FrancophonIA/ELRC3.0 huggingface dataset:
English: With regards to the treatment of acute withdrawal syndrome, the experts shared the views that there are well-established, evidence-based pharmacological treatments currently available, namely benzodiazepines, which are used throughout the European Union.
Slovenian: Kar zadeva zdravljenje akutnega odtegnitvenega sindroma, so strokovnjaki menili, da so trenutno na voljo dobro uveljavljena, na dokazih utemeljena farmakološka zdravljenja, in sicer benzodiazepini, ki se uporabljajo po vsej Evropski uniji.
English: Furthermore, it was noted by the CHMP that, despite the limited sample size in the clinical trials, this patient population cannot be considered as a ‘small population' as defined by the EMA Guideline on Clinical Trials in Small Populations (CHMP/EWP/83561/2005).
Slovenian: Odbor CHMP je ugotovil tudi, da kljub omejeni velikosti vzorca v kliničnih preskušanjih te populacije bolnikov ni mogoče šteti za „majhno populacijo“, kot jo opredeljuje smernica EMA o kliničnih preskušanjih pri majhnih populacijah (CHMP/EWP/83561/2005).
English: The experts noted that only a minority of those patients receive indeed a pharmacotherapy and usually only a limited proportion of them respond to these treatments.
Slovenian: Strokovnjaki so opozorili, da se le manjšina teh bolnikov res zdravi z zdravili in da se le omejen del teh bolnikov na zdravila odzove.
English: Whilst such studies could confirm or further characterise the efficacy of a medicinal product, they cannot replace the demonstration of efficacy in the claimed indications, which is a requirement of a marketing authorisation.
Slovenian: Tudi če bi takšni študiji lahko potrdili ali nadalje opredelili učinkovitost zdravila, pa ne moreta nadomestiti dokaza učinkovitosti za predloženi indikaciji, kar je zahtevano za dovoljenje za promet z zdravilom.
English: Also experts were in favor of further monitoring the risk of seizures, particularly without convulsions.
Slovenian: Strokovnjaki so podprli nadaljnje spremljanje tveganja za epileptične napade, zlasti brez konvulzij.
English: However the experts acknowledged that it may be difficult to evaluate and to have successful results for both endpoints within the same trial design.
Slovenian: Vendar pa so strokovnjaki priznali, da je morda težavno ovrednotiti oba opazovana dogodka in imeti uspešne rezultate v okviru iste zasnove preskušanja.
English: Regarding the outcome measures, the experts considered that data should be collected both on continuous abstinence and harm reduction.
Slovenian: Kar zadeva merila izidov, so strokovnjaki presodili, da je treba zbirati podatke tako o neprekinjeni abstinenci kot o zmanjševanju škode.
English: A stronger signal of efficacy was found in the most severe population which was a promising result as those patients are less prone to placebo response and have limited therapeutic options.
Slovenian: Pri populaciji z najtežjo obliko odvisnosti je bil ugotovljen močnejši signal učinkovitosti, kar je obetaven rezultat, saj so ti bolniki manj nagnjeni k odzivu na placebo in imajo omejene možnosti zdravljenja.
English: The reference Member State RMS Austria considered that based on the studies submitted within the application, a lack of efficacy, as raised by some Member states, could not be supported.
Slovenian: Referenčna država članica Avstrija je presodila, da na podlagi študij, predloženih v vlogi, ni mogoče potrditi pomanjkljive učinkovitosti, kot so trdile nekatere države članice.
English: It is also highlighted that post-authorisation efficacy studies, as governed by Commission Delegated Regulation (EU) No 357/2014, should not be used as a justification for the premature granting of a marketing authorisation or for granting a marketing authorisation for medicinal products for which the risk-benefit balance is not considered positive.
Slovenian: Poudaril je tudi, da se študije učinkovitosti po pridobitvi dovoljenja za promet z zdravilom, kot to ureja Delegirana uredba Komisije (EU) št. 357/2014, ne smejo uporabljati kot utemeljitev za predčasno izdajo dovoljenja za promet z zdravilom ali za izdajo dovoljenja za promet z zdravilom za zdravila, pri katerih razmerje med tveganji in koristmi ni ocenjeno kot pozitivno.
