FrancophonIA/ELRC3.0 huggingface dataset:
English: After excluding one double entry, 1616 cases were considered for the analysis.
Danish: Efter udelukkelse af en enkelt dobbeltpostering omfattede analysen 1 616 tilfælde.
English: Tetrazepam containing medicinal products are authorised in Austria, Belgium, Bulgaria, Czech Republic, France, Germany, Latvia, Lithuania, Luxembourg, Poland, Romania, Slovakia and Spain (see Annex I for the list of tetrazepam containing medicinal products authorised in the EU).
Danish: Lægemidler indeholdende tetrazepam er godkendt i Østrig, Belgien, Bulgarien, Tjekkiet, Frankrig, Tyskland, Letland, Litauen, Luxembourg, Polen, Rumænien, Slovakiet og Spanien (bilag I indeholder en fuldstændig liste over EU-godkendte lægemidler indeholdende tetrazepam).
English: In these studies only limited efficacy was shown.
Danish: Undersøgelser har vist begrænset virkning.
English: The option of a patient alert card was also discussed but this was not considered effective in preventing these types of SCARs.
Danish: Muligheden af et patientadvarselskort blev ligeledes drøftet, men blev ikke anset for effektivt til at forhindre sådanne typer af SCAR.
English: At the date of 30 June 2012, 2382 cases with tetrazepam were registered in the French national database.
Danish: Pr. 12. juni 2012 var der registreret 2382 tilfælde med tetrazepam i den franske nationale database.
English: In 10 cases, the diagnosis was confirmed by skin biopsy.
Danish: I 10 tilfælde blev diagnosen bekræftes ved hudbiopsi.
English: Allergic tests were performed in several cases.
Danish: I flere tilfælde blev der foretaget allergitest.
English: The conditions for lifting the suspension of the marketing authorisations are set out in Annex III.
Danish: Betingelserne for ophævelse af suspenderingen af markedsføringstilladelserne fremgår af bilag III.
English: Of these, 1617 had a "suspected” or “interaction” WHO code.
Danish: Heraf havde 1 617 fået tildelt WHO-koden “formodet” eller “interaktion”.
English: In view of the unpredictability of this type of adverse reactions, a restricted indication would not be an effective risk minimisation measure.
Danish: I betragtning af uforudsigeligheden af denne type bivirkninger ville en begrænset indikation ikke være en effektiv risikominimeringsforanstaltning.
English: In most of the cases, the causal relationship of tetrazepam was reported as possible (86% of the cases) and in some cases as probable (11% of the cases).
Danish: I de fleste tilfælde blevet årsagssammenhængen med tetrazepam beskrevet som mulig (86 % af tilfældene), i nogle som sandsynlig (11 % af tilfældene).
English: Thirty-eight (38) cases were non medically-confirmed cases and 475 cases were medically-confirmed; among them, 180 cases were directly reported to the Company, 245 cases were reported by Health Authorities, and 50 cases were identified in the scientific worldwide literature.
Danish: 38 tilfælde var ikke lægeligt bekræftet, mens 475 tilfælde var lægeligt bekræftet; heraf blev 180 tilfælde direkte indberettet af virksomheden, 245 blev indberettet af sundhedsmyndighederne, og 50 tilfælde blev fundet i den videnskabelige litteratur fra hele verden.
English: These cases concerned 31 cases of SJS and 35 cases of TEN, including one case with both reactions.
Danish: Af disse tilfælde var 31 SJS, og 35 var TEN, heraf ét tilfælde med begge reaktioner.
English: Severe cutaneous adverse reactions with tetrazepam are also described in published literature1,2,3,4,5,6,7,8,9,10,11.
Danish: I den publicerede litteratur beskrives ligeledes svære kutane bivirkninger med tetrazepam 1,2,3,4,5,6,7,8,9,10,11.
English: Scientific conclusions and grounds for suspension of the marketing authorisations (see Annex I)
Danish: Videnskabelige konklusioner og begrundelse for suspendering af markedsføringstilladelserne (se bilag I)
English: This is confirmed by the results of the allergic tests for which in a number of cases only tetrazepam had positive results.
