FrancophonIA/ELRC3.0 huggingface dataset:
English: It was also concluded that diacerein should no longer be recommended in patients aged 65 years and above as this patient population is more vulnerable to diarrhoea complications.
Slovenian: Zaključil je tudi, da diacereina ni več priporočljivo uporabljati pri bolnikih, starejših od 65 let, saj je ta populacija bolnikov dovzetnejša za zaplete, povezane z drisko.
English: To ensure adequate screening of the patients at start of treatment, the PRAC also recommended that diacerein is only initiated by specialists experienced in the treatment of osteoarthritis.
Slovenian: Da bi zagotovili ustrezno presejanje bolnikov ob začetku zdravljenja, je odbor PRAC priporočil tudi, naj diacerein predpisujejo samo specialisti, ki imajo izkušnje z zdravljenjem osteoartritisa.
English: In addition, warnings were considered necessary for patients receiving concomitantly diuretics, cardiac glycosides or laxatives.
Slovenian: Poleg tega je menil, da so potrebna opozorila za bolnike, ki sočasno uporabljajo diuretike, srčne glikozide ali odvajala.
English: The high dropout rate due to diarrhoea in clinical trials showed that the acceptability of the treatment was worse in the diacerein group than in the placebo group.
Slovenian: Visoka stopnja prekinitve sodelovanja v kliničnih preskušanjih zaradi driske kaže na to, da je bila sprejemljivost zdravljenja slabša v skupini z diacereinom kot v skupini s placebom.
English: In 2012, the French national competent authority (Agence nationale de sécurité du médicament et des produits de santé, ANSM) initiated a review of the benefit-risk of diacerein containing medicinal products that underlined the occurrence of very frequent digestive disorders, cases of hepatitis and serious skin reactions in patients treated with diacerein.
Slovenian: Francoski pristojni nacionalni organ (Agence nationale de sécurité du médicament et des produits de santé - ANSM) je leta 2012 sprožil pregled razmerja med tveganji in koristmi zdravil, ki vsebujejo diacerein, med katerim je odkril, da se pri bolnikih, ki se zdravijo z diacereinom, zelo pogosto pojavljajo prebavne motnje ter tudi primeri hepatitisa in resnih kožnih reakcij.
English: The PRAC also noted that spontaneous notifications reported serious cases of diarrhoea with dehydration and electrolyte disorders.
Slovenian: Odbor PRAC je upošteval tudi, da so v spontanih poročilih navajali resne primere driske z dehidracijo in motnjami elektrolitov.
English: Only the Dougados study showed efficacy on variables related to a beneficial impact of diacerein on structural progression or disease modifying properties in OA.
Slovenian: Samo Dougadosova študija je pokazala učinek na spremenljivke, povezan z ugodnim vplivom diacereina na napredovanje strukturnih sprememb ali vplivom na potek osteoartritisa.
English: Moreover, two cases raised serious concerns: one fatal hepatitis case in which no other reasons of hepatitis except for diacerein could be found; and one case of acute hepatitis with suggestive chronology and no other explanation.
Slovenian: Dva primera sta vzbudila resno zaskrbljenost: en primer hepatitisa s smrtnim izidom, za katerega niso našli nobenega drugega vzroka razen diacereina, in en primer akutnega hepatitisa, ki je časovno sovpadal z diacereinom, druge razlage pa ni bilo.
English: In spontaneous reports, one quarter of serious gastrointestinal cases were related with diarrhoea.
Slovenian: Med spontanimi poročili je bila z drisko povezana četrtina resnih primerov bolezni prebavil.
English: In addition, the management of diarrhoea could also expose patients to symptomatic treatments.
Slovenian: Poleg tega bi lahko bili bolniki med zdravljenjem driske izpostavljeni tudi simptomatskemu zdravljenju.
English: These included a recommendation to start treatment at half the normal daily dose, a contraindication in patients with a history and/or current liver disease and a clear recommendation for patients to stop treatment as soon as diarrhoea occurs.
