FrancophonIA/ELRC3.0 huggingface dataset:
English: Two types of studies, open and controlled masked, were carried out in order to evaluate the efficacy of ciclosporin in the treatment of severe sight-threatening intermediate and posterior uveitis.
Danish: Der blev udført to typer undersøgelser, åbne og kontrollerede maskerede, til vurdering af virkningen af ciclosporin til behandling af svær, synstruende intermediær og posterior uveitis.
English: The agreed Core Safety profile (CSP) from the last PSUR 13 work sharing procedure (EE/H/PSUR/0007/001) and the public AR from the paediatric article 45 procedure (CZ/W/04/pdWS/01, 2010) were also used.
Danish: Desuden anvendte virksomheden de vedtagne centrale sikkerhedsoplysninger (CSP) fra den seneste PSUR 13-arbejdsdelingsprocedure (EE/H/PSUR/0007/001) og den offentlige vurderingsrapport fra den pædiatriske artikel 45-procedure (CZ/W/04/pdWS/01, 2010).
English: ciclosporin has been extensively studied in several clinical trials in patients with rheumatoid arthritis in whom conventional therapy is ineffective or inappropriate, as well as in many published studies reporting the use of ciclosporin in this indication.
Danish: Ciclosporin er grundigt undersøgt i flere kliniske undersøgelser hos patienter med reumatoid arthritis, hos hvem sædvanlig behandling er ineffektiv eller uegnet, foruden i mange publicerede undersøgelser, der beskriver anvendelsen af ciclosporin til denne indikation.
English: The MAH proposed wordings for the sub-sections “Absorption, Distribution, Biotransformation and Elimination, Special populations and Paediatric population.” based on a harmonized text already approved in 13 EU countries.
Danish: Indehaveren af markedsføringstilladelsen foreslog en ordlyd til underafsnittene “Absorption, Fordeling, Biotransformation, Udskillelse, Særlige populationer og Pædiatrisk population” baseret på en harmoniseret tekst, der i forvejen var godkendt i 13 EU-lande.
English: However the statement “The daily doses of Neoral should always be given in two divided doses” was partly endorsed by the CHMP since the word “always” should be omitted (in some cases, three times daily administration may be needed).
Danish: Angivelsen “Den daglige dosis af Sandimmun Neoral bør altid fordeles på to separate doser” blev delvis godkendt af CHMP, da ordet “altid” bør udelades (i nogle tilfælde kan administration tre gange dagligt være nødvendig).
English: As an outcome of this full review, both CDSs were finalized with a release date of 13 February 2012.
Danish: Som resultat af denne gennemgang blev begge sæt centrale datablade afsluttet og frigivet den 13. februar 2012.
English: European controlled double-blind trials used 5 mg/kg/d that allowed a downward titration to find the maximum tolerated dose.
Danish: I de europæiske dobbeltblindede undersøgelser anvendtes 5 mg/kg/dag, hvilket gav mulighed for nedtitrering til fastlæggelse af den maksimale tolererede dosis.
English: The Psoriasis is an approved therapeutic indication in all EU countries.
Danish: Psoriasis er en godkendt terapeutisk indikation i alle EU-lande.
English: At the time of the submission of the oil-based formulation of ciclosporin, Sandimmun, in 1987, a comprehensive clinical data summary on endogenous uveitis was available (Nussenblatt 1987).
Danish: På tidspunktet for ansøgningen for den oliebaserede formulering af ciclosporin, Sandimmun, i 1987, forelå der en komplet sammenfatning af kliniske data om endogen uveitis (Nussenblatt 1987).
English: Finally the inclusion of the term “cellular” rejection was also discussed since the diagnosis of humoral rejection episodes is controversial.
Danish: Endelig drøftedes anvendelsen af betegnelsen “cellulær” afstødning, da diagnosen humorale afstødningsepisoder er kontroversiel.
English: However concerning HMG CoA reductase inhibitors (statins), the CHMP agreed that a strict contraindication may not be warranted, however, information in section 4.4 should be strengthened.