English: As the objections raised on the efficacy, safety and overall benefit-risk during the procedure were considered to be a potential serious risk to public health and no agreement could be reached during the CMDh procedure, the procedure was referred to the CHMP under Article 29(4) of Directive 2001/83/EC by the RMS Austria.
Slovenian: Ker so med postopkom navedli pomisleke o učinkovitosti, varnosti in splošnem razmerju med tveganji in koristmi, ki naj bi pomenili morebitno resno tveganje za javno zdravje, in ker med postopkom skupine CMDh ni bilo mogoče doseči dogovora, je referenčna država članica Avstrija napotila postopek na odbor CHMP v skladu s členom 29(4) Direktive 2001/83/ES.
English: It was underlined, however, that the pharmacokinetics properties of the product may be unfavourable for substitution due to short half-life and from clinical perspective the complete abstinence may not always be achievable.
Slovenian: Poudarili pa so, da farmakokinetične lastnosti zdravila zaradi kratke razpolovne dobe morda niso ugodne za nadomestno zdravljenje in s kliničnega vidika popolna abstinenca morda ni vedno dosegljiva.
English: Finally, it was noticed that it could be anticipated that long-term use of sodium oxybate might have effects on cognitive function.
Slovenian: Opozorili so tudi, da je mogoče predvidevati, da bi dolgoročna uporaba natrijevega oksibata lahko vplivala na kognitivno funkcijo.
English: In particular, there could be an advantage, for pragmatic reasons, to have a medicine which has a favourable impact on the craving process and thereby allow in-patient to become out-patient.
Slovenian: Zlasti iz pragmatičnih razlogov bi bila prednost imeti zdravilo z ugodnim vplivom na proces hlepenja, ki bi omogočilo, da bi bolnišnični bolnik postal ambulantni bolnik.
English: Like GABA, it exerts an overall inhibiting effect on the central nervous system (CNS).
Slovenian: Tako kot GABA ima zdravilo Alcover splošen zaviralni učinek na centralni živčni sistem.
English: The target population expected to benefit most should be refined based on the data available and expert advice.
Slovenian: Ciljno populacijo, ki naj bi imela od zdravljenja največjo korist, bi morali na podlagi razpoložljivih podatkov in strokovnega nasveta natančneje opredeliti.
English: The experts considered that the company has generated an interesting hypothesis which requires confirmation in a prospective, well designed trial in the target population.
Slovenian: Strokovnjaki so presodili, da je družba postavila zanimivo hipotezo, ki jo je treba potrditi s prospektivnim, dobro zasnovanim preskušanjem pri ciljni populaciji.
English: Further investigation is also needed to assess the risk of abuse in the sub-population of interest with psychiatric comorbidities.
Slovenian: Potrebne so nadaljnje preiskave za oceno tveganja za zlorabo v želeni podpopulaciji s psihiatričnimi soobolevnostmi.
English: The experts agreed that psychiatric comorbidities in stabilised patients should not be an exclusion criterion, considering the high medical need in this patient group.
Slovenian: Strokovnjaki so se strinjali, da psihiatrične soobolevnosti pri stabiliziranih bolnikih glede na visoko medicinsko potrebo v tej skupini bolnikov ne morejo biti izključitveno merilo.
English: Considering that the presented evidence mainly relied on post-hoc analyses, and that there is also significant heterogeneity in the study populations, the overall evidence for efficacy was not considered robust enough.
Slovenian: Glede na to, da so se predstavljeni dokazi v glavnem sklicevali na posthoc analize in da so bile študijske populacije močno heterogene, celokupni dokazi o učinkovitosti niso bili ocenjeni kot dovolj robustni.