Slovenian: Ti vključujejo priporočilo, naj se zdravljenje začne s polovico običajnega dnevnega odmerka, kontraindikacijo pri bolnikih z obstoječo boleznijo jeter in/ali boleznijo jeter v anamnezi ter jasno priporočilo, naj bolniki prekinejo zdravljenje, takoj ko se pojavi driska.
English: Diacerein has a delayed initial onset of action and should not be recommended in patients with rapidly progressive hip osteoarthritis, as they may have a weaker response to diacerein.
Slovenian: Za diacerein je značilen zapoznel začetek delovanja in se ne priporoča pri bolnikih s hitro napredujočim osteoartritisom kolka, saj bi se lahko slabše odzvali nanj.
English: To conclude, the review found that the most frequently reported reactions with diacerein were, as expected, gastrointestinal disorders, especially diarrhoeas, which were frequently severe and leading to complications such as dehydration and disturbances of fluid and electrolyte balance.
Slovenian: Pregled je torej pokazal, da so bili najpogostejši neželeni učinki, o katerih so poročali pri uporabi diacereina, po pričakovanjih bolezni prebavil, še zlasti driska, ki je bila pogosto huda in je povzročila zaplete, kot so dehidracija ter motnje ravnovesja tekočin in elektrolitov.
English: The PRAC, as a consequence, concluded that the benefit-risk balance of the medicinal products containing diacerein identified in Annex I remains favourable, subject to the changes to the product information and conditions as provided for in Annex IV.
Slovenian: Posledično je odbor PRAC zaključil, da je razmerje med tveganji in koristmi zdravil, ki vsebujejo diacerein in so navedena v Prilogi I, še naprej ugodno pod pogojem, da se upoštevajo spremembe informacij o zdravilu in pogoji, opredeljeni v Prilogi IV.
English: The evidence obtained from different meta-analysis of the clinical trials performed with diacerein showed a small beneficial effect of diacerein in the treatment of OA of the knee and hip with different criteria for the inclusion of the clinical trials in the meta-analyses.
Slovenian: Dokazi, pridobljeni iz različnih metaanaliz kliničnih preskušanj, opravljenih z diacereinom, so pokazali majhen ugoden učinek diacereina pri zdravljenju osteoartritisa kolena in kolka ob različnih merilih za vključitev kliničnih preskušanj v metaanalize.
English: As part of this referral procedure, the PRAC reviewed all available data on the efficacy of diacerein containing medicinal products.
Slovenian: Odbor PRAC je v okviru tega napotitvenega postopka pregledal vse razpoložljive podatke o učinkovitosti zdravil, ki vsebujejo diacerein.
English: However, treatment with diacerein is not recommended in patients with rapidly progressive hip osteoarthritis, as they may have a weaker response to diacerein.
Slovenian: Vendar pa se zdravljenje z diacereinom ne priporoča pri bolnikih s hitro napredujočim osteoartritisom kolka, saj bi se lahko slabše odzvali nanj;
English: • The PRAC considered that the available data supporting the use of diacerein have shown a modest but statistically significant effect in the treatment of osteoarthritis of the knee and hip, with a delayed effect.
Slovenian: • odbor PRAC je menil, da razpoložljivi podatki v podporo uporabi diacereina kažejo na skromen, vendar statistično značilen učinek diacereina pri zdravljenju osteoartritisa kolena in kolka, ki se sicer pojavi z zakasnitvijo.
English: The CMDh, having considered the revised final PRAC recommendation dated 10 July 2014 with regards to diacerein containing medicinal products, agrees with the recommendation therein as stated below:
Slovenian: Skupina CMDh se je po proučitvi pregledanega končnega priporočila, ki ga je za zdravila, ki vsebujejo diacerein, 10. julija 2014 izdal odbor PRAC, strinjala s priporočilom, ki je navedeno v nadaljevanju:
English: • The PRAC considered that available data from pre-clinical studies, clinical trials, post-marketing spontaneous case reports, and published literature have shown that the use of diacereincontaining products is associated with safety concerns such as frequent cases of severe diarrhoea and cases of potentially serious hepatotoxicity; a risk of cutaneous reactions could not be excluded.