Danish: Hvad angår HMG CoA-reduktasehæmmere (statiner) fandt CHMP derimod, at en streng kontraindikation ikke nødvendigvis er påkrævet, men at oplysningerne i punkt 4.4 bør skærpes.
English: Overall, these properties result in lower within-patient variability in the pharmacokinetics of ciclosporin and a stronger correlation between trough concentrations and total exposure.
Danish: Tilsammen resulterer i disse egenskaber i mindre intraindividuel variabilitet i farmakokinetikken af ciclosporin og stærkere korrelation mellem dalkoncentrationer og total eksponering.
English: However the CHMP considered that this paragraph should be complemented with recommendations for further controls to be made, e.g. of liver function, bilirubin, serum electrolytes and blood pressure and that it is preferred to use glomerular filtration rate determined by a reliable and reproducible method rather than serum creatinine.
Danish: CHMP fandt dog, at dette afsnit burde udvides med anbefalinger om yderligere kontroller, f.eks. leverfunktion, bilirubin, serumelektrolytter og blodtryk, og at bestemmelse af glomerulær filtrationshastighed ved en pålidelig og reproducerbar metode må foretrækkes frem for serumkreatinin.
English: Due to the divergent national decisions taken by Member States (MS) concerning the authorization of Sandimmun Neoral (and associated names), the European Commission (EC) notified the EMA/CHMP secretariat of an official referral under Article 30(2) of Directive 2001/83/EC as amended, to resolve divergences amongst the nationally authorised Sandimmun Neoral SmPCs across the EU/EEA region.
Danish: På grund af de divergerende nationale afgørelser, der var truffet af medlemsstaterne ved godkendelsen af Sandimmun Neoral (og relaterede navne), anmeldte EuropaKommissionen til EMA/CHMP's sekretariat en officiel indbringelse i henhold til artikel 30, stk. 2, i direktiv 2001/83/EF, som ændret, med henblik på at få ophævet divergenserne mellem de nationalt godkendte produktresuméer for Sandimmun Neoral i hele EU/EØS.
English: The MAH presented respectively the clinical efficacy outcome of the US and Canada studies and then the European studies.
Danish: Indehaveren af markedsføringstilladelsen forelagde først det kliniske udfald af de amerikanske og canadiske undersøgelser, derefter de europæiske undersøgelser.
English: Section 4.6 - Pregnancy and Lactation
Danish: Punkt 4.6 - Graviditet og amning
English: The MAH proposed a wording that was approved in between 18 an 24 MS, depending on subsections.
Danish: Indehaveren af markedsføringstilladelsen foreslog en ordlyd, der var godkendt i mellem 18 og 24 medlemsstater, afhængigt af underafsnittene.
English: The CHMP requested the MAH to compile all available data on switch to ciclosporin in case of rejection with any other immunosuppressive agent, not only tacrolimus.
Danish: CHMP anmodede indehaveren af markedsføringstilladelsen om at sammenstille alle foreliggende data om skift til ciclosporin i tilfælde af afstødning med alle andre immunosuppressiva, ikke kun tacrolimus.
English: The MAH confirmed that the storage conditions in the SmPCs of Sandimmun Neoral soft gelatin capsules and oral solutions are already aligned with the requirements set in the Guideline on Declaration of Storage Conditions (CPMP/QWP/609/96/Rev 2 dated 19 Nov 2007).
Danish: Indehaveren af markedsføringstilladelsen fastslog, at opbevaringsbetingelserne i produktresuméerne for Sandimmun Neoral, bløde gelatinekapsler og orale opløsninger, i forvejen er rettet ind efter kravene i “Guideline on Declaration of Storage Conditions” (CPMP/QWP/609/96/Rev 2, dateret den 19. november 2007).
English: Sandimmun Neoral is a microemulsified formulation of ciclosporin.
Danish: Sandimmun Neoral er en mikroemulsionsformulering af ciclosporin.
