FrancophonIA/ELRC3.0 huggingface dataset:
English: The CHMP has considered the totality of the available data on the safety and efficacy of tolperisone.
Danish: CHMP har vurderet samtlige tilgængelige data om tolperisons sikkerhed og virkning.
English: For the remaining indications (rehabilitation after orthopaedic and trauma surgery, treatment of obliterative vascular diseases as well as syndromes due to impaired vascular innervation, and Little's disease and other encephalopaties accompanied by dystonia) there is extremely limited evidence of efficacy, mainly based on small studies with inadequate design and including a heterogeneous population.
Danish: For så vidt angår de resterende indikationer (revalidering efter ortopæd- og traumekirurgi, behandling af obliterative vaskulære sygdomme samt syndromer som følge af begrænset vaskulær innervation og Littles sygdom og andre encefalopatier ledsaget af dystoni), er dokumentationen for virkningen yderst begrænset og hovedsagelig baseret på mindre undersøgelser med uhensigtsmæssig udformning og en heterogen population.
English: In this respect, the CHMP took note of the fact that the marketing authorisation holder of the products for which these indications are approved concluded that the evidence of efficacy is insufficient to balance the risks associated to the product and proposed that the indications be deleted.
Danish: I denne henseende tog CHMP til efterretning, at indehaveren af markedsføringstilladelserne for de produkter, for hvilke disse indikationer er godkendt, konkluderede, at dokumentationen for virkningen er utilstrækkelig til at opveje de risici, der er forbundet med lægemidlet, og foreslog, at indikationerne skulle slettes.
English: • The Committee is of the opinion that the evidence for clinically significant efficacy of tolperisone in the currently approved indications is extremely limited, and therefore the potential benefit for patients in these indications is outweighed by the identified risk.
Danish: • udvalget mener, at dokumentationen for klinisk signifikant virkning af tolperison inden for de aktuelt godkendte indikationer er yderst begrænset, og at de potentielle fordele for patienter inden for disse indikationer derfor ikke opvejer risikoen
English: It is important to note that the evidence of efficacy is mainly based on the results of the Stamenova study, which only included patients with post-stroke spasticity.
Danish: Det er vigtigt at bemærke, at dokumentationen for virkningen primært er baseret på resultaterne af Stamenova-undersøgelsen, der udelukkende omfattede patienter med spasticitet som følge af postapopleksi.
English: It possesses high affinity for nervous tissue, reaching the highest concentrations in the brain stem, spinal cord and peripheral nerve tissue.
Danish: Tolperison har høj affinitet for nervevæv og når de højeste koncentrationer i hjernestammen, rygmarven og det perifere nervevæv.
English: While no fatal case of hypersensitivity was reported, around 10% of all cases reported with tolperisone were considered to be life-threatening.
Danish: Selv om der ikke er indberettet overfølsomhedsreaktioner med dødelig udgang, blev omkring 10 % af de indberettede overfølsomhedsreaktioner over for tolperison opfattet som livstruende.
English: • The revocation of the marketing authorisation for the parenteral formulations of medicinal products referred to in annex I.
Danish: • inddragelse af markedsføringstilladelsen for parenterale formuleringer af de i bilag I omhandlede lægemidler.
English: Van Denburg et al. (2008) have found a 33% change in the Ashworth Scale to correlate with a 1-point change in the Physician's global assessment score in patients with post-stroke spasticity, indicating clinical relevance.
Danish: I henhold til Van Denburg et al. (2008) korrelerer en 33-%-ændring på Ashworth-skalaen med en et-point-ændring på GAF-skalaen (»Global Assessment of Functioning«) hos patienter med spasticitet som følge af postapopleksi, hvilket indikerer klinisk relevans.
English: In conclusion the Stamenova study can be regarded as a positive study, the results of which are indicative of a clinically relevant effect of tolperisone in the treatment of patients with post-stroke spasticity.
Danish: Sammenfattende kan Stamenovaundersøgelsen vurderes som en positiv undersøgelse, hvis resultater indikerer en klinisk relevant virkning af tolperison i behandlingen af patienter med spasticitet som følge af postapopleksi.
English: Following the adoption of the CHMP opinion and recommendations during the June 2012 CHMP meeting, re-examination requests were received from Gedeon Richter PLC and PP Nature Balance Lizenz GmbH, as they considered that there is adequate data supporting the efficacy of tolperisone in the “treatment of muscular hypertonicity and muscle spasms associated with locomotor diseases” indication.