Slovenian: • odbor PRAC je menil, da razpoložljivi podatki iz predkliničnih študij, kliničnih preskušanj, spontanih poročil o primerih v obdobju trženja in objavljene literature kažejo, da je uporaba zdravil, ki vsebujejo diacerein, povezana z varnostnimi tveganji, kot so pogosti primeri hude driske in primeri potencialno resne hepatotoksičnosti, izključiti pa ni mogoče niti tveganja za kožne reakcije;
English: The PRAC confirmed it had considered the totality of the data submitted by the MAHs in the context of the initial referral procedure.
Slovenian: Odbor PRAC je potrdil, da je vse podatke, ki sta jih predložila imetnika dovoljenja za promet z zdravilom, proučil v okviru prvotnega napotitvenega postopka.
English: Some cases of hospitalisation to further investigate the event of diarrhoea were also reported.
Slovenian: Poročali so tudi o nekaj primerih hospitalizacije, ki je bila potrebna za nadaljnjo preiskavo primera driske.
English: A laxative effect was observed in up to 50% of the diacerein-treated patients in clinical studies.
Slovenian: V kliničnih študijah so odvajalni učinek opazili pri do 50 % bolnikov, ki so jih zdravili z diacereinom.
English: It was reiterated that structure-modifying effects of cartilage by diacerein in OA and long-term efficacy had not been demonstrated by the presented studies; however, a carry-over effect was confirmed by three studies.
Slovenian: Ponovno je bilo poudarjeno, da predložene študije ne dokazujejo vpliva diacereina na strukturne spremembe na hrustancu pri osteoartritisu in njegove dolgoročne učinkovitosti, so pa tri študije potrdile učinek prenosa.
English: The CMDh also agreed with the PRAC that the PSURs should be submitted on a yearly basis.
Slovenian: Skupina CMDh se je tudi strinjala z odborom PRAC, da se morajo redno posodobljena poročila o varnosti zdravila predložiti enkrat na leto.
English: With regards to the potential risk of hepatic reactions, several hepatic events have been reported, including serious hepatic reactions and one fatal case of hepatitis was reported.
Slovenian: Kar zadeva možno tveganje za jetrne reakcije, so poročali o več jetrnih dogodkih, med katerimi so bile tudi resne jetrne reakcije in en primer hepatitisa s smrtnim izidom.
English: The available data were therefore not sufficient to conclude on the structure modifying effects of diacerein in osteoarthritis and no data were available regarding a potential effect of diacerein for delaying surgery.
Slovenian: Razpoložljivi podatki torej niso bili zadostni, da bi omogočali zaključek o vplivu diacereina na strukturne spremembe pri osteoartritisu, podatki o morebitnem učinku diacereina, ki bi podaljšal čas do potrebne operacije, pa niso bili na voljo.
English: The product information should reflect the recommendation to monitor signs of hepatic injury and caution should be exercised when diacerein is used concomitantly with other medicinal products associated with hepatic injury.
Slovenian: V informacije o zdravilu je treba vključiti priporočilo o spremljanju znakov poškodbe jeter, prav tako pa je potrebna previdnost, kadar se diacerein uporablja sočasno z drugimi zdravili, ki lahko povzročijo poškodbo jeter.
English: Notwithstanding this, and given the new proposals from the MAHs on possible measures to minimise the risks, the PRAC carried out a new assessment of the available data in the context of the re-examination.
Slovenian: Kljub temu je odbor PRAC ob upoštevanju novih predlogov imetnikov dovoljenja za promet z zdravilom glede možnih ukrepov za zmanjšanje tveganj znova ocenil razpoložljive podatke v okviru ponovnega pregleda.
English: A reduction in the use of NSAID was only shown in one study and therefore a sparing effect of diacerein on NSAIDs could not be confirmed.
Slovenian: Zmanjšanje uporabe nesteroidnih protivnetnih zdravil so zabeležili samo v eni študiji, zato vpliva diacereina na zmanjšanje potrebe po uporabi nesteroidnih protivnetnih zdravil ni bilo mogoče potrditi.
English: Furthermore, as previously assessed, a paracetamol sparing effect (in eight trials) and a sparing effect on NSAIDs (in one trial) could be detected, but further research would be needed as proof of evidence.
