FrancophonIA/ELRC3.0 huggingface dataset:
English: The results provided as a whole clearly indicate the non inferiority of the generic product to the reference product and the Applicant considered both products to be fully interchangeable.
Slovenian: Rezultati, ki so bili predloženi kot celota, jasno kažejo, da generično zdravilo ni slabše od referenčnega zdravila, tako da je predlagatelj obe zdravili obravnaval kot popolnoma medsebojno zamenljivi.
English: The CHMP noted the position of the Applicant but considered that this oversimplifies the effect of all generated particles on the respiratory and alimentary tract and that it is difficult to define the role of the individual stages in terms of safety and efficacy, effects such as differences in breathing patterns, aerosol velocity in entering the airways and the shape of the plume must be taken into account.
Slovenian: Odbor CHMP je upošteval stališče predlagatelja, vendar je menil, da s tem prekomerno poenostavlja učinek vseh generiranih delcev na dihalnem in prebavnem traktu in da je težko opredeliti vlogo posameznih stopenj v zvezi z varnostjo in učinkovitostjo zdravila ter da je treba upoštevati učinke, kot so razlike v dihalnih vzorcih, hitrost aerosola pri vstopu v dihalne poti in oblika oblaka.
English: In addition, the study demonstrated indirectly the same lung deposition with a trend to a deeper lung deposition based on a higher ratio in Cmax and a shorter Tmax.
Slovenian: Poleg tega je študija posredno pokazala enako raven odlaganja v pljučih s trendom odlaganja v globljih delih pljuč, in sicer na podlagi večjega razmerja za Cmax in krajšega za Tmax.
English: According to the Applicant, a comparison of the results for the different approaches (individual stages 3, 4 and 5 versus pooled stages 3/4/5) demonstrates that except for stage 3 (below the -15% limit), both approaches lead to comparable results.
Slovenian: Po navedbah predlagatelja je primerjava rezultatov pri različnih pristopih (primerjava posamične 3., 4. in 5. stopnje z združeno skupino stopenj 3, 4 in 5 skupaj) dokazala, da se z izjemo 3. stopnje (pod mejo -15 %) z obema pristopoma dobi primerljive rezultate.
English: Question 6 - The first part of question 5 of the LoQ, “The Applicant should discuss the storage stability of the product, in light of studies demonstrating that the inverted and lying orientations of the device are the most stable” has not been fully answered, since only discussions about upright and lying position, but not about inverted orientation has been submitted.
Slovenian: Šesto vprašanje - Prvi del petega vprašanja glede meje kvantifikacije („Predlagatelj mora razložiti stabilnost pri shranjevanju zdravila glede na študije, ki dokazujejo, da sta obrnjen in ležeč položaj pripomočka najbolj stabilna“) ni bil odgovorjen v celoti, ker so bile predložene samo razlage o pokončnem in ležečem položaju, ne pa tudi o obrnjenem položaju.
English: Single stage comparison revealed that most of the values are within the ± 15 % range (except from stage 0, 1 and filter) and after pooling, all values were within the ± 15 % range.
Slovenian: Primerjava posameznih stopenj je razkrila, da je večina vrednosti v ±15-odstotnem razponu (z izjemo 0., 1. in filtrirne stopnje) ter da so po združitvi vse vrednosti v ±15-odstotnem razponu.
English: The CHMP acknowledged the improved device design and agreed with the Applicant response, the issue was considered resolved.
Slovenian: Odbor CHMP je priznal izboljšavo oblike naprave in se strinjal z odgovorom predlagatelja, zadržek pa je bilo tako odpravljen.
English: Similarly, the final report of the three comparisons should be provided indicating the study dates, the raw data and the study results with its corresponding QA certificate.
Slovenian: Priskrbeti mora tudi končno poročilo o treh primerjavah, v katerem so navedeni datumi študij, neobdelani podatki in rezultati študij z ustreznimi certifikati zagotavljanja kakovosti.
English: The CHMP noted the inclusion of the requested raw data but considered that the results did not demonstrate similarity in all stages and that it was therefore difficult to conclude on therapeutic equivalence.