Danish: Efter vedtagelsen af CHMP's udtalelse og anbefalinger på udvalgets møde i juni 2012 modtoges en anmodning om revurdering fra Gedeon Richter PLC og PP Nature Balance Lizenz GmbH, som var af den opfattelse, at der forelå tilstrækkelig dokumentation til støtte for virkningen af tolperison ved indikationen behandling af muskulær hypertonicitet og muskelspasmer i forbindelse med lokomotoriske sygdomme.
English: The company that holds these marketing authorisations was asked to submit any existing data in support of its safety and dosing recommendations, but no relevant data was submitted for assessment as the marketing authorisation holder concluded itself that the data is insufficient to conclude that the benefits outweigh the risks and proposed that the marketing authorisations for the parenteral formulations be revoked.
Danish: Indehaveren af markedsføringstilladelserne blev anmodet om at indsende eventuelle eksisterende data til støtte for selskabets sikkerheds- og doseringsanbefalinger, men der blev ikke indsendt relevante data til vurdering, eftersom indehaveren af markedsføringstilladelserne selv konkluderede, at dataene er utilstrækkelige til at konkludere, at fordelene opvejer risiciene, og foreslog, at markedsføringstilladelserne til de parenterale formuleringer skulle tilbagekaldes.
English: Analysis of spontaneous reports suggests that hypersensitivity reactions are more frequent in women, patients with previous or current allergic disease or those using NSAIDs or other analgesics concomitantly.
Danish: Analyser af spontane indberetninger indikerer, at overfølsomhedsreaktioner er hyppigere hos kvinder, patienter, som har lidt eller lider af allergiske sygdomme, og patienter, som anvender non-steroide anti-inflammatoriske lægemidler eller andre analgetika samtidig.
English: • The Committee is also of the opinion that there is evidence of clinically significant efficacy of tolperisone in the symptomatic treatment of post-stroke spasticity in adults.
Danish: • udvalget mener endvidere, at der er dokumentation for klinisk signifikant virkning af tolperison i symptombehandling af spasticitet som følge af postapopleksi hos voksne
English: While the results are difficult to interpret due to the lack of a placebo control group to verify assay integrity, this randomised, double-blind actively controlled study provides supporting evidence of efficacy of tolperisone in terms of improvement of mobility in patients with spasticity caused by neurological disorders.
Danish: Resultaterne er vanskelige at fortolke på grund af manglen på en placebokontrolgruppe til verificering af assayintegriteten, men denne randomiserede, dobbeltblinde aktivt kontrollerede undersøgelse giver understøttende dokumentation for tolperisons virkning til forbedring af mobiliteten hos patienter med spasticitet som følge af neurologiske lidelser.
English: The CHMP endorsed a communication i.e. ‘Dear Healthcare Professional Communication (DHPC)' to communicate the outcome of the present review.
Danish: CHMP godkendte en direkte meddelelse til fagfolk i sundhedssektoren (DHPC) om resultatet af gennemgangen.
English: On the efficacy side, the existing dataset is indicative of a modest effect of tolperisone in the treatment of spasticity caused by neurological disorders, but it is important to note that the evidence is mainly based on the results of the Stamenova study - which only included patients with post-stroke spasticity.
Danish: For så vidt angår virkningen, indikerer det eksisterende datasæt en beskeden virkning af tolperison i behandlingen af spasticitet som følge af neurologiske lidelser, men det er vigtigt at bemærke, at dokumentationen primært er baseret på resultaterne af Stamenova-undersøgelsen - der udelukkende omfattede patienter med spasticitet som følge af postapopleksi.
English: There are no GCPcompliant studies, there is 1 actively-controlled trial and a few observational studies.
Danish: Der er ikke gennemført undersøgelser, som lever op til god klinisk praksis, men et aktivt kontrolleret forsøg og nogle få observationsundersøgelser.
English: With regard to the safety of tolperisone, the CHMP reviewed the available safety data and retained its previous conclusions that there is a risk of hypersensitivity reactions associated with tolperisone, with data showing that 10% of all reported cases of hypersensitivity were considered to be life-threatening.
Danish: Vedrørende sikkerheden af tolperison gennemgik CHMP de foreliggende sikkerhedsdata og fastholdt sine tidligere konklusioner om, at tolperison er forbundet med risiko for overfølsomhedsreaktioner, idet 10 % af alle indberettede tilfælde af overfølsomhed ifølge dataene blev anset for at være livstruende.