English: Furthermore, in addition to a strengthening of the monitoring of renal function, the CHMP was of the view that occasional monitoring of ciclosporin blood levels were also relevant in these indications.
Danish: Foruden skærpet overvågning af nyrefunktionen fandt CHMP desuden, at lejlighedsvis overvågning af blodkoncentrationen af ciclosporin er relevant ved disse indikationer.
English: Based on the higher Cmax and AUC values achieved with Sandimmun Neoral compared to Sandimmun, the resulting individualized doses of Sandimmun Neoral were on average lower compared to Sandimmun.
Danish: Som følge af de højere Cmax- og AUC-værdier, der opnås med Sandimmun Neoral end med Sandimmun, var de resulterende individualiserede doser af Sandimmun Neoral gennemsnitligt lavere end med Sandimmun.
English: Other changes were also introduced including several proposed downgraded positions; justifications were requested by the CHMP and provided by the MAH subsequently.
Danish: Der blev desuden foretaget andre ændringer, herunder flere foreslåede nedgraderede placeringer; CHMP anmodede om begrundelser, som efterfølgende blev givet af indehaveren af markedsføringstilladelsen.
English: Ciclosporin is a potent immunosuppressive agent used in human solid organ and bone marrow transplantation to prevent graft rejection and in Graft Versus Host Disease (GVHD).
Danish: Ciclosporin er et potent immunosuppressivt middel, der anvendes ved organ- og knoglemarvstransplantation til at forhindre transplantatafstødning samt ved Graft Versus Host Disease (GVHD).
English: The registration of Sandimmun Neoral was based on efficacy and safety data from clinical studies performed with the oilbased formulation (Sandimmun), first registered in Switzerland in December 1982.
Danish: Registreringen af Sandimmun Neoral byggede på data vedrørende virkning og sikkerhed fra kliniske undersøgelser med den oliebaserede formulering (Sandimmun), der første gang blevet registreret i Schweiz i december 1982.
English: The MAH discussed the need of a contraindication of statins for cyclosporin and the need of further contraindications for other medicinal products/herbals.
Danish: Indehaveren af markedsføringstilladelsen drøftede behovet for at gøre statiner kontraindiceret ved behandling med ciclosporin og behovet for andre kontraindikationer for andre lægemidler/plantelægemidler.
English: The MAH proposed wordings for the sub-sections “Food interactions, Drug interactions, Drugs that decrease ciclosporin levels, Drugs that increase ciclosporin levels, Other relevant drug interactions, Recommendations, Paediatric population and Other relevant drug interactions.”
Danish: Indehaveren af markedsføringstilladelsen fremlagde forslag til ordlyden af underafsnittene “Interaktion med fødeindtagelse, Lægemiddelinteraktioner, Lægemidler, der nedsætter niveauet af ciclosporin, Lægemidler, der øger niveauet af ciclosporin, Andre relevante lægemiddelinteraktioner, Anbefalinger, Den pædiatriske population og Andre relevante lægemiddelinteraktioner”.
English: However, since the studies in the original Sandimmun dossier are old and the posology based on those data is therefore obsolete in comparison with the different transplantation regimens used today, the CHMP was of the view that the dosage should also be guided by monitoring of ciclosporin blood levels.
Danish: Men da undersøgelserne i den oprindelige dokumentation for Sandimmun er gamle, vil en dosering baseret på disse data være forældet i forhold til nutidige transplantationsregimer, hvorfor CHMP fandt, at doseringen også burde styres ved overvågning af blodkoncentrationerne af ciclosporin.
English: As a consequence of these additional advantages, Sandimmun Neoral can be administered independently of mealtimes.
Danish: Disse yderligere fordele bevirker, at Sandimmun Neoral kan administreres uafhængigt af måltider.
English: In addition, the CHMP considered that substrates for CYP3A4 and/or P-gp and for which elevated plasma levels are associated with serious safety concerns should not be combined with ciclosporin (e.g. dabigatran etexilate, bosentan, aliskiren).