Slovenian: Kot so ocenili že pri prejšnjem pregledu, je mogoče zaznati vpliv na zmanjšanje potrebe po uporabi paracetamola (opazili so ga v osmih preskušanjih) in potrebe po uporabi nesteroidnih protivnetnih zdravil (opazili so ga v enem preskušanju), vendar bi bile za potrditev teh ugotovitev potrebne dodatne raziskave.
English: Having considered the overall submitted data provided by the MAHs in writing and at the oral explanation, the PRAC concluded that the benefit-risk balance of diacerein containing products is not favourable in the currently approved indications.
Slovenian: Po proučitvi vseh podatkov, ki so jih v obliki pisne dokumentacije in ustnih pojasnil podali imetniki dovoljenja za promet z zdravilom, je odbor PRAC zaključil, da razmerje med tveganji in koristmi zdravil, ki vsebujejo diacerein, ni ugodno pri trenutno odobrenih indikacijah.
English: With regards to posology, as some patients may experience loose stools or diarrhoea after the intake of two capsules per day during the first few weeks of treatment, it is advisable to start treatment with half the recommended daily dose, i.e. one capsule of diacerein 50 mg per day.
Slovenian: Kar zadeva odmerjanje, je zaradi dejstva, da se lahko pri nekaterih bolnikih ob jemanju dveh kapsul na dan v prvih nekaj tednih zdravljenja pojavi mehko blato ali driska, priporočil, naj se zdravljenje začne s polovico priporočenega dnevnega odmerka, kar je ena 50-miligramska kapsula diacereina na dan. O prehodni driski večinoma poročajo v prvih 2 do 4 tednih, poleg tega pa so odvajalni učinki diacereina verjetno odvisni od odmerka.
English: About 10% of adverse drug reactions (ADR) reported were hepatic disorders and in over 68% of these cases, diacerein was the only drug suspected.
Slovenian: Bolezni jeter so predstavljale približno 10 % vseh neželenih učinkov, o katerih so poročali pri uporabi zdravila, pri čemer je bil diacerein v več kot 68 % primerov edini domnevni vzrok.
English: The PRAC was of the view that diacerein should be contraindicated in patients with current and/or history of liver disease and that patient should be screened for major causes of active hepatic disease before start of treatment.
Slovenian: Odbor PRAC je menil, da je treba diacerein kontraindicirati pri bolnikih z obstoječo boleznijo jeter in/ali boleznijo jeter v anamnezi in da je treba pred začetkom zdravljenja pri bolnikih opraviti presejalne teste za glavne vzroke aktivne bolezni jeter.
English: In addition, and according to the clinical trials and bibliographical data, the efficacy appeared weak in the symptomatic treatment of osteoarthritis with low impact on pain and functional symptoms and with no demonstration of a decrease of NSAIDs intake in the population treated with diacerein.
Slovenian: Poleg tega klinična preskušanja in bibliografski podatki kažejo na majhno učinkovitost zdravila pri simptomatskem zdravljenju osteoartritisa z majhnim vplivom na bolečino in funkcionalne simptome, poleg tega pa ni dokazov o tem, da bi se pri bolnikih, zdravljenih z diacereinom, zmanjšal vnos nesteroidnih protivnetnih zdravil.
English: The present review showed that rash, pruritus and eczema were the most common cutaneous reactions reported in clinical trials but available post-marketing data revealed cases of erythema multiforme, Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN).
Slovenian: Ta pregled je pokazal, da so bile najpogostejše kožne reakcije, o katerih so poročali v kliničnih preskušanjih, izpuščaj, pruritus in ekcem, vendar pa so razpoložljivi podatki iz obdobja trženja razkrili primere multiformnega eritema, Stevens-Johnsonovega sindroma (SJS) in toksične epidermalne nekrolize (TEN).
English: The MAHs considered that there is adequate data supporting the efficacy of diacerein in the symptomatic treatment of osteoarthritis of the hip and the knee and proposed further risk minimisation measures to reduce the risk of diarrhoea and potential risk of hepatic reactions associated with diacerein.
