FrancophonIA/ELRC3.0 huggingface dataset:
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.
Danish: • udvalget gennemgik alle foreliggende data fra prækliniske og kliniske undersøgelser, farmakoepidemiologiske undersøgelser, den publicerede litteratur og erfaringer efter markedsføring om sikkerheden af systemiske lægemidler indeholdende thiocolchicosid hvad angår dets genotoksicitet,
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),
Danish: • 1 tilfælde forårsaget af eksponering i den føtale periode (dvs. et tilfælde, hvor føtotoksiske virkninger medførte påvirkning af den føtale eller neonatale vækst eller den histologiske eller funktionelle modning af dannede organer (perioden med størst risiko begynder i anden fjerdedel af graviditeten),
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.
Danish: Risikostyringsplanen skal indeholde en model af den nævnte formular til indberetning om graviditeter, og sammen med PSUR skal der forelægges en rapport om disse indsamlede data.
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.
Danish: • 20 tilfælde som følge af eksponering i den embryonale periode, heraf: o to tilfælde af teratogene virkninger (misdannelser) ved eksponering tidligt i graviditeten (den første fjerdedel er perioden med størst risiko), o fire tilfælde resulterende i afbrydelse af graviditeten (3 spontanaborter og en abort fremkaldt af ikke-medicinske grunde), o fem tilfælde med gunstig udvikling (ingen virkning på den nyfødte), o ni tilfælde, hvor udviklingen af graviditeten var usikker som følge af manglende dokumentation.
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)).
Danish: Den aneugene virkning blev iagttaget ved en LOEL svarende til kun 1,6 x den humane Cmax og 4,1 x AUC (8 mg oralt to gange dagligt).
English: Clinical studies
Danish: Kliniske undersøgelser
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.
Danish: Aneuploidi (forandringer i antallet af kromosomer og tab af heterozygositet) er en kendt potentiel risikofaktor for kræft, når den berører somatiske celler, og for teratogenicitet, embryotoksicitet/spontanaborter samt nedsat fertilitet hos manden, når den berører kønsceller1.
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.
Danish: Efter at den nævnte kliniske fase I-undersøgelse med TCC var blevet indstillet, blev det genotoksiske potentiale af aglycon-metabolitten SL59.0955 (M2) undersøgt nærmere.
English: These PSURs should include a report compiling continuous monitoring of any safety signal correlated with aneuploidy and pregnancy on accidental exposure to the drug.
Danish: Disse PSUR skal indeholde en opgørelse over den løbende overvågning af alle sikkerhedssignaler, der korrelerer med aneuploidi, og graviditet ved accidentel eksponering for lægemidlet,
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.
Danish: Efterfølgende mekanistisk analyse med in situ-fluorescenshybridisering (FISH) med pan-centromere DNA-sonder viste, at mikronuklei ved alle behandlingsbetingelser fortrinsvis dannedes ved en aneugen mekanisme (numerisk kromosomaberration); aneuploidi blev klart bekræftet ved centromerfarvning.
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.
Danish: CHMP var derfor af den opfattelse, at der burde træffes risikominimeringsforanstaltninger til imødegåelse af risiciene for teratogenicitet, embryotoksicitet/spontanaborter, nedsat fertilitet hos manden og kræft.
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.
Danish: Som konklusion viste ovenstående prækliniske undersøgelser, at M2 (SL59.0955) inducerede mikronuklei in vitro og in vivo via en overvejende aneugen mekanisme ved alle behandlingsbetingelser.
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.
Danish: • udvalget fandt, at systemiske lægemidler indeholdende thiocolchicosid fortsat er effektive til adjuvant behandling af smertefulde kontrakturer ved akutte columnalidelser.
English: The study protocol should be provided within the RMP.
Danish: Undersøgelsens protokol skal indgå i risikostyringsplanen.
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.
Danish: I denne forbindelse fandt CHMP, at indikationen “Parkinsons sygdom og lægemiddelinduceret parkinsonisme, særligt neurodyslektisk syndrom” skulle udgå, da dette er en indikation til kronisk anvendelse.