Danish: Dette bekræftes af resultaterne af allergitestene, hvor det i en række tilfælde kun var tetrazepam, der gav positivt resultat.
English: Further risk minimisation measures such as additional amendments to the product information (contraindications, warnings), communication material (patient alert card, dear Health Care Professional Letter) and reduction of pack size were also considered during the discussions.
Danish: Desuden drøftedes yderligere risikominimeringsforanstaltninger såsom supplerende ændringer af produktinformationen (kontraindikationer, advarsler), kommunikationsmateriale (patientadvarselskort, direkte meddelelse til sundhedspersoner) og reduktion af pakningsstørrelsen.
English: In addition, 10 cases of angioedema evoking an immediate hypersensitivity mechanism and 67 cases of drug eruption, in addition to the previous cases, with or without the involvement of at least one organ were described.
Danish: Desuden blev der beskrevet 10 tilfælde af angioødem med hypersensitivitet af straks-typen og 67 tilfælde af lægemiddeludslæt, ud over de nævnte tilfælde, med eller uden inddragelse af mindst ét organ.
English: The PRAC also noted that current guidelines do not refer to the use of tetrazepam in the spasticity indication.
Danish: PRAC bemærkede desuden, at de gældende retningslinjer ikke henviser til anvendelse af tetrazepam ved spasticitetsindikationen.
English: PRAC acknowledged that majority of cases reported involved the use of multiple medicinal products.
Danish: PRAC vedgik, at der i størstedelen af de indberettede tilfælde var tale om polyfarmaci.
English: Time to onset ranged from 1 to 3 weeks in 14 patients, while 9 cases were reported with a shorter time to onset (< 7 days) including 6 cases with a very short time to onset between 1- 3 days.
Danish: Tiden til indsætten var mellem 1 og 3 uger hos 14 af patienterne, mens der i 9 tilfælde blev angivet kortere tid til indsætten (< 7 dage), heraf 6 med meget kort tid til indsætten (1-3 dage).
English: Therefore, following the provisions under Article 107i of Directive 2001/83/EC, the PRAC recommends the suspension of the marketing authorisations for all medicinal products referred to in Annex I.
Danish: I henhold til bestemmelserne i artikel 107i, i direktiv 2001/83/EF, anbefaler PRAC derfor suspendering af markedsføringstilladelserne for alle lægemidler omhandlet i bilag I.
English: Overall summary of the scientific evaluation of Tetrazepam containing medicinal products by PRAC
Danish: Samlet resumé af PRAC's videnskabelige vurdering af lægemidler indeholdende tetrazepam
English: Tetrazepam affinity for skin could explain the localization of the hypersensitivity reaction.
Danish: Tetrazepams affinitet for hud kan tænkes at være forklaringen på hypersensitivitetsreaktionens lokalisering.
English: This is indicative that serious cutaneous reactions with tetrazepam are probably linked to a type IV delayed hypersensitivity mechanism, as supported by positive patch tests in 79 out of 115 cases having had an allergy test.
Danish: Dette tyder på, at de alvorlige kutane reaktioner med tetrazepam hænger sammen med en forsinket hypersensitivitetsmekanisme af type IV, hvilket underbygges af de positive lappeprøver i 79 ud af de 115 tilfælde, hvor der blev testet for allergi.
English: Following reporting of new serious cutaneous reactions with the use of tetrazepam, the French National Competent Authority reviewed in November 2012 the cutaneous risk associated with tetrazepam based on results of a national pharmacovigilance survey.
Danish: Efter indberetninger om nye alvorlige kutane reaktioner ved anvendelse af tetrazepam gennemgik de kompetente franske myndigheder i november 2013 den kutane risiko forbundet med tetrazepam på grundlag af en national lægemiddelovervågningsundersøgelse.
English: Taking into account the indications of tetrazepam, the effectiveness of a reduction of duration of treatment was questioned by the PRAC in view of the potential for repeated use.
Danish: I betragtning af indikationerne for tetrazepam betvivlede PRAC, at en afkortning af behandlingsvarigheden ville blive ført ud i praksis på baggrund af potentialet for gentagen anvendelse.
