogene djelotvornosti poput: osjetljivost na hladnoću, periferan protok krvi, prehodani put, bol, kvaliteta života.
English: To conclude, given the cases reported for a reaction difficult to early diagnose (delayed symptoms) and probably under reported, the use of the drug at an approved dosage, added to a plausible pharmacological profile, nicergoline is considered to be associated with a risk of fibrotic reactions.
Croatian: Zaključno, s obzirom da se slučajevi prijavljeni za reakciju teško rano dijagnosticiraju (kasni simptomi) i vjerojatno su premalo prijavljivani, uporaba lijeka u odobrenoj dozi, uz plauzibilan farmakološki profil, nicergolin se smatra povezanim s rizikom od fibrotičke reakcije.
English: The CHMP considered the MAH's proposal for risk minimisation measures: the inclusion of information related to fibrosis and ergotism in section 4.4 of the Summary of Product Characteristics.
Croatian: CHMP razmotrio je prijedlog nositelja odobrenja za mjere za smanjivanje rizika: uključivanje informacija povezanih s fibrozom i ergotizmom u dio 4.4 sažetka opisa svojstava lijeka.
English: In addition, a scientific advisory group (SAG) was convened in December 2012 at the request of the CHMP during which the experts discussed, based on their clinical experience, whether this substance plays a role in the prophylaxis of migraine headache.
Croatian: Nadalje, znanstvena savjetodavna grupa (SAG) sazvana je u prosincu 2012. godine na zahtjev CHMPa, tijekom koje su stručnjaci, na temelju svojeg kliničkog iskustva, raspravljali igra li ova tvar značajnu ulogu u profilaksi mingrenske glavobolje.
English: For the indication “ancillary treatment of Raynaud's syndrome”, the submitted studies did not really assess nicergoline in patients with this specific indication, but were rather conducted in patients with peripheral arteriopathy.
Croatian: Za indikaciju „pomoćno liječenje Raynaudovog sindroma“, dostavljena ispitivanja nisu uistinu ocijenila nicergolin u bolesnika s ovom specifičnom indikacijom, već su provedena u bolesnika s perifernom arteriopatijom.
English: For the indication “prophylaxis of migraine headache” the available data in migraine headache are from open label studies in a small number of patients (40 and 17 patients).
Croatian: Za indikaciju „profilaksa mingrenske glavobolje“, dostupni podaci o mingrenskoj glavobolji potječu iz otvorenih (tzv. open label) ispitivanja provedenih na malom broju bolesnika (40 i 70 bolesnika).
English: Therefore, the CHMP was of the opinion that these substantial methodological deficiencies preclude any conclusion on the efficacy of nicergoline (oral or parenteral) on Raynaud's syndrome, and more largely in peripheral circulation disorders.
Croatian: Stoga, mišljenje je CHMP-a da ovi značajni metodološki nedostaci isključuju bilo kakav zaključak o djelotvornosti nicergolina (oralnog ili parenteralnog) za Raynaudov sindrom, te šire gledano za poremećaje periferne cirkulacije.
English: Fourty (40) patients with migraine were assessed in an open clinical study that became available after the initial marketing authorisation was granted (Prusinski, Wiad.Lek, 1984).
Croatian: Ocijenjeno je četrdeset (40) bolesnika s migrenom u otvorenom kliničkom ispitivanju, koje je postalo dostupno nakon izdavanja prvotnog odobrenja za stavljanje lijeka u promet (Prusinski, Wiad.Lek, 1984.).
English: This Cochrane review on efficacy of nicergoline was performed in patients with mild to moderate dementia and is therefore also outside the scope of the procedure.
Croatian: Ovaj Cochraneov pregled djelotvornosti nicergolina proveden je u bolesnika s blagom do umjerenom demencijom, te se stoga nalazi izvan predmeta postupka.
English: Ninety (90) cases were found to contain terms potentially indicative of symptoms or ergotism, such as paraesthesia, formication, tingling, intestinal/cerebrovascular/peripheral/tongue ischaemia, angina pectoris, coronaropathy, thoracic pain, nausea, vomiting, diarrhoea, abdominal pain, cold sensation, thrombosis, stroke, gangrene, necrosis, vasoconstriction/vasospasm, cyanosis, myalgia, muscular cramps, pain in extremities, vertigo, hypoaesthesia, numbness, headache, confusion, hallucinations.