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);
Danish: • en in vitro-mikronukleustest i en primær kultur af humane lymfocytter med aglyconmetabolitten (SL59.0955) med centromerfarvning (Whitwell J., 2012);
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.
Danish: Der blev imidlertid ikke bestemt en NOAEL for aneugene virkninger hos hunrotter (LOEL = 25 mg/kg), og der fandtes ikke klar dosisrelateret virkning, idet der hos hanner og hunner kun var lille forskel mellem de forskellige doser hvad angår eksponeringen (AUC0-24 og Cmax) for 3-demethylthiocolchicin (SL59.0955).
English: The in vitro MN test in human lymphocytes showed that M2 induced micronuclei in cultured human peripheral blood lymphocytes in all treatment conditions.
Danish: In vitro-mikronukleustesten i humane lymfocytter viste, at M2 ved alle behandlingsbetingelser inducerede mikronuklei i dyrkede humane lymfocytter fra perifert blod.
English: Genotoxicity data on TCC and its main circulating metabolite SL18.0740 (M1)
Danish: Genotoksicitetsdata om TCC og dets vigtigste cirkulerende metabolit SL18.0740 (M1)
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.
Danish: Der blev udført en række genotoksikologiske undersøgelser på TCC og dets vigtigste identificerede metabolit 3-O-glucuronideret aglycon (SL18.0740), som er den aktive metabolit.
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.
Danish: Efter at en virksomhed indstillede sin kliniske fase I-undersøgelse med TCC på grund af nye ikkekliniske fund, anmodede den italienske lægemiddelstyrelse (AIFA) en af markedsføringstilladelsesindehaverne for TCC om at foretage en nærmere undersøgelse af TCC's genotoksiske potentiale, navnlig dets metabolitter.
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
Danish: Resultaterne af en af metabolitundersøgelserne (metabolit SL59.0955, M2) gav anledning til betænkelighed: Der blev fundet tegn på genotoksisk potentiale i nye data om den aneugene virkning af M2-metabolitten af TCC i de forelagte prækliniske undersøgelser.
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.
Danish: I 2011 og 2012 blev der udført nye undersøgelser af genotoksiciteten af moderstoffet (TCC), dets vigtigste cirkulerende metabolit SL18.0740 og aglycon-metabolitten SL59.0955.
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).
Danish: • en in vivo-mikronukleustest i knoglemarv fra rotter efter oral administration af aglyconmetabolitten (SL59.0955) til rotter med centromerfarvning og fuld bestemmelse af eksponeringen for SL59.0955 og 3-O-glucuronideret aglycon-metabolit (SL18.0740) med henblik på bedre bestemmelse af eksponeringstærsklen (Wase K., Oktober 2012).
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.
Danish: • Da TCC's metabolit M2 er påvist at være aneugen ved en eksponering tæt på den terapeutiske humane dosis, fandt CHMP for det første, at dosis skulle begrænses (til 8 mg peroralt gange dagligt og 4 mg intramuskulært to gange dagligt) og langtidsanvendelse undgås.
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.
Danish: Hvad dette angår, fandt CHMP, at indikationen “Parkinsons sygdom og lægemiddelinduceret parkinsonisme, særlig neurodyslektisk syndrom” burde udgå, da den kræver længere behandlingsvarighed.
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.
Danish: I betragtning af risiciene fandt udvalget dog, at systemiske lægemidler indeholdende thiocolchicosid kun bør administreres til patienter over 16 år ved akutte tilstande og med en behandlingsvarighed, der ved oral indgift ikke er over 7, og ved intramuskulær indgift ikke over 5 konsekutive dage.
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.
Danish: In vivo-mikronukleustest på knoglemarv fra rotter var negativ hos handyrene efter oral administration af M2 i doser på 25, 50, 70, 100 og 150 mg/kg/d én gang dagligt i to på hinanden efterfølgende dage.
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.
Danish: Til imødegåelse heraf fandt CHMP de foreslåede risikominimeringsforanstaltninger passende (begrænsning af indikationen til akutte tilstande, begrænsning af behandlingsvarigheden til syv konsekutive dage, undgåelse af langvarig anvendelse).
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.