English: The efficacy of tetrazepam was also compared to other active drugs in controlled double blind studies: these studies did not show statistically significant difference between the groups in both indications.
Danish: Derudover blev virkningen af tetrazepam sammenlignet med andre aktive lægemidler i randomiserede, dobbeltblindede, placebo-kontrollerede undersøgelser: I undersøgelserne var der ikke statistisk signifikant forskel mellem grupperne ved nogen af indikationerne.
English: Almost all cases with information about duration of treatment with tetrazepam, a duration of up to one month treatment was observed in most cases; in 9 cases, the duration was very short (less than 4 days).
Danish: Behandlingsvarigheden med tetrazepam blev oplyst i næsten alle tilfælde og var for størstedelen op til en måned, men i 9 tilfælde var behandlingsvarigheden meget kort (under 4 dage).
English: The PRAC therefore concluded that the benefit-risk balance of tetrazepam containing medicinal products is not favourable.
Danish: PRAC konkluderede derfor, at benefit/risk-forholdet for lægemidler indeholdende tetrazepam ikke er positivt.
English: Benzodiazepines (BZP) facilitate the inhibitory activity of gamma-aminobutyric acid (GABA) leading to sedative, hypnotic, anticonvulsant and muscle relaxant properties.
Danish: Benzodiazepiner (BZP) faciliterer den hæmmende aktivitet af gammaaminosmørsyre (GABA) og virker derfor sedativt, hypnotisk, antikonvulsivt og muskelrelakserende.
English: Many of the skin adverse events were maculopapular, but they were also vesicular, pustular, purpuric or bullous at times.
Danish: Hudreaktionerne var for manges vedkommende makulopapuløse, men undertiden også vesikulære, pustulære, purpurrøde eller bulløse.
English: As provided by the Marketing Authorisation Holder of the originator medicinal product in their written response to the PRAC list of questions, according to the MAH's pharmacovigilance database since the product launch in 1969 up to the 31 of May 2012 (Data Lock Point), 513 cutaneous or allergic distinct cases referring to 748 reactions were reported with tetrazepam.
Danish: Som angivet af markedsføringstilladelsesindehaveren for det oprindelige lægemiddel i dennes skriftlige besvarelse af spørgsmålene fra PRAC er der siden produktets lancering i 1969 og indtil den 31. maj 2012 (hvor databasen blev låst) indberettet 513 klare tilfælde af kutane eller allergiske reaktioner med tetrazepam vedrørende 748 reaktioner.
English: • The PRAC considered the procedure under Article 107i of Directive 2001/83/EC, for tetrazepam containing products.
Danish: • PRAC fulgte proceduren i overensstemmelse med artikel 107i, i direktiv 2001/83/EF for lægemidler indeholdende tetrazepam,
English: During the French national pharmacovigilance survey an analysis of cutaneous cases reported in the national pharmacovigilance database since the initial Marketing Authorisation up to 30 June 2012 was performed.
Danish: Under den franske nationale lægemiddelovervågningsundersøgelse blev der foretaget en analyse af de kutane tilfælde, der var indberettet til den nationale lægemiddelovervågningsdatabase fra tidspunktet for den oprindelige markedsføringsgodkendelse og frem til 30. juni 2012.
English: Annex II Scientific conclusions and grounds for suspension of the marketing authorisations
Danish: Videnskabelige konklusioner og begrundelse for suspendering af markedsføringstilladelserne
English: This review of pharmacovigilance concerned skin adverse drug reactions (ADRs) recorded in the French National Pharmacovigilance database since the granting of the first marketing authorisations of tetrazepam in 1967 in that Member State.
Danish: Gennemgangen af lægemiddelovervågningen vedrørte lægemiddelrelaterede hudreaktioner, der var registreret i den franske nationale database for lægemiddelovervågning siden udstedelsen af de første markedsføringsgodkendelser for tetrazepam i 1967 i denne medlemsstat.
English: Within these 1616 cases, 805 (49.80 %) ADRs involved “skin and subcutaneous tissue disorders” SOC, of which 305 (37.9%) were serious cases including life threatening and fatal cases.