Slovenian: Imetnika dovoljenja za promet z zdravilom sta menila, da je na voljo dovolj podatkov, ki dokazujejo učinkovitost diacereina pri simptomatskem zdravljenju osteoartritisa kolka in kolena, ter predlagala dodatne ukrepe za zmanjšanje tveganja za drisko in možnega tveganja za jetrne reakcije, povezane z diacereinom.
English: • The PRAC reviewed all the available data on the efficacy and safety of diacerein-containing medicines in particular data in relation to the risk of hepatotoxicity, gastrointestinal disorders and cutaneous reactions provided by the MAHs in writing and in the oral explanations;
Slovenian: • odbor PRAC je pregledal vse razpoložljive podatke o učinkovitosti in varnosti zdravil, ki vsebujejo diacerein, zlasti podatke, povezane s tveganjem za hepatotoksičnost, bolezni prebavil in kožne reakcije, ki so jih v obliki pisne dokumentacije in ustnih pojasnil podali imetniki dovoljenja za promet z zdravilom;
English: With regards to the safety profile of diacerein, it was noted that the most frequently reported events with diacerein when used as per label (100mg/day) in the clinical trials, were loose stools and diarrhoea, including severe diarrhoea.
Slovenian: Pri oceni varnostnega profila je bilo ugotovljeno, da so bili najpogostejši neželeni učinki, o katerih so v kliničnih preskušanjih poročali pri uporabi diacereina v skladu z navodili (100 mg/dan), mehko blato in driska, vključno s hudo drisko.
English: Furthermore, evidence of hepatic reactions was reported, including symptomatic acute liver injury.
Slovenian: Poleg tega so zabeležili dokaze o jetrnih reakcijah, vključno s simptomatsko akutno poškodbo jeter.
English: • The PRAC concluded that the risk of severe diarrhoea associated with the use of diacerein containing medicinal products and the occurrence of potentially severe hepatic reactions could be mitigated by the above mentioned risk minimisation measures to be reflected in the SmPC and adequately monitored with yearly PSUR submissions.
Slovenian: • odbor PRAC je zaključil, da je tveganje za hudo drisko, povezano z uporabo zdravil, ki vsebujejo diacerein, in pojav potencialno hudih jetrnih reakcij mogoče zmanjšati z zgoraj navedenimi ukrepi za zmanjšanje tveganja, ki bodo obravnavani v povzetku glavnih značilnosti zdravila in jih bodo ustrezno spremljali z redno posodobljenimi poročili o varnosti zdravila, ki se bodo oddajala enkrat na leto.
English: However, although double blind was an intended methodological feature of the clinical trials performed with diacerein, it was considered doubtful that blinding was achieved in practice, considering the very apparent effects (urine coloration, diarrhoea) produced by diacerein.
Slovenian: Vendar pa naj bi metodologija kliničnih preskušanj, opravljenih z diacereinom, po načrtu vključevala dvojno zakrivanje, a se je pojavil dvom, ali je bilo zakrivanje doseženo tudi v praksi, saj ima diacerein zelo očitne neželene učinke (obarvanje urina, driska).
English: Hepatic reactions were reported, including symptomatic acute liver injury and one fatal case of fulminant hepatitis.
Slovenian: Poročali so o jetrnih reakcijah, med katerimi sta bila tudi simptomatska akutna poškodba jeter in en primer fulminantnega hepatitisa s smrtnim izidom.
English: In addition, in a comparative study of the efficacy and tolerability of two therapeutic regimens of diacerein (usual treatment (50 mg twice a day) for 3 months versus progressive treatment (50 mg once a day for one month; then 50 mg twice a day for two months) the proportion of patients developing diarrhoea decreased by approx. 10% in the group treated by 50mg once a day followed by 50mg twice a day compared to the group with no titration.
Slovenian: Opravili so tudi dodatno študijo, v kateri so proučili učinkovitost in tolerančnost obeh zdravljenj, ki vključujejo diacerein (običajno zdravljenje (50-miligramski odmerek dvakrat na dan) v obdobju 3 mesecev ter napredujoče zdravljenje (50-miligramski odmerek nekrat dnevno v obdobju enega meseca, nato isti odmerek dvakrat dnevno v obdobju dveh mesecev).
