FrancophonIA/ELRC3.0 huggingface dataset:
English: In comparison to Sandimmun (oil-based formulation of ciclosporin), Sandimmun Neoral (microemulsified formulation) provides improved dose linearity of ciclosporin exposure, a more consistent absorption profile and shows less influence from concomitant food intake and from diurnal rhythm.
Danish: I forhold til Sandimmun (oliebaseret formulering af ciclosporin), giver Sandimmun Neoral (mikroemulgeret formulering) bedre dosislinearitet af eksponeringen for ciclosporin og en mere ensartet absorptionsprofil, der er mindre påvirkelig af samtidig fødeindtagelse og af døgnrytmen.
English: Furthermore, since ciclosporin from a non-clinical point of view is a well-known compound, the CHMP requested the MAH to delete the paragraph concerning clinical safety data on development of malignancy.
Danish: Da ciclosporin endvidere fra et ikke-klinisk synspunkt er et velkendt stof, anmodede CHMP indehaveren af markedsføringstilladelsen om at slette afsnittet om kliniske sikkerhedsdata vedrørende udvikling af maligne sygdomme.
English: The MAH's proposed indication wording for the uveitis and Behçet uveitis is approved in 14 EU countries.
Danish: Den af markedsføringstilladelsesindehaveren foreslåede ordlyd til uveitis og Behçets uveitis er godkendt i 14 EU-lande.
English: However, in case of a more prolonged inability to use oral ciclosporin, use of IV ciclosporin should be considered, provided that care is taken to administer an adequate IV dose.
Danish: Når det i længere tid ikke er muligt at anvende oralt ciclosporin, bør det dog overvejes at administrere ciclosporin intravenøst, forudsat at der drages omsorg for at anvende en passende intravenøs dosis.
English: Section 6.4 - Special precautions for storage
Danish: Punkt 6.4 - Særlige forholdsregler ved opbevaring
English: • Endogenous uveitis
Danish: • Endogen uveitis
English: Lastly the MAH recommended oral administration in non-transplantation indications due to lack of data and potential risk for anaphylactic reactions with intravenous use; this was acknowledged by the CHMP.
Danish: Indehaveren af markedsføringstilladelsen anbefalede endelig oral administration ved andre indikationer end transplantation på grund af manglende data og den potentielle risiko for anafylaktiske reaktioner ved intravenøs anvendelse; dette bifaldtes af CHMP.
English: The CHMP questioned the MAH's justification with regards to the listing of specific organ transplantations in the indication.
Danish: CHMP betvivlede markedsføringstilladelsesindehaverens begrundelse for at opføre specifikke organtransplantationer i indikationen.
English: Hence, this supports the lower doses proposed for Sandimmun Neoral in the proposed SmPC.
Danish: Dette underbygger således de lavere doser af Sandimmun Neoral i det ansøgte produktresumé.
English: In line with this agreement, the MAH did not include the indication of aplastic anemia in the harmonized label of Sandimmun and Sandimmun Neoral since this indication is approved in only one of 27 member states and is not listed in Sandimmun and Sandimmun Neoral CDSs.
Danish: Følgelig medtog indehaveren af markedsføringstilladelsen ikke indikationen aplastisk anæmi i den harmoniserede produktinformation for Sandimmun og Sandimmun Neoral, da denne indikation kun er godkendt i en af de 27 medlemsstater og ikke er indeholdt i de centrale datablade for Sandimmun og Sandimmun Neoral.
English: Considering the narrow therapeutic window for ciclosporin, the CHMP requested the MAH to consider ciclosporin intake in order to reduce intra-individual variability.
Danish: I betragtning af ciclosporins snævre terapeutiske vindue anmodede CHMP indehaveren af markedsføringstilladelsen om at gennemgå indtagelse af ciclosporin med henblik på at mindske den intraindividuelle variabilitet.
English: This data, along with ciclosporin experience in other nontransplant diseases, helped to design the four pivotal placebocontrolled double-blind Sandimmun (SIM) trials in severe RA in the US and Canada.