Danish: At disse 1 616 tilfælde vedrørte 805 (49,80 %) bivirkninger fra systemorganklassen “hud og subkutane væv”, hvoraf 305 (37,9 %) var alvorlige og for nogles vedkommende livstruende eller fatale.
English: Delayed hypersensitivity to tetrazepam.
Danish: Forsinket hypersensitivitet over for tetrazepam.
English: Based on the above, the PRAC concluded that tetrazepam is associated with safety concerns in relation to serious, potentially fatal, skin reactions and shows limited clinical efficacy.
Danish: På ovenstående grundlag konkluderede PRAC, at tetrazepam er forbundet med sikkerhedsproblemer i form af alvorlige, potentielt fatale hudreaktioner og udviser begrænset klinisk virkning.
English: The PRAC considered available data including data from the French pharmacovigilance survey, data provided by other Member States, stakeholder's submissions and data submitted by MAHs, as well as published data.
Danish: PRAC gennemgik de foreliggende data, herunder data fra den franske lægemiddelovervågningsundersøgelse og data, der var forelagt af andre medlemsstater eller indsendt af interesserede parter og af markedsføringstilladelsesindehavere, samt publicerede data.
English: On 20 December 2012 France informed the European Medicines Agency, pursuant to Article 107i of Directive 2001/83/EC, of their consideration to revoke the marketing authorisations for Tetrazepam containing medicines further to the evaluation of data resulting from pharmacovigilance activities.
Danish: Den 20. december 2012 underrettede Frankrig Det Europæiske Lægemiddelagentur om, at det i medfør af artikel 107i, i direktiv 2001/83/EF, overvejede at tilbagekalde markedsføringsgodkendelserne for lægemidler indeholdende tetrazepam efter en gennemgang af lægemiddelovervågningsdata.
English: In addition, cases of rechallenge with new skin disorders episodes were reported.
Danish: Desuden blev der indberettet tilfælde, hvor behandlingen genoptoges, hvilket efterfulgtes af nye episoder med hudlidelser.
English: Concerning the SJS/TEN cases described by the MAH 65 medically-confirmed serious cases of SJS/TEN were reported.
Danish: Indehaveren af markedsføringstilladelsen beskrev 65 lægeligt bekræftede alvorlige tilfælde af SJS/TEN.
English: Cases of anaphylaxis were also reported.
Danish: Der blev også indberettet tilfælde af anafylaksi.
English: In addition the PRAC considered that the clinical data supporting the 6-day duration treatment benefit were insufficiently robust.
Danish: Desuden fandt PRAC, at der ikke var tilstrækkelige kliniske data til at underbygge virkningen ved en behandlingsvarighed på 6 dage.
English: In view of the safety concerns in relation to serious, potentially fatal, skin reactions and the limited efficacy of tetrazepam, the PRAC concluded that pursuant to Article 116 of Directive 2001/83/EC the benefit-risk balance of tetrazepam containing medicines is considered no longer favourable.
Danish: konkluderede PRAC, at i betragtning af de sikkerhedsmæssige problemer, der er forbundet med potentielt fatale hudreaktioner, og den begrænsede virkning af tetrazepam kan benefit/riskforholdet for lægemidler indeholdende tetrazepam i henhold til artikel 116 i direktiv 2001/83/EF ikke længere anses for at være positivt.
English: • The PRAC noted that serious adverse cutaneous reactions have been reported with tetrazepam, including fatal cases.
Danish: • PRAC konstaterede, at der er indberettet alvorlige kutane reaktioner med tetrazepam, heraf nogle med dødelig udgang,
English: 1 Sanchez I et al. Stevens-Johnson syndrome from tetrazepam.
Danish: 1 Sanchez I et al. Stevens-Johnsons syndrom fremkaldt af tetrazepam.
English: The potential for nucleophilic attack proposed in the literature (by Barbaud et al, 2009) is consistent with the mechanism proposed by in silico analysis, and may explain the reported lack of cross-reactivity between tetrazepam and other benzodiazepines in patients with cutaneous hypersensitivity reactions.