English: • Treatment of muscular hypertonicity and muscle spasms associated with locomotor diseases (e.g. spondylosis, spondylarthrosis, cervical and lumbar syndromes, arthrosis of large joints)
Danish: • behandling af muskulær hypertonicitet og muskelspasmer i forbindelse med lokomotoriske sygdomme (f.eks. spondylose, spondylartrose, cervikale og lumbare syndromer, artrose i store led)
English: The only double-blind, placebo-controlled studies identified where parenteral tolperisone was used and that have acceptable methodological standards were conducted in indications where efficacy has not been demonstrated, that have never been approved for the product or included only a very small number of patients in the indication of interest.. No data was submitted in support of the dosing recommendations.
Danish: De eneste identificerede dobbeltblinde, placebokontrollerede undersøgelser, hvor der blev anvendt parenteral tolperison, og som er af acceptabel metodologisk standard, blev gennemført i indikationer, hvor virkningen ikke er dokumenteret, og som aldrig er blevet godkendt for lægemidlet eller kun omfattede et meget lavt antal patienter inden for den relevante indikation.
English: In this randomised, double-blind, placebo controlled, multicentre study efficacy of tolperisone has been shown in the symptomatic treatment of patients with spasticity following cerebral stroke.
Danish: I denne randomiserede, dobbeltblinde, placebokontrollerede multicenterundersøgelse er tolperisons virkning dokumenteret i symptombehandling af patienter med spasticitet som følge af postapopleksi.
English: • Treatment of obliterative vascular diseases as well as syndromes due to impaired vascular innervation (e.g. acrocyanosis, dysbasia angioneurotica intermittens)
Danish: • behandling af obliterative vaskulære sygdomme samt syndromer som følge af begrænset vaskulær innervation (f.eks. akrocyanose, intermittent angioneurotisk dysbasi)
English: Grounds for the variation/revocation to the terms of the marketing authorisation
Danish: Begrundelse for ændring/tilbagekaldelse af betingelserne for markedsføringstilladelsen Ud fra følgende betragtninger:
English: Taken together, the existing dataset is indicative of a modest effect of tolperisone in the treatment of spasticity caused by neurological disorders.
Danish: Samlet indikerer det eksisterende datasæt en beskeden virkning af tolperison i behandlingen af spasticitet som følge af neurologiske lidelser.
English: As a result, the CHMP considered that none of the provided pooled analyses could be considered as supportive to demonstrate the efficacy of tolperisone in the “treatment of muscular hypertonicity and muscle spasms associated with locomotor diseases” indication, nor in the proposed restricted indication.
Danish: CHMP fandt derfor, at ingen af de forelagte samlede analyser kunne anses for at støtte virkningen af tolperison ved indikationen behandling af muskulær hypertonicitet og muskelspasmer i forbindelse med lokomotoriske sygdomme eller ved den foreslåede begrænsede indikation.
English: Hypersensitivity reactions account for more than half of the spontaneous reports in the originators database, followed by adverse events (AEs) from the SOCs (System Organ Class) Gastrointestinal disorders, General disorders and administration site conditions and Nervous system disorders.
Danish: Overfølsomhedsreaktioner udgør mere end halvdelen af de spontane indberetninger i ophavsmandens database, fulgt af bivirkninger fra systemorganklasserne (SOC) gastrointestinale gener, almene forstyrrelser og tilstande på indgivelsesstedet og neurologiske forstyrrelser.
English: Treatment of obliterative vascular diseases as well as syndromes due to impaired vascular innervation
Danish: Behandling af obliterative vaskulære sygdomme samt syndromer som følge af svækket vaskulær innervation
English: Little's disease and other encephalopaties accompanied by dystonia
Danish: Littles sygdom og andre encefalopatier ledsaget af dystoni
English: The Melka study can only be considered as providing supportive evidence of efficacy in the treatment of spasticity caused by neurological diseases.
Danish: Melka-undersøgelsen kan udelukkende vurderes som understøttende dokumentation for virkningen i behandlingen af spasticitet som følge af neurologiske lidelser.
English: The CHMP also noted the MAH proposal to conduct a clinical study to collect additional evidence of the efficacy of tolperisone in the proposed restricted low back pain indication, as a post-referral commitment, as well as the related draft study synopsis.
Danish: CHMP noterede sig desuden forslaget fra indehaveren af markedsføringstilladelsen om at påtage sig at udføre en klinisk undersøgelse med henblik på at samle supplerende evidens for virkningen af tolperison ved den foreslåede begrænsede indikation lænderygsmerter, som en forpligtelse efter indbringelsesproceduren samt det tilknyttede udkast til en synopsis af undersøgelsen.
English: • Acute or chronic treatment of pathologically elevated skeletal muscle tone in organic neurological disorders
Danish: • akut eller kronisk behandling af patologisk øget tonus i skeletmuskulaturen som følge af organiske neurologiske lidelser
English: The Committee also concluded that the benefit-risk balance of tolperisone-containing parenteral formulations is not positive, and recommends the revocation of the corresponding marketing authorisations.