Danish: Sammen med erfaringerne med ciclosporin ved andre ikketransplantationsrelaterede sygdomme var disse data grundlag for valget af design til de fire placebokontrollerede dobbeltblindede (SIM) hovedundersøgelser med Sandimmun ved svær reumatoid arthritis i USA og Canada.
English: The CHMP is of the view that introducing Sandimmun Neoral for the treatment of rejection is most appropriate for cellular rather than humoral rejection, based on the mechanism of action of CNI's.
Danish: CHMP er af den opfattelse, at anvendelse af Sandimmun Neoral til behandling af afstødning er mere hensigtsmæssig til cellulær end til humoral afstødning, baseret på virkningsmekanismen af calcineurinhæmmere.
English: Sections 4.3 - Contraindications
Danish: Punkt 4.3 - Kontraindikationer
English: The CHMP was in agreement with this approach and a revised wording was agreed consequently.
Danish: CHMP var enig i dette, og der blev vedtaget en revideret ordlyd i overensstemmelse hermed.
English: Referring to the “non-transplantation indications” section, likewise, the MAH proposed a posology for each of the special populations (i.e. patients with renal impairment, patients with hepatic impairment, paediatric population, elderly population).
Danish: Til afsnittet “andre indikationer end transplantation” foreslog indehaveren af markedsføringstilladelsen ligeledes en dosering for hver særlig population (dvs. patienter med nedsat nyrefunktion, patienter med nedsat leverfunktion, den pædiatriske population og den ældre population).
English: The MAH proposed a new general wording to introduce the paragraph on non- transplantation indications, as general recommendations.
Danish: Indehaveren af markedsføringstilladelsen foreslog en ny generel ordlyd, der indførte afsnittet om andre indikationer end transplantation i form af generelle anbefalinger.
English: Ciclosporin is also used in a variety of conditions that are known, or may be considered, to be of autoimmune origin (endogenous uveitis, nephrotic syndrome, rheumatoid arthritis, psoriasis and atopic dermatitis).
Danish: Ciclosporin anvendes desuden ved en række sygdomme af kendt eller formodet autoimmun oprindelse (endogen uveitis, nefrotisk syndrom, reumatoid arthritis, psoriasis og atopisk dermatitis).
English: Further to this introduction paragraph on non-transplantation, the MAH proposed a posology for each of the non-transplantation indications (i.e. endogenous uveitis, nephrotic syndrome, rheumatoid arthritis, psoriasis, atopic dermatitis).
Danish: Foruden dette indledningsafsnit om andre indikationer end transplantation foreslog indehaveren en dosering for hver ikke-transplantationsindikation (dvs. endogen uveitis, nefrotisk syndrom, reumatoid arthritis, psoriasis og atopisk dermatitis).
English: The CHMP questioned though the benefit-risk of ciclosporin in “prevention of graft rejection following bone marrow transplantation”: the CHMP requested the MAH to submit data confirming a positive benefit-risk of ciclosporin in terms of frequency of stem cell engrafting/graft failure beyond the benefits/risk (B/R) of conditioning treatment.
Danish: CHMP betvivlede dog benefit/risk-forholdet for ciclosporin til “forebyggelse af transplantatafstødning efter knoglemarvstransplantation”: CHMP anmodede indehaveren af markedsføringstilladelsen om at forelægge data, der bekræfter, at ciclosporin har et positivt benefit/risk-forhold for hyppigheden af anslag af stamceller/tab af transplantat, der rækker længere end til fordele/risici ved konditionerende behandling.
English: In October 2010, Sandimmun Neoral was included in the list of products for Summary of Product Characteristics (SmPC) harmonization, requested by the CMD(h), in accordance with Article 30(2) of Directive 2001/83/EC, as amended.