Danish: CHMP fandt derfor, at de foreliggende data bekræfter en klar aneugen virkning af thiocolchicosid-metabolitten M2 ved koncentrationer 4 gange den humane eksponering i plasma efter oral behandling med 8 mg TCC to gange dagligt (den anbefalede dosis), begyndende ved en dosis på 25 mg/kg.
English: Pre-clinical studies
Danish: Prækliniske undersøgelser
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.
Danish: Endelig skal oplysningsmateriale til ordinerende læger og til patienter forelægges for de nationale kompetente myndigheder som en del af risikostyringsplanen.
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.
Danish: På grundlag af den almindelige anvendelse ved akutte tilstande blev der indsat andre anbefalinger om dosering med begrænsning af behandlingsvarigheden til 7 dage for oral og 5 dage for intramuskulær administration; det blev ligeledes anbefalet at angive den maksimale tilladelige dosis.
English: In addition, three-yearly PSURs should be submitted by all MAHs of these products.
Danish: Desuden skal alle indehavere af markedsføringstilladelse for produkterne indsende PSUR hvert 3. år.
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.
Danish: Efter ovenstående bemærkninger konkluderede CHMP, at benefit/risk-forholdet fortsat er gunstigt for lægemidler indeholdende TCC til adjuverende behandling af smertefulde kontrakturer ved akutte columnalidelser hos voksne og unge over 16 år under forudsætning af de vedtagne begrænsninger, advarsler, andre ændringer i produktinformationen, supplerende lægemiddelovervågning og supplerende risikominimeringsforanstaltninger.
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.
Danish: konkluderede CHMP, at benefit/risk-forholdet fortsat er gunstigt for lægemidler indeholdende thiocolchicosid til behandling af smertefulde muskelkontrakturer ved akutte columnalidelser hos voksne og unge over 16 år under forudsætning af de vedtagne begrænsninger, advarsler, andre ændringer i produktinformationen, supplerende lægemiddelovervågning og supplerende risikominimeringsforanstaltninger.
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.
Danish: CHMP finder, at der ikke kan drages definitive konklusioner om konsekvenserne af aneuploidi hos mennesker af den kliniske evidens fra de tilfælde, der er indberettet af markedsføringstilladelsesindehaverne.
English: Clinical trials and post marketing spontaneous reports were submitted by the MAHs.
Danish: Indehaverne af markedsføringstilladelse forelagde kliniske undersøgelser og spontane indberetninger efter markedsføring.
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.
Danish: Skønt kromosomal nondisjunction er det mest hensigtsmæssige endepunkt ved undersøgelse af lavdosisvirkninger af stoffer med toksisk virkning på spindelapparatet, kunne der imidlertid ikke drages konklusioner om tærskeldoser for induktion af aneuploidi.
English: Genotoxic mechanisms, such as aneuploidy, involving cell division and non-DNA targets, are known to occur above a certain threshold of exposure.
Danish: Eksponering over en vis tærskel vides at udløse genotoksiske mekanismer såsom aneuploidi, der påvirker celledelingen og andre mål end DNA.
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.
Danish: Vedrørende risikoen for infertilitet hos manden vides forhøjet forekomst af aneuploidi af kromosomerne i sædceller at have sammenhæng med infertilitet hos manden.
English: [The currently approved indications should be deleted and replaced by the following:]
Danish: [De nuværende godkendte indikationer skal slettes og erstattes af følgende:]
English: The duration of treatment must not exceed 2 weeks.
Danish: Behandlingsvarigheden må ikke overstige 2 uger.
English: [400 mg MR pharmaceutical form]
Danish: [400 mg MR lægemiddelform]
English: Section 4.1 Therapeutic indications
Danish: 4.1 Terapeutiske indikationer
English: If a longer duration of use is required, other pharmaceutical forms are available.
Danish: Hvis længere behandlingsvarighed er nødvendig, forefindes der andre lægemiddelformer.
English: Annex III Amendments to relevant sections of the summary of product characteristics and package leaflet
Danish: BILAG III ÆNDRINGER TIL RELEVANTE AFSNIT AF PRODUKTRESUME, ETIKETTERING OG INDLÆGSSEDDEL
English: See the end of section 4 for how to report side effects.