Slovenian: Odbor CHMP je upošteval vključitev zahtevanih neobdelanih podatkov, vendar je menil, da rezultati ne dokazujejo podobnosti na vseh stopnjah in da je zato težko sklepati o terapevtski enakovrednosti.
English: Therefore the CHMP considered in vivo data to be necessary to confirm therapeutic equivalence.
Slovenian: Zato je CHMP menil, da so za potrditev terapevtske enakovrednosti potrebni in vivo podatki.
English: The CHMP adopted a List of Questions summarising a number of unresolved issues to be addressed and substantiated by the Applicant.
Slovenian: Odbor CHMP je sprejel seznam vprašanj, v katerem je bilo povzetih več nerešenih zadev, na katera je predlagatelj moral odgovoriti in jih tudi ustrezno utemeljiti.
English: The reason for stage pooling is to become discriminative in terms of lung deposition and the measurement of particle size with an instrument such as an impactor is a way to obtain information on particle size of the aerosolized medication and the particle size distribution.
Slovenian: Razlog za združevanje stopenj v skupine je doseči diskriminacijo glede odlaganja v pljučih, merjenje velikosti delcev z instrumentom, kot je impaktor, pa je način pridobivanja informacij o velikosti delcev zdravila v obliki aerosola in porazdelitve velikosti delcev.
English: - the CHMP considered that a similar particle size distribution between the test and the reference product was demonstrated,
Slovenian: - CHMP je menil, da je bila dokazana podobna porazdelitev velikosti delcev pri testnem in referenčnem zdravilu,
English: The CHMP concluded that the applied product had not shown enough similarity to the reference product to establish therapeutic equivalence with regards to efficacy and safety and therefore adopted a list of seven Outstanding Issues to be addressed by the Applicant.
Slovenian: Odbor CHMP je zaključil, da uporabljeno zdravilo ni bilo dovolj podobno referenčnemu zdravilu, da bi bilo mogoče ugotoviti terapevtsko enakovrednost glede učinkovitosti in varnosti, zato je sprejel seznam sedmih nerešenih zadržkov, ki jih mora predlagatelj odpraviti.
English: the CHMP has recommended the granting of the Marketing Authorisations for which the valid Summary of Product Characteristics, labelling and package leaflet are the final versions achieved during the Coordination group procedure are set out in Annex III for Sabumalin and associated names (see Annex I).
Slovenian: je CHMP priporočil odobritev dovoljenj za promet z zdravilom, katerega povzetek glavnih značilnosti zdravila, označevanje in navodilo za uporabo so končne različice, oblikovane med postopkom usklajevalne skupine in navedene v Dodatku III za zdravilo Sabumalin in z njim povezana imena (glejte Dodatek I).
English: The CHMP noted the additional data but remained of the opinion that the pooling method masked the differences between the test products and that in addition, the used spacer decreased the amount of the larger particles and increased the amount of fine particles.
Slovenian: Odbor CHMP je upošteval dodatne podatke, vendar je ostal mnenja, da metoda združevanja stopenj zakrije razlike med testnimi zdravili in da poleg tega uporaba podaljška zmanjša količino večjih delcev ter poveča količino drobnih delcev.
English: The supplied data on particle size distribution did not allow the prediction of the lung deposition pattern affecting clinical efficacy and safety and the aerodynamic particle size distribution differed significantly between the two products.
Slovenian: Predloženi podatki o porazdelitvi velikosti delcev niso omogočali napovedi vzorca odlaganja v pljučih, ki vpliva na klinično učinkovitost in varnost, porazdelitvi velikosti aerodinamičnih delcev pri obeh zdravilih pa sta bili bistveno drugačni.
English: The CHMP noted the Applicant response, but considered that the data was not analysed according to the methodological requirements for clinical comparison.
Slovenian: Odbor CHMP je upošteval odgovor predlagatelja, vendar je menil, da ta podatkov ni analiziral skladno z metodološkimi zahtevami za klinično primerjavo.
English: The valid Summary of Product Characteristics, labelling and package leaflet are the final versions achieved during the Coordination group procedure.