English: • The Committee considered the notification of the referral initiated by Austria under Article 29(4) of Directive 2001/83/EC, where Denmark, Spain, Finland, France, Ireland, the Netherlands, Portugal, Sweden and the United Kingdom raised objections to the marketing authorisation application for Alcover and associated names, 750 mg, 1250 mg, 1750 mg granules in sachets, which were considered to be a potential serious risk to public health;
Slovenian: • odbor je preučil obvestilo o napotitvi, ki jo je predložila Avstrija v skladu s členom 29(4) Direktive 2001/83/ES, pri čemer so Danska, Španija, Finska, Francija, Irska, Nizozemska, Portugalska, Švedska in Združeno kraljestvo nasprotovali vlogi za pridobitev dovoljenja za promet z zdravilom za zdravilo Alcover in povezana imena, 750 mg, 1 250 mg, 1 750 mg zrnca v vrečkah, saj naj bi ta zdravila pomenila resno tveganje za javno zdravje;
English: With regard to the indication for the maintenance of alcohol abstinence, none of these studies can be seen as being in line with the scientific requirements for a clinical efficacy/safety study that would provide clear evidence of efficacy in the aimed at Very High DRL patient group.
Slovenian: V zvezi z indikacijo za vzdrževanje abstinence od alkohola za nobeno od teh študij ni mogoče trditi, da je v skladu z znanstvenimi zahtevami za študijo klinične učinkovitosti/varnosti, ki bi zagotovila jasne dokaze o učinkovitosti pri ciljni skupini bolnikov z zelo visoko stopnjo tveganja za zlorabo alkohola.
English: Therefore, it would be advisable to monitor the cognitive adverse effects of sodium oxybate, particularly in patients with pre-existing cognitive impairments.
Slovenian: Zato bi bilo priporočljivo spremljati neželene učinke natrijevega oksibata na kognitivno funkcijo, zlasti pri bolnikih z obstoječimi kognitivnimi motnjami.
English: The applicant performed a subpopulation analysis (meta-analysis of seven RCTs and observational studies), which was not sufficiently robust to establish efficacy of the medicinal product in the claimed indication.
Slovenian: Predlagatelj je opravil analizo podpopulacij (metaanalizo sedmih randomiziranih kliničnih preskušanj in opazovalnih študij), kar ni bilo dovolj robustno, da bi ugotovili učinkovitost zdravila pri predloženi indikaciji.
English: Furthermore, the number of patients included was quite small, and only Gallimberti showed positive results, whereas the results on abstinence rate in Very High DRL patients from study SMO032/10/03 and Di Bello 1995 are deemed inconclusive.
Slovenian: Poleg tega je bilo število vključenih bolnikov precej majhno, in le Gallimberti je pokazal pozitivne rezultate, medtem ko so rezultati o stopnji abstinence pri bolnikih z zelo visoko stopnjo tveganja za zlorabo alkohola iz študij SMO032/10/03 in Di Bello 1995 nejasni.
English: However, the conduct of the proposed post-authorisation study would not impact or change the Committee's conclusion that the efficacy of the medicinal product is not established.
Slovenian: Vendar izvedba predlagane študije po pridobitvi dovoljenja za promet z zdravilom ne bi vplivala na stališče odbora, da učinkovitost zdravila ni dokazana, oziroma ga ne bi spremenila.
English: The Committee also carefully considered the proposal from the applicant to perform a post-authorisation efficacy study.
Slovenian: Odbor je tudi skrbno preučil predlagateljev predlog, da bi izvedel študijo učinkovitosti po pridobitvi dovoljenja za promet z zdravilom.
English: Sodium oxybate is a partial agonist on both GABAA and GABAB receptors and also binds with high affinity to GHB-specific receptors.
Slovenian: Natrijev oksibat je delni agonist receptorjev GABAA in GABAB, z visoko afiniteto pa se veže tudi na receptorje, specifične za GHB.
English: Overall, whilst the experts considered that conditions of taking the medication are well-controlled and that no major safety issues have been reported so far, concerns were raised regarding the use of the product in patients of high risk groups, e.g. with renal impairment, liver dysfunction and/or electrolytes imbalance.
Slovenian: Strokovnjaki so sicer presodili, da so pogoji jemanja zdravila dobro nadzorovani in da do zdaj še niso poročali o večjih težavah z varnostjo, vendar so se pojavili pomisleki o uporabi zdravila pri bolnikih iz skupin z visokim tveganjem, npr. z ledvično okvaro, jetrno okvaro in/ali neravnovesjem elektrolitom.