Croatian: Utvrđeno je da devedeset (90) slučajeva sadrži uvjete koji su potencijalno indikativni za simptome ili ergotizam, poput paraestezije, formikacije, trnaka, intestinalne/cerebrovaskularne/periferalne ishemije / ishemije jezika, angine pektoris, koronaropatije, torakalne boli, mučnine, povraćanja, proljeva, abdominalne boli, osjećaja hladnoće, tromboze, moždanog udara, gangrene, nekroze, vazokonstrikcije/vazospazma, cijanoze, mijalgije, mišićnih grčeva, boli u ekstremitetima, vrtoglavice, hipoastezije, tuposti, glavobolje, konfuzije, halucinacija.
English: Based on the clinical experience the group considered that no special population exists that could benefit from the treatment with this active substance in the prophylaxis of migraine headache.
Croatian: Na temelju kliničkog iskustva grupa smatra da ne postoji posebna populacija koja bi imala koristi od liječenja s ovom djelatnom tvari u profilaksi mingrenske glavobolje.
English: This does not exactly reflect the indication supported by the MAH.
Croatian: Ovo ne prikazuje uistinu indikaciju koju podupire nositelj odobrenja.
English: In addition, a scientific advisory group (SAG) was convened in December 2012 at the request of the CHMP during which the experts discussed, based on their clinical experience, whether this substance plays a role in the symptomatic treatment of chronic pathological cognitive and neurosensorial impairment in elderly (excluding Alzheimer's disease and other dementia).
Croatian: Nadalje, znanstvena savjetodavna grupa (SAG) sazvana je u prosincu 2012. godine na zahtjev CHMPa, tijekom koje su stručnjaci raspravljali, na temelju svojeg kliničkog iskustva, igra li ova tvar značajnu ulogu u simptomatskom liječenju kroničnog patološkog kognitivnog i neurosenzoričkog oštećenja u starijih osoba (isključujući Alzheimerovu bolest i druge demencije).
English: The CHMP was of the opinion that overall based on these data there is some evidence of positive effects of nicergoline on cognition and behaviour in patients with senile cerebral insufficiency of different origins.
Croatian: Mišljenje je CHMP-a da ukupno gledajući na temelju ovih podataka postoji određeni dokaz pozitivnog djelovanja nicergolina na kogniciju i ponašanje bolesnika sa senilnom cerebralnom insuficijencijom različitih porijekla.
English: On the efficacy side for the indication “symptomatic treatment of chronic pathological cognitive and neurosensorial impairment in elderly (excluding Alzheimer's disease and other dementia)”, the efficacy data were mainly provided from study publications conducted in patients with dementia (Alzheimer disease, multi-infarct dementia, vascular dementia, Parkinson disease, etc), while dementia is excluded from the scope of this referral procedure.
Croatian: Vezano uz pitanje djelotvornosti za indikaciju „simptomatsko liječenje kroničnog patološkog kognitivnog i neurosenzoričkog oštećenja u starijih osoba (isključujući Alzheimerovu bolest i druge demencije)“, podaci o djelotvornosti dostavljeni su uglavnom iz publikacija ispitivanja provedenih u bolesnika s demencijom (Alzheimerovom bolesti, multiinfarktnom demencijom, vaskularnom demencijom, Parkinsonovom bolesti, itd.), dok je demencija isključena iz predmeta ovog postupka upućivanja.
English: For the indications “ancillary treatment of visual acuity decrease and visual field disturbances presumably of vascular origin” and “acute retinopathies of vascular origin” the CHMP noted that positive clinical results (in particular regarding the progression of visual acuity) were described mainly in one open long-term study in the context of an ambulatory ophthalmological practice that involved 213 patients with heterogeneous pathologies (e.g. retina degeneration, inflammatory diseases of the retina and of the optic nerve, venous and arterial vessels occlusions, glaucoma, etc) (Hasslinger, 1986).
Croatian: Za indikacije „pomoćno liječenje smanjenja oštrine vida i poremećaja vidnoga polja za koje se pretpostavlja da su vaskularnog porijekla“ i „akutne retinopatije vaskularnog porijekla“, CHMP je napomenuo da su pozitivni klinički rezultati (posebice u vezi s progresijom oštrine vida) opisani uglavnom u jednom otvorenom dugoročnom ispitivanju u kontekstu ambulantne oftalmološke prakse, koje je obuhvatilo 213 bolesnika s heterogenim patologijama (primjerice degeneracije rožnice, upalnim bolestima rožnice i optičkog živca, okluzijama venskih i arterijskih krvnih žila, glaukomom, itd.) (Hasslinger, 1986.).