Danish: I litteraturen nævnes potentialet for nukleofile reaktioner (Barbaud et al, 2009), hvilket svarer til den mekanisme, som in silico-analyse peger på, og også kan være forklaringen på den manglende krydsreaktivitet mellem tetrazepam og andre benzodiazepiner hos patienter med kutane hypersensitivitetsreaktioner.
English: Overall, the most frequently reported skin reactions are by decreasing order various types of rashes without any specificity (162 cases), pruritus (94 cases), Erythema Multiforme (48 cases), urticaria (47 cases), Toxic Epidermal Necrolysis (35 cases), angioedema (34 cases), Stevens-Johnson Syndrome (31 cases), erythema (28 cases), toxic skin eruption (19 cases), skin exfoliation (16 cases), dermatitis bullous, Not Otherwise Specified (NOS) (16 cases) and DRESS Syndrome (7 cases).
Danish: De oftest indberettede hudreaktioner er følgende, ordnet efter faldende hyppighed: Forskellige typer uspecifikt udslæt (162 tilfælde), pruritus (94 tilfælde), erythema multiforme (48 tilfælde), urticaria (47 tilfælde), toksisk epidermal nekrolyse (35 tilfælde), angioødem (34 tilfælde), Stevens-Johnsons syndrom (31 tilfælde), erytem (28 tilfælde), toksisk huderuption (19 tilfælde), eksfoliation af huden (16 tilfælde), bulløs dermatitis, ikke nærmere specificeret (16 tilfælde) og DRESS-syndrom (7 tilfælde).
English: Tetrazepam is a benzodiazepine indicated for painful contractures in rheumatology or spasticity.
Danish: Tetrazepam er et benzodiazepin, der er indiceret til smertefulde kontrakturer ved reumatologiske og spastiske lidelser.
English: These included 33 cases of SJS (including 1 fatal case), 33 cases of Lyell's Syndrome (TEN) (including 9 fatal cases), 59 cases of EM (including 1 fatal case), 15 cases of DRESS Syndrome, 3 possible cases of DRESS Syndrome and 5 cases of acute generalised exanthematous pustulosis.
Danish: Heraf var der 33 tilfælde af SJS (heraf 1 med dødelig udgang), 33 af Lyells syndrom (TEN) (heraf 9 med dødelig udgang) 59 af EM (heraf 1 med dødelig udgang), 15 af DRESS-syndrom, 3 mulige tilfælde af DRESS-syndrom og 5 tilfælde af akut generaliseret eksantematøs pustulose.
English: This included data from the Member States and published literature data which became available since the original marketing authorisations, as well as the MAH responses and the Stakeholders submissions.
Danish: Heri indgik data fra medlemsstaterne og publicerede data, der blev tilgængelige efter de oprindelige markedsføringsgodkendelser, samt besvarelser fra indehaveren af markedsføringstilladelsen og data indsendt fra interesserede parter,
English: Overall, more than 40% of the reported cases are related to the skin disorder SOC; severe Cutaneous Adverse Reactions to Drugs (SCARs), such as SJS, TEN, DRESS Syndrome and EM were diagnosed upon tetrazepam treatment and 11 fatal cases were reported; in 8 cases, it was reported as the result of the skin reaction and in 3 cases, it was related to an associated reaction.
Danish: I alt vedrørte mere end 40 % af de indberettede tilfælde systemorganklassen hud og subkutane væv; der blev diagnosticeret svære kutane lægemiddelreaktioner (SCAR) såsom SJS, TEN, DRESS-syndrom og EM ved behandling med tetrazepam, heraf 11 med dødelig udgang, af hvilke 8 blev beskrevet som resultat af hudreaktioner, og 3 blev beskrevet at have sammenhæng med en tilknyttet reaktion.
English: Results of clinical studies with the use of tetrazepam in both indications have been published since the marketing authorisations of tetrazepam.
Danish: Siden udstedelsen af markedsføringstilladelserne for tetrazepam er der publiceret kliniske undersøgelser om anvendelse af tetrazepam til begge indikationer.