English: • The Committee was of the view that the data submitted in support of the efficacy of Alcover granules in sachets in the claimed indications suffers from relevant methodological limitations relating to the design of the studies (such as insufficient sample size, selection of the patient population, post-hoc analyses).
Slovenian: • odbor je menil, da imajo podatki, predloženi v podporo učinkovitosti zdravila Alcover zrnca v vrečkah, pri predloženih indikacijah metodološke omejitve glede zasnove študij (kot so nezadostna velikost vzorca, izbira populacije bolnikov, post-hoc analize).
English: As an additional point, the experts commented on the potential place of this medicine as substitution treatment or reduction of craving and prolongation of abstinence.
Slovenian: Strokovnjaki so podali dodatno pripombo na morebitno mesto zdravila pri nadomestnem zdravljenju ali zmanjševanju hlepenja ter podaljšanju abstinence.
English: The experts considered that sodium oxybate could potentially be a valuable addition to the current therapeutic armamentarium in the maintenance of abstinence from alcohol, if supported by adequate data.
Slovenian: Strokovnjaki so presodili, da bi bil natrijev oksibat morebiti lahko pomemben dodatek trenutnemu naboru zdravil pri vzdrževanju abstinence od alkohola, če bi bilo to podprto z ustreznimi podatki.
English: In absence of a positive benefit-risk balance established, the Committee is not in position to recommend grant of the marketing authorisation and the proposed post-authorisation study is not relevant.
Slovenian: Ker pozitivno razmerje med tveganji in koristmi ni bilo potrjeno, odbor ni v takšnem položaju, da bi lahko priporočil izdajo dovoljenja za promet z zdravilom, in torej predlagana študija po pridobitvi dovoljenja za promet ni relevantna.
English: With regards the risk minimisation measures proposed by the applicant, the experts considered them generally welcome although some may be less realistic, notably the measure restricting the packaging to 4 days of treatment which may be difficult to handle in the clinical practice, and the contraindications about severe psychiatric disorders and poly-addicts which was not considered appropriate given the target population.
Slovenian: Kar zadeva ukrepe za zmanjševanja tveganja, ki jih je predlagal predlagatelj, so strokovnjaki menili, da so načeloma dobrodošli, vendar pa so nekateri manj realistični, zlasti ukrep o omejevanju pakiranja na štiridnevno zdravljenje, ki bi bil v klinični praksi težko izvedljiv, in kontraindikacije za resne psihiatrične motnje in večkratno zasvojenost, kar glede na ciljno populacijo ni bilo ocenjeno kot primerno.
English: Risks of abuse / misuse are higher in polymedication users (cocaine or heroin) and/or patients with severe psychiatric comorbidities.
Slovenian: Tveganja za zlorabo/napačno uporabo so višja pri uporabnikih, ki sočasno uporabljajo več snovi (kokain ali heroin) in/ali bolnikih s hudimi sočasnimi psihiatričnimi boleznimi.
English: Regarding safety, concerns were expressed with regards to the potential risk of misuse/abuse/dependence, and other identified safety issues, which considered too substantial and difficult to mitigate by the proposed RMMs.
Slovenian: V zvezi z varnostjo so bili izraženi pomisleki o morebitnem tveganju za napačno uporabo/zlorabo/odvisnost in druga vprašanja o varnosti, ki so preveč pomembna in težavna, da bi jih lahko obvladali s predlaganimi ukrepi za zmanjšanje tveganj.
English: However these data were considered too sparse, not consistent or sufficiently robust to support the indication maintenance of alcohol abstinence in this Very High DRL patient population.
Slovenian: Vendar so bili ti podatki ocenjeni kot preskopi, neskladni ali ne dovolj robustni za podporo indikaciji za vzdrževanje abstinence od alkohola pri tej skupini bolnikov z zelo visoko stopnjo tveganja za zlorabo alkohola.
English: However the objecting concerned Member States (CMSs) were of the view that although there were trends towards positive results across a few of the studies submitted and some level of statistical significance, there were also some failed studies.