Danish: Desuden fandt CHMP, at stoffer, der er substrater for CYP3A4 og/eller P-gp og i høje plasmakoncentrationer er forbundet med alvorlige sikkerhedsproblemer, ikke bør anvendes i kombination med ciclosporin (f.eks. dabigatranetexilat, bosentan og aliskiren).
English: In November 2011, a full review of the company label (CDSs for both products Sandimmun and Sandimmun Neoral) was initiated.
Danish: I november 2011 blev der indledt en fuldstændig gennemgang af virksomhedens produktoplysninger (centrale datablade for de to produkter Sandimmun og Sandimmun Neoral).
English: From the data provided and other published data the CHMP concluded that benefit-risk ratio for ciclosporin in treatment of endogenous refractory uveitis, including Behçet uveitis, is positive.
Danish: Af de forelagte data og andre publicerede data konkluderede CHMP, at benefit/risk-forholdet for ciclosporin er positivt til behandling af endogen refraktær uveitis, herunder Behçets uveitis.
English: The efficacy of ciclosporin has been demonstrated in bone marrow transplant (BMT) recipients in eight studies carried out in Europe and US with a total of 227 patients.
Danish: Virkningen af ciclosporin er påvist hos recipienter af knoglemarvstransplantater i otte undersøgelser i Europa og USA hos i alt 227 patienter.
English: Section 4.4 - Special Warnings and Precautions for Use
Danish: Punkt 4.4 - Særlige advarsler og forsigtighedsregler vedrørende brugen
English: The wording proposed by the MAH is already approved in 24 countries and several other countries have very similar information.
Danish: Den af indehaveren af markedsføringstilladelsen foreslåede ordlyd er i forvejen godkendt i 24 lande og ligner meget i flere andre lande.
English: Although some patients experienced adverse reactions, mostly nephrotoxicity, hypertension and metabolic disorders, the CHMP noted that these adverse reactions are well known and could be managed in dose dependent manner.
Danish: Skønt nogle patienter fik bivirkninger, hovedsagelig nefrotoksicitet, hypertension og metaboliske forstyrrelser, konstaterede CHMP, at disse bivirkninger er velkendte og kunne behandles på dosisafhængig måde.
English: The MAH addressed the CHMP's concerns; the CHMP is of the view that clinical experience supports the proposed additions in the indication.
Danish: Indehaveren af markedsføringstilladelsen imødekom CHMP's synspunkt; CHMP finder, at de kliniske erfaringer støtter de foreslåede tilføjelser i indikationen.
English: The MAH proposed the following wording for this indication: “Sandimmun Neoral is indicated in patients with severe atopic dermatitis when systemic therapy is required.” The MAH's proposed indication wording for the Atopic dermatis is approved in 15 EU countries.
Danish: Indehaveren af markedsføringstilladelsen foreslog følgende ordlyd til denne indikation: “Sandimmun Neoral er indiceret til patienter med svær atopisk dermatitis, når systemisk behandling er påkrævet.” Indikationen atopisk dermatitis er godkendt i 15 EU-lande med den ordlyd, der er foreslået af indehaveren af markedsføringstilladelsen.
English: With regards to the sub-section Summary of the safety profile, the MAH proposed the inclusion of an overall summary of the principal adverse reactions which were most frequently reported in clinical trials.
Danish: Vedrørende underafsnittet Sammenfatning af sikkerhedsprofilen foreslog indehaveren af markedsføringstilladelsen, at der medtoges en overordnet sammenfatning af de vigtigste bivirkninger, der oftest blev indberettet i kliniske undersøgelser.
English: The CHMP therefore requested the MAH to justify the positive benefit risk for all nephrotic conditions except the primary minimal change glomerulonephritis, primary focal segmental glomerulosclerosis, or primary membranous glomerulonephritis.
Danish: CHMP anmodede derfor indehaveren af markedsføringstilladelsen om at begrunde det positive benefit/risk-forhold for alle nefrotiske sygdomme bortset fra de primære minimale forandringer ved glomerulonefritis, primær fokal segmental glomerulosklerose og primær membranøs glomerulonefritis.