Danish: Se sidst i afsnit 4, hvordan du indberetter bivirkninger.>
English: [Solution for injection (i.m.)]
Danish: [Injektionsvæske, opløsning (i.m.)]
English: [All pharmaceutical forms]
Danish: [Alle lægemiddelformer]
English: B. Package Leaflet <This medicine is subject to additional monitoring.
Danish: < Dette lægemiddel er underlagt supplerende overvågning.
English: For single dose application in adults with postoperative pain.
Danish: Til enkeltdosisbehandling hos voksne med postoperative smerter.
English: [The wording below should be inserted at the end of this section]
Danish: [Nedenstående skal indsættes sidst i dette afsnit]
English: Healthcare professionals are asked to report any suspected adverse reactions via the national reporting system listed in Appendix V*.
Danish: Læger og sundhedspersonale anmodes om at indberette alle formodede bivirkninger via det nationale rapporteringssystem anført i Appendiks V*.
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
Danish: Produktresume og indlægsseddel vil muligvis blive ændret efterfølgende af den nationale myndighed, evt. i samarbejde med referencemedlemslandet.
English: [Oral pharmaceutical forms and suppositories] Treatment of acute pain in adults.
Danish: [Orale lægemiddelformer og suppositorier] Behandling af akutte smerter hos voksne.
English: < Product Name > must only be used if treatment with other analgesics (e.g. non-steroidal antiinflammatory drugs, weak opioids) is contraindicated.
Danish: {X} må kun anvendes, hvis behandling med andre analgesika (f.eks. non-steroide antiinflammatoriske lægemidler, svage opioider) er kontraindiceret.
English: Very common: Liver enzymes increased Frequency not known: Hepatitis, liver failure
Danish: Meget almindelig: Forhøjede aminotransferaser Ikke kendt: Hepatitis, leversvigt.
English: <Product Name> should not be used in patients with pre-existing liver disease or alcohol abuse.
Danish: {X} bør ikke anvendes til patienter med præeksisterende leversygdom eller alkoholmisbrug.
English: [100 mg IR pharmaceutical form, suppositories] Flupirtine should be used at the lowest effective dose for the shortest duration necessary to achieve adequate pain relief.
Danish: [100 mg IR lægemiddelform, suppositorier] Flupirtine skal anvendes med den laveste virksomme dosis og i så kort tid som muligt for at opnå en passende smertelindring.
English: If liver function tests show pathological results your doctor will ask you to discontinue intake/use of <Product Name> immediately.
Danish: Hvis leverfunktionstesten viser tegn på leverskade, vil din læge bede dig om straks at stoppe behandlingen med {X}.
English: Patients should be advised to remain vigilant for any symptoms compatible with hepatic damage during treatment with <Product Name> (e.g. loss of appetite, nausea, vomiting, abdominal pain, fatigue, dark urine, jaundice, pruritus) and to discontinue intake of <Product Name> and to seek medical advice immediately if any such symptoms occur.
Danish: Patienter i behandling med{X} bør informeres om at være opmærksomme på alle symptomer, der kan være tegn på leverskade (f.eks. appetitløshed, kvalme, opkastning, abdominalsmerter, træthed, mørkfarvet urin, gulsot, pruritus), og til at stoppe behandlingen med {X} og straks søge læge, hvis nogen af disse symptomer opstår.
English: [All pharmaceutical forms] Liver disorders:
Danish: [Alle lægemiddelformer] Leversygdomme:
English: If you observe any symptoms that may indicate hepatic damage during treatment with <Product Name> (e.g. loss of appetite, nausea, vomiting, abdominal discomfort, fatigue, dark urine, jaundice, pruritus) you have to discontinue intake/use of <Product Name> and to seek medical advice immediately if any such symptoms occur.
Danish: Hvis du oplever symptomer, der kan være tegn på leverskade, mens du er i behandling med {X} (f.eks. appetitløshed, kvalme, opkastning, ubehag i maven, træthed, mørkfarvet urin, gulsot, kløe), skal du stoppe behandlingen med {X}, og du skal søge læge med det samme, hvis du får nogen af ovennævnte symptomer.