English: Therefore, diacerein is still a relevant option for some patients for symptomatic treatment of OA of the hip and knee, but caution is advised and patients must stop treatment should diarrhoea develop.
Slovenian: Zato diacerein še vedno velja za ustrezno zdravljenje za simptomatsko zdravljenje osteoartritisa kolkov in kolen pri nekaterih bolnikih, vendar se priporoča previdnost in takojšnje prenehanje z zdravljenjem, če bolniki dobijo drisko.
English: The PRAC reviewed all available data from clinical studies, published literature, and post-marketing experience on the safety of the diacerein containing products, in particular in relation to the risk of hepatotoxicity, gastro-intestinal disorders and cutaneous disorders.
Slovenian: Odbor PRAC je pregledal vse razpoložljive podatke iz kliničnih študij, objavljene literature in izkušenj v obdobju trženja o varnosti zdravil, ki vsebujejo diacerein, zlasti v povezavi s tveganjem za hepatotoksičnost, bolezni prebavil in bolezni kože.
English: • The PRAC considered the grounds for re-examination provided by the MAHs in writing and in the oral explanations;
Slovenian: • odbor PRAC je proučil razloge za ponoven pregled, ki so jih v obliki pisne dokumentacije in ustnih pojasnil podali imetniki dovoljenja za promet z zdravilom;
English: The PRAC acknowledged that although neither the available randomised clinical trials nor the metaanalyses were without flaws, clinical trials show a modest and statistically significant effect for diacerein in the end-points pain relief and function disability.
Slovenian: Odbor PRAC je potrdil, da so kljub pomanjkljivostim, ki so jih imela razpoložljiva naključna klinična preskušanja in metaanalize, klinična preskušanja pokazala skromen, vendar statistično značilen učinek diacereina pri končnih točkah, ki sta bili lajšanje bolečine in funkcionalna prizadetost.
English: Furthermore, cases of hepatic enzymes elevations have been reported and as well as serious cases, including a fatal hepatic reaction in a patient treated with diacerein.
Slovenian: Poleg tega so poročali tudi o primerih zvišanja jetrnih encimov in o resnih primerih, med katerimi je bila tudi jetrna reakcija s smrtnim izidom pri bolniku, ki se je zdravil z diacereinom.
English: Finally, with regards to the risk of cutaneous disorders, safety concerns were raised with diacerein following a publication of a fatal case of a toxic epidermal necrolysis, with diacerein being the most suspected drug for the events.
Slovenian: V zvezi s tveganjem za bolezni kože, povezanim z diacereinom, so se pojavili varnostni zadržki zaradi objavljenega primera toksične epidermalne nekrolize s smrtnim izidom, za katerega je bil domnevno najverjetnejši vzrok prav diacerein.
English: Although it was noted that the data from clinical studies showed no significant differences in hepatic disorders between diacerein and the placebo group, when present, hepatic disorders were in most of cases in the diacerein group.
Slovenian: Podatki iz kliničnih študij sicer niso pokazali pomembnih razlik pri boleznih jeter, ki so se pojavile v skupini, zdravljeni z diacereinom in tisti s placebom, vendar pa so te bolezni večinoma opažali v skupini, zdravljeni z diacereinom.
English: In addition, given the gastrointestinal risk and potential risk of hepatic reactions, the PRAC considered necessary to restrict prescription to specialists experienced in the treatment of osteoarthritis.
Slovenian: Poleg tega je odbor PRAC ob upoštevanju tveganja za bolezni prebavil in možnega tveganja za jetrne reakcije menil, da je treba omejiti predpisovanje zdravila na specialiste, ki imajo izkušnje z zdravljenjem osteoartritisa.
English: However, it was acknowledged that a sparing effect on paracetamol use had been demonstrated in four out of eight clinical trials.
Slovenian: Po drugi strani pa so upoštevali, da so štiri od osmih kliničnih preskušanj pokazala vpliv na zmanjšanje potrebe po uporabi paracetamola.