English: The MAH presented its views on the possible mechanism of cutaneous reactions induced by tetrazepam: a structural difference between tetrazepam and other benzodiazepines (i.e. the substituted cyclohexenyl ring of tetrazepam) may be linked to the various cutaneous hypersensitivity reactions observed for tetrazepam.
Danish: Indehaveren af markedsføringstilladelsen redegjorde for sine synspunkter vedrørende den mulige mekanisme for de kutane reaktioner, der fremkaldes af tetrazepam: De iagttagne overfølsomhedsreaktioner med tetrazepam kan have sammenhæng med en strukturel forskel mellem tetrazepam og andre benzodiazepiner (den substituerede cyclohexenylring i tetrazepam).
English: Fatal toxic epidemal necrolysis associated with tetrazepam.
Danish: Fatal toksisk epidermal nekrolyse forbundet med tetrazepam.
English: Having assessed the totality of the risk minimisation measures proposed, the PRAC concluded that given the risk and the unpredictability of serious cutaneous adverse reactions with tetrazepam the proposed measures were not sufficient to reduce the risk to a clinically acceptable level.
Danish: Efter at have gennemgået samtlige foreslåede risikominimeringsforanstaltninger konkluderede PRAC, at de foreslåede foranstaltninger ikke var tilstrækkelige til at nedsætte risikoen for alvorlige kutane bivirkninger med tetrazepam til et klinisk acceptabelt niveau i betragtning af risikoens størrelse og bivirkningernes forudsigelighed.
English: • The PRAC considered that the risk minimisations measures discussed during the assessment, including reduction of duration of treatment and restricted indication, were not sufficient to reduce the risk of serious cutaneous reactions.
Danish: • PRAC fandt, at de risikominimeringsforanstaltninger, der blev drøftet under vurderingen, herunder nedsættelse af behandlingsvarigheden og begrænsning af indikationen, ikke var tilstrækkelige til at nedsætte risikoen for alvorlige kutane reaktioner,
English: The PRAC considered risk minimisations measures, including reduction of duration of treatment to 6 days and a restricted indication, to mitigate the risk of serious cutaneous adverse reactions.
Danish: PRAC overvejede risikominimeringsforanstaltninger, herunder afkortning af behandlingsvarigheden til 6 dage og begrænsning af indikationen for at nedsætte risikoen for alvorlige kutane bivirkninger.
English: Skin adverse events were also submitted in responses from other MAHs and the Stakeholders submissions.
Danish: Der blev også indberettet bivirkninger fra huden i besvarelser fra andre markedsføringstilladelsesindehavere og i oplysninger fra interesserede parter.
English: Allergy 1999;54(11):1226-27 Sanchez-Morillas L et al.
Danish: Allergy 1999;54(11):1226-27 Sanchez-Morillas L et al. Systemisk dermatitis som følge af tetrazepam.
English: The CMDh, having considered the PRAC recommendation dated 11 April 2013 pursuant to Article 107k(1) and (2) of Directive 2001/83/EC and the oral explanation attended by a Marketing Authorisation Holder on 22 April 2013, reached a position on the suspension of the marketing authorisations of tetrazepam containing medicinal products.
Danish: CMDh tog stilling til fordel for suspendering af markedsføringstilladelserne for lægemidler indeholdende tetrazepam efter at have gennemgået PRAC's anbefaling af 11. april 2013 i medfør af artikel 107, stk. 1 og 2, i direktiv 2001/83/EF og den mundtlige fremlæggelse den 22. april 2013, hvor en markedsføringstilladelsesindehaver deltog,
English: In view of the above, the PRAC considered that tetrazepam, compared to the medicines of the same pharmacological class, is associated with an increased risk of serious cutaneous adverse reactions including Stevens-Johnson syndrome, Toxic Epidermal Necrolysis , Erythema Multiform and DRESS syndrome which can be life threatening and fatal.
Danish: På ovenstående baggrund fandt PRAC, at tetrazepam i forhold til andre lægemidler i samme farmakologiske klasse er forbundet med højere risiko for alvorlige, potentielt livstruende og fatale kutane bivirkninger, herunder Stevens-Johnsons syndrom, toksisk epidermal nekrolyse, erythema multiforme og DRESS-syndrom.