Slovenian: Platný Súhrn charakteristických vlastností lieku, platné označenie obalu a platná písomná informácia pre používateľov predstavujú finálne verzie dosiahnuté počas konania Koordinačnej skupiny.
English: - the CHMP concluded that the products are bioequivalent and that the benefit-risk ratio is positive,
Slovenian: - CHMP je zaključil, da sta zdravili biološko enakovredni ter da je razmerje med koristmi in tveganji pozitivno,
English: The CHMP stated that the draft guideline proposed a more conservative approach to the applied acceptance range mainly due to lack of experience in this filed and the fact that pooling may mask the differences in the evaluated products, as is the case for the current product.
Slovenian: Odbor CHMP je navedel, da je v osnutku smernice predlagan previdnejši pristop k uporabljenemu razponu sprejemljivosti, predvsem zaradi pomanjkanja izkušenj na tem področju in zaradi dejstva, da lahko združevanje stopenj v skupine zakrije razlike med vrednotenimi zdravili, kar se je zgodilo pri tem zdravilu.
English: Question 1- The Applicant should provide the protocol of the in vitro comparisons of the particle size distributions in dry conditions, humid conditions and with spacer where all the relevant information should have been pre-specified, e.g. objective, sample size required to demonstrate equivalence in the predefined pools of stages within a pre-specified acceptance range, the pre-specified batches and the pre-specified statistical methods.
Slovenian: Prvo vprašanje - Predlagatelj mora zagotoviti protokol za in vitro primerjave porazdelitev velikosti delcev v suhih pogojih, vlažnih pogojih in ob uporabi podaljška, kjer bi morale biti vse koristne informacije predhodno določene, npr. cilj, velikost vzorca, potrebna za dokazovanje enakovrednosti v predhodno opredeljenih skupinah stopenj znotraj predhodno določenega razpona sprejemljivosti, predhodno določenih serijah in predhodno določenih statističnih metodah.
English: The Applicant provided in vitro data to demonstrate the in vitro equivalence between the test product and the reference product and presented justifications for the pooling of the data including a second pooling using the following grouped stages: Throat separately (oropharyngeal deposition and hence swallowed dose), Pooling 1: Stage 0, 1, and 2 (large non respirable particles deposited in upper airway, which can be ignored as clinically insignificant), Pooling 2: Stage 3, 4 and 5 (fine particle dose (FPD) between 1.1 and 4.5 µm, deposited on bronchi and predictive of the in vivo bronchodilator efficacy and of Cmax (early lung bioavailability)) and Pooling 3: Stage 6, 7, and Filter (reflects extra fine particles deposited in alveoli).
Slovenian: Predlagatelj je priskrbel in vitro podatke, da bi dokazal in vitro enakovrednost testnega zdravila in referenčnega zdravila, ter predstavil utemeljitve za združevanje podatkov, vključno z drugim združevanjem, kjer je uporabil naslednje stopnje, urejene v skupine: samo grlo (orofaringealno odlaganje, torej pogoltnjen odmerek), prvo združevanje: 0., 1. in 2. stopnja (veliki delci, ki jih ni mogoče vdihniti in se odlagajo v zgornjih dihalnih poteh ter se lahko zanemarijo kot klinično nepomembni), drugo združevanje: 3., 4. in 5. stopnja (odmerek drobnih delcev (FPD), velikih med 1,1 in 4,5 µm, ki se odlagajo v bronhijih in kažejo in vivo učinkovitost pri bronhodilataciji in Cmax (zgodnjo biološko razpoložljivost v pljučih) ter tretje združevanje: 6., 7. in filtrirna stopnja (odraža izredno drobne delce, ki se odlagajo v alveolih).
English: The new formal protocol of the performed retrospective analysis and the new final report on the in vitro data indicated that the 90% CI remained outside the 15% or 20% acceptance range for stage 0, stage 1 and stage 2 and within the 20% CI but outside the 15% CI for stage 3 the 90% CI.