Slovenian: Vendar pa so nekatere zadevne države članice ugovarjale, saj so menile, da je bilo kljub trendom v smeri pozitivnih rezultatov v nekaterih predloženih študijah in določeni stopnji statistične značilnosti tudi nekaj neuspešnih študij.
English: In order to demonstrate the efficacy of sodium oxybate granules in Very High DRL patients - the target population that was identified post-hoc, the applicant performed several post-hoc subgroup analyses and meta-analyses of the data obtained in clinical trials in medium and long-term maintenance of abstinence.
Slovenian: Za dokaz učinkovitosti natrijevega oksibata v obliki zrnc pri bolnikih z zelo visoko stopnjo tveganja za zlorabo alkohola - ciljni populaciji, ki so jo opredelili post-hoc -, je predlagatelj opravil več naknadnih analiz podskupin in metaanaliz podatkov, pridobljenih v kliničnih preskušanjih pri srednje- in dolgoročnem vzdrževanju abstinence.
English: Furthermore, safety was considered to be acceptable taking into account the proposed risk minimisation measures (RMM).
Slovenian: Varnost je bila z upoštevanjem predlaganih ukrepov za zmanjševanje tveganj ocenjena kot sprejemljiva.
English: Considering the modest responder rates in the posthoc subgroup analyses in the short-term, there is a potential risk that Very High DRL patients will not sufficiently respond to Alcover, but would still have the potential to become dependent on sodium oxybate in the longer term.
Slovenian: Glede na kratkoročne zmerne stopnje odzivnosti v post-hoc analizah podskupin obstaja tveganje, da se bolniki z zelo visoko stopnjo tveganja za zlorabo alkohola ne bodo v zadostni meri odzvali na zdravilo Alcover, še vedno pa bi obstajalo tveganje, da dolgoročno postanejo odvisni od natrijevega oksibata.
English: Grounds for the CHMP opinion following the re-examination procedure
Slovenian: Podlaga za mnenje odbora CHMP po postopku ponovne preučitve
English: Therefore, the Committee recommends the refusal of the marketing authorisation for Alcover and associated names, 750 mg, 1250 mg, 1750 mg granules in sachets.
Slovenian: Zato odbor priporoča zavrnitev vloge za pridobitev dovoljenja z zdravilom Alcover in povezana imena, 750 mg, 1 250 mg, 1 750 mg zrnca v vrečkah.
English: Alcover granules in sachet contains the active substance sodium oxybate, which is the sodium salt of Gamma-hydroxybutyric acid (GHB), a derivative of gamma-aminobutyric acid (GABA).
Slovenian: Zdravilo Alcover zrnca v vrečki vsebuje zdravilno učinkovino natrijev oksibat, tj. natrijevo sol gamahidroksimaslene kisline (GHB), derivata gama-aminomaslene kisline (GABA).
English: Taking into account all the available evidence submitted by the applicant and at the oral explanation before the CHMP, it was concluded that the data does not establish the efficacy of Alcover granules in the claimed indications.
Slovenian: Z upoštevanjem vseh razpoložljivih dokazov, ki jih je predložil predlagatelj, in ustnih pojasnil pred odborom CHMP je bilo zaključeno, da na podlagi podatkov ni mogoče potrditi učinkovitosti zdravila Alcover v obliki zrnc pri predloženih indikacijah.
English: • With regards to the identified and potential risks related to the use of Alcover granules in sachets, the Committee considered the proposed risk minimisation measures, mainly to mitigate the potential risk of abuse, switch of addiction/ dependence and withdrawal in the light of the proposed indications;
Slovenian: • v zvezi z ugotovljenimi in morebitnimi tveganji, povezanimi z uporabo zdravila Alcover zrnca v vrečkah, je odbor preučil predlagane ukrepe za zmanjševanje tveganj, predvsem za zmanjšanje morebitnega tveganja za zlorabo, prehod na drugo zasvojenost/odvisnost in odtegnitvene težave glede na predlagane indikacije;
English: The results of the submitted efficacy studies cannot be considered to provide sufficiently robust evidence to establish the efficacy of Alcover (sodium oxybate) granules in the maintenance of alcohol abstinence and treatment of alcohol withdrawal syndrome (AWS).