English: The proposed wording was reviewed and agreed accordingly.
Danish: Den foreslåede ordlyd blev revideret og vedtaget i overensstemmelse hermed.
English: Similarly to the section 4.2, wordings for each of the sub-sections for the different non-transplantation indications were discussed and agreed between the CHMP and MAH.
Danish: Ligesom for punkt 4.2 blev ordlyden for hvert underafsnit vedrørende de forskellige andre indikationer end transplantation drøftet og aftalt mellem CHMP og indehaveren af markedsføringstilladelsen.
English: In their response the MAH confirmed that the data from these studies as well as extensive clinical experience are supportive of the indication “Prevention of graft rejection” for Ciclosporin.
Danish: I sin besvarelse fastslog indehaveren af markedsføringstilladelsen, at dataene fra disse undersøgelser samt omfattende kliniske erfaringer støtter indikationen “Forebyggelse af transplantatafstødning” for ciclosporin.
English: Sandimmun was used as a basis of the review as the dossier supporting the approval of the new ciclosporin formulation (Sandimmun Neoral) was based on pharmacokinetics evaluation that demonstrated equivalence between the 2 forms of ciclosporin (oil-based formulation versus microemulsified formulation).
Danish: Dossieret for Sandimmun dannede grundlag for gennemgangen, da dossieret til ansøgningen for den nye formulering af ciclosporin (Sandimmun Neoral) byggede på en farmakokinetisk vurdering, som viste ækvivalens mellem de to former af ciclosporin (oliebaseret formulering versus mikroemulgeret formulering).
English: The MAH explained that shelf life periods were not harmonised and proposed to follow the safest approach to Sandimmun (to fix 36 months period) and the last reduced period for Sandimmun Neoral that is approved in EU countries via variation procedure.
Danish: Indehaveren af markedsføringstilladelsen forklarede, at opbevaringstiderne ikke var harmoniseret, og foreslog at følge den sikreste tilgang for Sandimmun (fastsættelse af en 36-måneders opbevaringstid) og for Sandimmun Neoral den seneste reducerede opbevaringstid, der er godkendt i EU-landene ved ændringsansøgninger.
English: Ciclosporin is contraindicated for some HMG-CoA reductase inhibitors (statins) due to the CYP3A4 and/or Pgp inhibitory potential of ciclosporin.
Danish: Ciclosporin er kontraindiceret sammen med visse HMG-CoA reduktasehæmmere (statiner) på grund af ciclosporins potentiale for at hæmme CYP3A4 og/eller Pgp.
English: Section 5.3 - Preclinical Safety Data
Danish: Punkt 5.3 - Prækliniske sikkerhedsdata
English: The MAH stated in their response package that the absolute changes may be considered small, but in view of the narrow therapeutic window for ciclosporin, standardised intake in relation to food intake would be preferable to reduce intra-individual variability.
Danish: Indehaveren af markedsføringstilladelsen anførte i sin svarpakke, at de absolutte ændringer kan betragtes som små, men at standardiseret indtagelse i relation til måltider på baggrund af ciclosporins snævre terapeutiske vindue vil være at foretrække for at nedsætte den intraindividuelle variabilitet.
English: Lastly, based on the fact that ciclosporin is a potent active substance associated with serious safety concerns, the CHMP was of the opinion that the posology section should clearly state that Sandimmun/Sandimmun Neoral is a product to be handled by specialists within the respective therapeutic area; a general wording was agreed and included accordingly in section 4.2.
Danish: Da ciclosporin er et potent aktivt stof med tilknyttede alvorlige sikkerhedsproblemer, fandt CHMP, at det i doseringsafsnittet klart bør angives, at Sandimmun/Sandimmun Neoral bør anvendes af specialister inden for det pågældende område; der blev vedtaget en generel ordlyd, som blev indsat i punkt 4.2.
English: All MS except Norway have the indication bone marrow transplantation and GVHD approved.
Danish: Alle medlemsstater undtagen Norge har godkendt indikationen knoglemarvstransplantation og graftversus host disease (GVHD).