Danish: Udvalget konkluderede endvidere, at benefit/risk-forholdet for parenterale formuleringer, der indeholder tolperison, ikke er positivt, og anbefaler, at markedsføringstilladelserne herfor tilbagekaldes.
English: Based on the totality of the data made available on the safety and the efficacy of tolperisone, the CHMP considered that the risk of hypersensitivity is more significant than previously identified, and that as a consequence the demonstrated clinical benefits only outweigh the risks in the restricted indication symptomatic treatment of post-stroke spasticity in adults.
Danish: På baggrund af de samlede data om tolperisons sikkerhed og virkning vurderede CHMP, at risikoen for overfølsomhed er mere signifikant end hidtil dokumenteret, og at de påviste kliniske fordele derfor kun opvejer risiciene i den begrænsede indikation symptombehandling af spasticitet som følge af postapopleksi hos voksne.
English: Based on the totality of the data available on the safety and the efficacy of tolperisone and having noted the opinions of the BSWP and the SAG, the CHMP confirmed its initial conclusion that the risk of hypersensitivity is more significant than previously identified at the time of the initial marketing authorisation, and that as a consequence the benefits of tolperisone are outweighed by the risks in the indication “treatment of muscular hypertonicity and muscle spasms associated with locomotor diseases” as well as in the proposed restricted indication “short-term treatment of muscle spasms in adult patients with acute non-specific low back pain”.
Danish: På grundlag af det samlede datasæt vedrørende sikkerheden og virkningen af tolperison og under hensyntagen til udtalelserne fra BSWP og SAG fastholdt CHMP sin indledende konklusion om, at risikoen for overfølsomhed er større end antaget på tidspunktet for den oprindelige markedsføringstilladelse, og at fordelene ved tolperison derfor ikke opvejer risiciene ved anvendelse til indikationen behandling af muskulær hypertonicitet og muskelspasmer i forbindelse med lokomotoriske sygdomme såvel som ved den foreslåede begrænsede indikation kortvarig behandling af muskelspasmer hos voksne patienter med akutte uspecifikke lænderygsmerter.
English: Treatment of muscular hypertonicity and muscle spasms associated with locomotor diseases
Danish: Behandling af muskulær hypertonicitet og muskelspasmer i forbindelse med lokomotoriske sygdomme
English: Due to lack of adequate data, no firm conclusions on the influence of renal or hepatic function can be drawn, although the existing data does not raise cause for concern.
Danish: Om end de eksisterende data ikke giver anledning til bekymring, kan der på grund af manglen på relevante data ikke drages faste konklusioner om indflydelsen på nyre- eller leverfunktion.
English: • Rehabilitation after orthopaedic and trauma surgery
Danish: • revalidering efter ortopæd- og traumekirurgi
English: Rehabilitation after orthopaedic and trauma surgery
Danish: Revalidering efter ortopæd- og traumekirurgi
English: • Little's disease (infantile diplegia spastica) and other encephalopaties accompanied by dystonia
Danish: • Littles sygdom (infantil spastisk diplegi) og andre encefalopatier ledsaget af dystoni.
English: The CHMP also considered a recently conducted meta-analysis presented during the October 2012 oral explanation but raised concerns with regard to the methodology of the analysis and the quality of the included individual studies and therefore concluded that this meta-analysis did provide any additional support of the efficacy of tolperisone.
Danish: Udvalget var imidlertid betænkeligt ved den anvendte analysemetode og kvaliteten af de enkelte undersøgelser i analysen og konkluderede derfor, at denne metaanalyse ikke yderligere underbyggede virkningen af tolperison.
English: Treatment of pathologically elevated skeletal muscle tone in organic neurological disorders
Danish: Behandling af patologisk øget tonus i skeletmuskulaturen som følge af organiske neurologiske lidelser
English: The Committee concluded that the benefit-risk balance of tolperisone-containing oral formulations is positive under normal conditions of use only in the symptomatic treatment of post-stroke spasticity in adults, subject to the changes to the product information agreed.
Danish: Udvalget konkluderede, at benefit/risk-forholdet for orale formuleringer, der indeholder tolperison, kun er positivt under normale anvendelsesbetingelser til symptombehandling af spasticitet som følge af postapopleksi hos voksne, forudsat at de vedtagne ændringer af produktoplysningerne foretages.
English: The Committee therefore concluded that the benefit-risk balance of tolperisone-containing oral formulations is positive under normal conditions of use only in the symptomatic treatment of poststroke spasticity in adults, subject to the changes to the product information agreed.