Slovenian: Novi formalni protokol izvedene retrospektivne analize in novo končno poročilo o in vitro podatkih sta pokazala, da je 90-odstotni interval zaupanja ostal zunaj 15- ali 20-odstotnega razpona sprejemljivosti za 0., 1. in 2. stopnjo in znotraj 20-odstotnega intervala zaupanja, vendar zunaj 15-odstotnega intervala zaupanja za 3. stopnjo 90-odstotnega intervala zaupanja.
English: The particle size is considered to be one of the most significant characteristic influencing deposition in the respiratory tract and can be determined using Cascade Impactor measurements although the in vitro comparison should be performed per impactor stage or justified grouped stages which are relevant to efficacy and safety.
Slovenian: Velikost delcev se upošteva kot ena od najpomembnejših lastnosti, ki vplivajo na odlaganje v dihalnem traktu, določi pa se lahko z meritvami s kaskadnim impaktorjem, čeprav bi bilo treba izvesti in vitro primerjavo glede na stopnje impaktorja ali glede na utemeljene, v skupine zbrane stopnje, ki so pomembne za učinkovitost in varnost.
English: The CHMP was of the opinion that the bioequivalence study (2207-59-DOS-5) demonstrated equivalency in safety profile when used without a spacer, as well as similar Cmax and Tmax values.
Slovenian: Odbor CHMP je menil, da je študija biološke enakovrednosti (2207-59-DOS-5) dokazala enakovrednost varnostnega profila pri uporabi brez podaljška ter podobne vrednosti Cmax in
English: The in vivo bioequivalence study shows an equivalent but statistically significant superiority for the test product for Cmax and a shorter Tmax, indicating that the test product has a slightly higher peripheral deposition.
Slovenian: In vivo študija biološke enakovrednosti kaže enakovredno, vendar statistično pomembno prednost testnega zdravila pri Cmax in krajši Tmax, kar kaže na to, da se testno zdravilo malce bolj odlaga v perifernem delu.
English: The in-vitro data without spacer suggests inferiority in stages 0, 1, 2 and 3 and similarity for stages 4, 5, 6, 7 and the filter stage, which suggests a similar Cmax and a superior AUC or similar AUC if the small amount in stages 0/1/2 were negligible.
Slovenian: In vitro podatki brez uporabe podaljška nakazujejo na inferiornost na 0., 1., 2., in 3. stopnji ter podobnost med 4., 5., 6. in 7. stopnjo ter filtrirno stopnjo, kar nakazuje na podoben Cmax in boljše območje AUC ali podobno območje AUC, če je bila majhna količina na 0., 1. in 2. stopnji zanemarljiva.
English: The CHMP requested the Applicant to provide data from a PK study with concomitant use of a spacer.
Slovenian: Odbor CHMP je od predlagatelja zahteval, naj priskrbi podatke iz farmakokinetične študije s sočasno uporabo podaljška.
English: Regarding the storage stability, the Applicant complemented the already submitted repriming study with comparative data from inverted storage and found that all investigated shots for the generic product comply with the specified delivered dose up to a storage period of 7 days.
Slovenian: Kar zadeva stabilnost pri shranjevanju, je predlagatelj dopolnil že predloženo študijo ponovnega polnjenja s primerjalnimi podatki, dobljenimi pri shranjevanju v obrnjenem položaju, in odkril, da so vsi preiskani vpihi generičnega zdravila skladni z navedenim dovedenim odmerkom v času shranjevanja, ki traja do 7 dni.
English: In conclusion a Potential Serious Risk to Public Health was no longer identified and the CHMP concluded that the products are bioequivalent and that the benefit-risk ratio is positive.
Slovenian: Nenazadnje pa odbor CHMP ni več ugotovil morebitnega resnega tveganja za javno zdravje in zaradi tega zaključil, da sta zdravili biološko enakovredni ter da je razmerje med koristmi in tveganji pozitivno.
English: The Applicant stated that no protocol was established before the in vitro comparison but that in house documents with pre-specified criteria were used and that test product batches were subjected to release and stability testing according to protocols from the quality control department.