Slovenian: Ni mogoče šteti, da rezultati predloženih študij o učinkovitosti zagotavljajo dovolj robustne dokaze za potrditev učinkovitosti zdravila Alcover (natrijev oksibat) v obliki zrnc pri vzdrževanju abstinence od alkohola in zdravljenju alkoholnega odtegnitvenega sindroma.
English: Craving and cognitive aspects may also be considered as secondary outcome measures.
Slovenian: Merila sekundarnega izida bi lahko bila hlepenje in kognitivni vidiki.
English: The comment was also made with regards to the fact that for patients with benzodiazepines, dependence sodium oxybate could have a role.
Slovenian: Podali pa so tudi pripombe glede dejstva, da bi lahko natrijev oksibat imel vlogo pri bolnikih z odvisnostjo od benzodiazepinov.
English: These data are therefore considered insufficient to establish the efficacy of Alcover, granules in sachets, in the proposed indications;
Slovenian: Ti podatki torej ne zadoščajo za ugotovitev učinkovitosti zdravila Alcover zrnca v vrečkah pri predloženih indikacijah;
English: With regards to the identified and potential risks related to the use of Alcover granules, in particular the risks of diversion, abuse, switch of addiction and toxicity if co-administered with alcohol, the Committee considered that the feasibility, proportionality and effectiveness of the proposed risk minimisation measures cannot be deemed evident in the absence of a demonstrated efficacy in the claimed indications.
Slovenian: Kar zadeva prepoznana in morebitna tveganja, povezana z uporabo zdravila Alcover v obliki zrnc, zlasti tveganja za preusmeritev, zlorabo, preklop zasvojenosti in toksičnost ob sočasni uporabi z alkoholom, je odbor menil, da se izvedljivost, sorazmernost in učinkovitost predlaganih ukrepov za zmanjševanje tveganj v odsotnosti dokazane učinkovitosti pri predloženih indikacijah ne morejo šteti za dokazane.
English: Based on the above, the Committee concluded to maintain its previous opinion that the benefit-risk balance of this medicinal product is negative for both proposed indications.
Slovenian: Na podlagi zgoraj navedenega je odbor sklenil, da bo še dalje zastopal svoje predhodno mnenje, da je razmerje med tveganji in koristmi tega zdravila negativno za obe predlagani indikaciji.
English: The applicant has proposed to further reduce them by contraindicating the use of Alcover granules specifically in patients with severe psychiatric disorders and patients with past or present co-addiction to opiates or cocaine.
Slovenian: Predlagatelj je predlagal, da tveganja nadalje zmanjša z navedbo kontraindikacije pri uporabi zdravila Alcover v obliki zrnc pri bolnikih s hudimi psihiatričnimi motnjami in bolnikih s trenutno ali preteklo sočasno zasvojenostjo z opiati ali kokainom.
English: CHMP discussion on grounds for re-examination
Slovenian: Razprava odbora CHMP v zvezi z razlogi za ponovno proučitev
English: One of the experts with extensive experience with the use of marketed Alcover liquid considered the efficacy of sodium oxybate to be clinically shown and suggested to perform a study in the post-approval setting.
Slovenian: Eden od strokovnjakov z obširnimi izkušnjami z uporabo zdravila Alcover v tekoči obliki, ki je na trgu, je menil, da je učinkovitost natrijevega oksibata klinično dokazana, in predlagal izvedbo študije po odobritvi zdravila.
English: Regarding the safety of Alcover granules, the risk of Abuse / Misuse / Diversion / Overdose / Dependence / CNS / Respiratory Depression in Very High HDRL patients is well-recognized.
Slovenian: V zvezi z varnostjo zdravila Alcover v obliki zrnc je tveganje za zlorabo/napačno uporabo/preusmeritev/preveliko odmerjanje/odvisnost/centralni živčni sistem/depresijo dihanja pri bolnikih z zelo visoko stopnjo tveganja za zlorabo alkohola dobro znano.