Danish: Udvalget konkluderede derfor, at benefit/risk-forholdet for orale formuleringer, der indeholder tolperison, kun er positivt under normale anvendelsesbetingelser til symptombehandling af postapoplektisk spasticitet hos voksne, forudsat at de vedtagne ændringer af produktoplysningerne foretages.
English: The CHMP also consulted its Neurology Scientific Advisory Group (SAG).
Danish: CHMP rådførte sig desuden med den videnskabelige rådgivende gruppe vedrørende neurologi (SAG), som erklærede, at den ikke anså resultaterne af de fire samlede analyser for at underbygge virkningen af tolperison.
English: • The Committee also concluded that, in the absence of relevant data to support the efficacy in the dosing recommendations approved, the potential benefit of tolperisone-containing parenteral formulations is outweighed by the identified risk of hypersensitivity.
Danish: • udvalget konkluderede endvidere, at den potentielle fordel ved parenterale formuleringer, der indeholder tolperison, i fravær af relevante data til støtte for virkningen med de godkendte doseringsanbefalinger ikke opvejer den dokumenterede risiko for overfølsomhed konkluderede udvalget, at benefit/risk-forholdet for orale formuleringer, der indeholder tolperison, kun er positivt under normale anvendelsesbetingelser til symptombehandling af spasticitet som følge af postapopleksi hos voksne, forudsat at de vedtagne ændringer af produktoplysningerne foretages.
English: The full EPAR for Clopidogrel ratiopharm can be found on the Agency's website: ema.europa.eu/Find medicine/Human medicines/European public assessment reports.
Danish: Den fuldstændige EPAR for Clopidogrel ratiopharm findes på agenturets websted: ema.europa.eu/Find medicine/Human medicines/European public assessment reports..
English: EMA/785026/2012
Danish: EMA/670858/2012 EMEA/H/C/001173
English: It explains how the Committee for Medicinal Products for Human Use (CHMP) assessed the medicine to reach its opinion in favour of granting a marketing authorisation and its recommendations on the conditions of use for Clopidogrel ratiopharm.
Danish: Det forklarer, hvordan Udvalget for Humanmedicinske Lægemidler (CHMP) vurderede lægemidlet og nåede frem til sin udtalelse til fordel for udstedelse af en markedsføringstilladelse og til sine anbefalinger om anvendelsesbetingelserne for Clopidogrel ratiopharm.
English: This is a summary of the European public assessment report (EPAR) for Clopidogrel ratiopharm.
Danish: Dette dokument er et sammendrag af den europæiske offentlige vurderingsrapport (EPAR) for Clopidogrel ratiopharm.
English: The standard dose of Clopidogrel ratiopharm is one 75 mg tablet once a day.
Danish: Standarddosis af Clopidogrel ratiopharm er 75 mg en gang dagligt.
English: Clopidogrel ratiopharm is used in adults to prevent atherothrombotic events (problems caused by blood clots and hardening of the arteries).
Danish: Clopidogrel ratiopharm anvendes til forebyggelse af aterotrombotiske hændelser hos voksne (problemer forårsaget af blodpropper og åreforkalkning).
English: • patients with peripheral arterial disease (problems with blood flow in the arteries).
Danish: • patienter med perifere kredsløbsforstyrrelser (problemer med blodgennemstrømningen i arterierne),
English: For more information about treatment with Clopidogrel ratiopharm, read the package leaflet (also part of the EPAR) or contact your
Danish: Hvis du ønsker yderligere oplysninger om behandling med Clopidogrel ratiopharm, kan du læse indlægssedlen (også en del af denne EPAR) eller kontakte din læge eller dit apotek.
English: The CHMP concluded that, in accordance with EU requirements, Clopidogrel ratiopharm has been shown to have comparable quality and to be bioequivalent to Plavix.
Danish: CHMP konkluderede, at Clopidogrel ratiopharm i overensstemmelse med EU-kravene har vist sig at være af sammenlignelig kvalitet og at være bioækvivalent med Plavix.
English: This means that Clopidogrel ratiopharm is similar to a ‘reference medicine' already authorised in the European Union (EU) called Plavix.
Danish: Det betyder, at Clopidogrel ratiopharm er identisk med et referencelægemiddel, der allerede er godkendt i Den Europæiske Union, og som hedder Plavix.
English: The Committee recommended that Clopidogrel ratiopharm be given marketing authorisation.
Danish: Udvalget anbefalede udstedelse af markedsføringstilladelse for Clopidogrel ratiopharm.