Slovenian: Predlagatelj je navedel, da pred in vitro primerjavo ni bilo uvedenih protokolov, temveč so se uporabljali dokumenti na ravni družbe, ki so vključevali predhodno opredeljena merila, in da so bile serije testnega zdravila podvržene testiranju sproščanja in stabilnosti v skladu s protokoli oddelka za kontrolo kakovosti.
English: Pharmacokinetic and pharmacodynamic studies have shown that the swallowed fraction from oropharyngeal depositions contributes a negligible amount to the early systemic bioavailability and peak adverse effects of inhaled salbutamol and that there is only negligible direct absorption from the oropharynx.
Slovenian: Farmakokinetične in farmakodinamične študije so pokazale, da pogoltnjen delež orofaringealnih usedlin prispeva zanemarljivo malo k zgodnji sistemski biološki razpoložljivosti in največjim neželenim učinkom inhaliranega salbutamola ter da je neposredna absorpcija v mezofarinksu le zanemarljiva.
English: Following the assessment of the Applicants response to the CHMP List of Questions, the CHMP considered that the presented answers did not support the comparability of the Applicant's product to the reference product.
Slovenian: Po ovrednotenju odgovorov predlagatelja na seznam vprašanj CHMP je Odbor menil, da predloženi odgovori ne podpirajo primerljivosti zdravila predlagatelja z referenčnim zdravilom.
English: Sabumalin is a metered dose aerosol inhaler containing a suspension formulation of salbutamol sulphate 100 µg/spray, with HFA 134a as propellant.
Slovenian: Zdravilo Sabumalin je aerosolni inhalator z določenim odmerkom, ki vsebuje formulacijo suspenzije salbutamol sulfata 100 µg/pršilo s hidrofluoroalkanom 134a kot pogonskim plinom.
English: Question 5 - The Applicant should justify why the product is considered equivalent when the particle size comparison with spacer is not able to demonstrate equivalence in the pool of throat + stage 0 + stage 1, pooled as desired by the Applicant with the 20 % acceptance range and pool of stages 2 + 3, as desired by the Applicant, with the 15 % acceptance range, mainly because the sample size of this comparison has not been calculated appropriately.
Slovenian: Peto vprašanje - Predlagatelj mora utemeljiti, zakaj se zdravilo obravnava za enakovredno, če pri primerjavi velikosti delcev ob uporabi podaljška ni mogoče dokazati enakovrednosti za skupino stopenj, ki združuje stopnjo grla + 0. stopnjo + 1. stopnjo, oblikovano po želji predlagatelja, z 20odstotnim razponom sprejemljivosti, ter skupino 2. in 3. stopnje, oblikovano po želji predlagatelja, s 15-odstotnim razponom sprejemljivosti, kar gre pripisati predvsem neprimernemu izračunu velikosti vzorca v tej primerjavi.
English: The Applicant considered that the widening of the limits to +/- 20% is justifiable and demonstrated that the results obtained fall within the +/- 15% range, except for stage 3.
Slovenian: Predlagatelj je menil, da je razširitev omejitve na ±20 % utemeljena, in dokazal, da so dobljeni rezultati z izjemo 3. stopnje v razponu ±15 %.
English: The in vitro tests performed in humid environment show nonequivalence due to superiority in the stages with the finest particles both separately and after pooling.
Slovenian: In vitro testi, izvedeni v vlažnem okolju, kažejo neenakovrednost zaradi boljših rezultatov na stopnjah z najbolj drobnimi delci tako posamično kot po združevanju v skupine.
English: The amount of salbutamol depositing in the lung or in certain regions of the lung has clinical relevance and therefore single stages of the impactor represent a certain particle size or a size-range which correlates to the site of deposition.
Slovenian: Količina salbutamola, ki se odloži v pljučih ali v določenih predelih pljuč, ima klinični pomen, zato posamezne stopnje impaktorja predstavljajo določeno velikost delcev ali razpon velikosti delcev, ki ustreza mestu odlaganja.
English: The Applicant also included results from a comparative pharmacokinetic study evaluating systemic safety, which demonstrates equivalence and considered that the equivalence of the Cmax values as identified from the systemic safety study supports the prediction of equivalent lung bioavailability and equivalent lung deposition.