English: Given the fact that a harmonized label was agreed among the EU community in February 2011 through the PSUR 13 WS procedure, the MAH's position was to use the agreed CSP entirely (i.e. without any further changes).
Danish: På baggrund af, at der blev vedtaget harmoniserede produktoplysninger i EU i februar 2011 ved PSUR 13-arbejdsdelingsproceduren, var indehaveren af markedsføringstilladelsen indstillet på at anvende de vedtagne centrale sikkerhedsoplysninger i deres helhed (dvs. uden yderligere ændringer).
English: Based on literature and supportive data the MAH is of the view that the data presented supports the positive benefit/risk of the indication while recommending using Ciclosporin as systemic therapy both for non-infectious uveitis and for the ocular manifestations of Behcet's disease in patients without neurological manifestations.
Danish: På grundlag af litteraturdata og støttende data finder indehaveren af markedsføringstilladelsen, at de forelagte data støtter det positive benefit/risk-forhold for indikationen, og anbefaler systemisk brug af ciclosporin både til ikke-infektiøs uveitis og til de okulære manifestationer af Behçets sygdom hos patienter uden neurologiske manifestationer.
English: This was endorsed by the CHMP with the exceptions of some requests for clarifications, which were subsequently provided by the MAH with supportive data.
Danish: Dette blev bifaldet af CHMP bortset fra nogle anmodninger om præciseringer, der efterfølgende blev fremlagt af indehaveren af markedsføringstilladelsen sammen med støttende data.
English: Ciclosporin has been studied in several clinical trials in atopic dermatitis, although the studies by modern standards are considered small.
Danish: Der er udført flere kliniske undersøgelser med ciclosporin ved atopisk dermatitis, men de er små efter en moderne standard.
English: The MAH therefore agreed to revise the wording, recommending that Sandimmun Neoral should be administered on a consistent schedule with regard to time of day and relation to meals, as follows: “The daily doses of Sandimmun/Sandimmun Neoral always should be given in two divided doses equally distributed throughout the day, taken at the same time of the day, e.g., in the morning and in the evening.
Danish: Indehaveren af markedsføringstilladelsen indvilligede derfor i at revidere ordlyden som følger med anbefaling af ensartet administration af Sandimmun Neoral hvad angår klokkeslæt og i forhold til måltiderne: “Dagsdosis af Sandimmun/Sandimmun Neoral gives altid som to separate doser, der fordeles ligeligt over døgnet, og tages på samme klokkeslæt, dvs. aften og morgen.
English: Rheumatoid arthritis is an approved therapeutic indication in all EU countries.
Danish: Reumatoid arthritis er en godkendt terapeutisk indikation i alle EU-lande.
English: In view of the above dataset, the CHMP considered that the efficacy of Sandimmun (oil based formulation of ciclosporin) has been demonstrated in 4 randomized controlled and 5 uncontrolled studies as well as studies conducted in pediatric patients.
Danish: På baggrund af ovennævnte datasæt fandt CHMP, at virkningen af Sandimmun (oliebaseret formulering af ciclosporin) er godtgjort i 4 randomiserede kontrollerede og 5 ukontrollerede undersøgelser samt i undersøgelser hos pædiatriske patienter.
English: Since not all countries have such a text included in their national labels and in some countries only Sandimmun Neoral is available, the MAH recommended shortening the proposed text.
Danish: Da en sådan tekst ikke er indeholdt i produktinformationen i alle landene, og da det i nogle lande kun er Sandimmun Neoral, der markedsføres, anbefalede indehaveren af markedsføringstilladelsen at afkorte den foreslåede tekst.
English: The CHMP was of the opinion that a general message about the value of monitoring to guide posology was missing.
Danish: CHMP fandt, at der savnedes en generel erklæring om værdien af monitorering som retningslinje for doseringen.
English: Section 5.2 - Pharmacokinetic Properties
Danish: Punkt 5.2 - Farmakokinetiske egenskaber