Slovenian: Predlagatelj je vključil tudi rezultate primerjalne farmakokinetične študije, v kateri so ovrednotili sistemsko varnost in ki je dokazala enakovrednost, ter menil, da enakovrednost vrednosti Cmax, kot so bile ugotovljene v študiji sistemske varnosti, podpira napoved enakovredne biološke razpoložljivosti v pljučih in enakovrednega odlaganja v pljučih.
English: The Applicant considered that the overall data demonstrate that spacer use results in the same high extent of in vitro equivalence as inhaler testing without this device.
Slovenian: Predlagatelj je menil, da skupni podatki dokazujejo, da pomeni uporaba podaljška enako veliko in vitro enakovrednost, kot je opažena pri testiranju inhalatorja brez tega pripomočka.
English: Particles >4.5 µm are swallowed and contribute by negligible amount to the early systemic bioavailability (as Cmax) and peak adverse events of inhaled salbutamol.
Slovenian: Delci, večji od 4,5 µm, se zaužijejo in imajo zanemarljiv prispevek k zgodnji sistemski biološki razpoložljivosti (kot Cmax) in najmočnejše neželene učinke zaradi inhaliranega salbutamola.
English: b) The Applicant indeed considered that it is the amount of respirable particles <4.7 µm that will ultimately determine bronchodilator efficacy, particularly for stages 3/4/5 (i.e. particle size 1.1-4.7 µm) which correspond to bronchial deposition where the airway smooth muscle beta-2 adrenoceptors are located.
Slovenian: b) Predlagatelj je menil, da je količina delcev, ki jih je mogoče vdihniti in so manjši od 4,7 µm, tista, ki v končni fazi določa bronhodilatacijski učinek, posebej na 3., 4. in 5. stopnji (tj. velikost delcev 1,1-4,7 µm), kar ustreza odlaganju v bronhijih, kjer se nahajajo beta-2-adrenoceptorji gladkih mišic dihalnih poti.
English: The Applicant stated that for pharmacokinetic studies, equivalence is conventionally demonstrated by applying a +/- 20% limit for the 90% CI and therefore applied these limits to the FDP comparison, despite the recent EMEA guidance recommending +/- 15% limits for in vitro equivalence and +/- 20% limits for in vivo pharmacokinetic equivalence.
Slovenian: Predlagatelj je navedel, da se pri farmakokinetičnih študijah enakovrednost navadno dokazuje z uporabo ±20 % omejitve za 90-odstotni interval zaupanja, zato je za primerjavo odmerkov drobnih delcev uporabil navedene omejitve, čeprav zadnja smernica agencije EMEA priporoča ±15 % omejitve za in vitro enakovrednost in ±20 % omejitve za in vivo farmakokinetično enakovrednost.
English: Based on the submitted expert report from study 2007-76-DOS-6, the Applicant concluded that “the presented in vitro data for fine particle dose and the in vivo data for lung bioavailability as Cmax clearly point to the presence of therapeutic equivalence within the 20% limits for both airway and systemic beta-2 adrenoceptor mediated peak effects.
Slovenian: Predlagatelj je na podlagi predloženega strokovnega poročila za študijo 2007-76-DOS-6 zaključil, da „predstavljeni in vitro podatki za odmerek drobnih delcev ter in vivo podatki za biološko razpoložljivost v pljučih v obliki Cmax jasno nakazujejo na obstoj terapevtske enakovrednosti znotraj 20-odstotne omejitve za najmočnejše učinke v dihalnih poteh in učinke, ki jih mediirajo sistemski beta-2 adrenoceptorji.
English: The data clearly shows that the spacer induces a significant depletion of large particles in the throat and an increase in fine particle dose (< 5 µm particles), with the confidence intervals for the single impactor stages within the +/- 20% limit, except for stage 0.
Slovenian: Podatki jasno kažejo, da uporaba podaljška povzroči znatno zmanjšanje količine velikih delcev v grlu in povečanje odmerka drobnih delcev (manjših od 5 µm), intervali zaupanja za posamezne stopnje impaktorja pa so z izjemo 0. stopnje znotraj ±20-odstotne omejitve.