Danish: I oktober 2010 blev Sandimmun optaget på listen over de produkter, for hvilke produktresuméet ønskes harmoniseret af CMD(h) (Koordinationsgruppen Vedrørende Gensidig Anerkendelse og Decentraliserede Godkendelsesprocedurer - human) i overensstemmelse med artikel 30, stk. 2, i direktiv 2001/82/EF, som ændret.
English: More specifically, considering data on ADRs frequencies in clinical trials the CHMP requested the MAH to state the reasons to set different frequencies comparing to the ones that have been calculated and thus, proposals were made with regards to some ADRs such as hyperglycaemia, headache, migraine, abdominal discomfort and gingival hyperplasia.
Danish: På baggrund af data om bivirkninger i kliniske undersøgelser anmodede CHMP indehaveren af markedsføringstilladelsen om konkret at begrunde, at der var angivet andre hyppigheder end de beregnede, og udvalget kom med forslag for visse bivirkninger såsom hyperglykæmi, hovedpine, migræne, abdominalt ubehag og gingival hyperplasi.
English: Sandimmun Neoral was first registered in Germany in February 1993 and is available in the EU as 10 mg, 25 mg, 50 mg, 100 mg soft gelatin capsules and 100 mg/ml oral solution.
Danish: Sandimmun Neoral blev første gang registreret i Tyskland i februar 1993 og markedsføres i EU som 10 mg, 25 mg, 50 mg og 100 mg bløde gelatinekapsler samt oral opløsning, 100 mg/ml.
English: Finally the CHMP also requested the MAH to discuss whether the heading “bone marrow transplantation” shall be updated to “allogenous stem cell transplantation”, i.e. independent from the source (else than non-host) of the stem cells and blasts.
Danish: Endelig anmodede CHMP indehaveren af markedsføringstilladelsen om at klarlægge, om overskriften “knoglemarvstransplantation” bør ajourføres til “allogen stamcelletransplantation”, dvs. uafhængigt af stamcellernes og blastcellernes oprindelse (ud over, at de ikke er fra værtsorganismen).
English: However the CHMP considers that data of use in children in nephrotic syndrome should be included under the heading Paediatric population.
Danish: CHMP finder dog, at der under overskriften Pædiatrisk population bør indgå oplysninger om anvendelse hos børn med nefrotisk syndrom.
English: • Atopic dermatitis
Danish: • Atopisk dermatitis
English: The MAH dedicated the whole sub-section to a comparison between Sandimmun and Sandimmun Neoral.
Danish: Indehaveren af markedsføringstilladelsen afsatte hele underafsnittet til en sammenligning mellem Sandimmun og Sandimmun Neoral.
English: A wording was agreed accordingly.
Danish: Der blev vedtaget en ordlyd i overensstemmelse hermed.
English: The approach taken by the MAH to achieve a proposed harmonized SmPC with regard to the safety sections of the SmPC (sections 4.3 to 4.9) was to use as a basis the most recently updated MAH's Core Data Sheet (CDS) of Sandimmun Neoral, dated 13 February 2012 (as justified by a review of submitted legacy studies, and identified literature references) and the finalized Core Safety profile (CSP) from the last PSUR 13 work sharing (WS) procedure (EE/H/PSUR/0007/001).
Danish: Som grundlag for udarbejdelse af et forslag til harmonisering af produktresuméets sikkerhedsafsnit (punkt 4.3 til 4.9) anvendte indehaveren af markedsføringstilladelsen virksomhedens senest ajourførte centrale datablad (CDS) for Sandimmun Neoral dateret den 13. februar 2012 (begrundet ved en gennemgang af de forelagte ældre undersøgelser samt de fundne litteraturreferencer) samt de endelige centrale sikkerhedsoplysninger (CSP) fra den seneste arbejdsdelingsprocedure vedrørende den periodiske opdaterede sikkerhedsindberetning PSUR 13 (EE/H/PSUR/0007/001).
English: Concerning the wording contained in the sub-section Tabulated summary of ADRs, the MAH made a complete revision of the ADR table and changed many of the frequency figure, in most cases based on the fact that several ADRs originated from post-marketing data and a denominator was missing for the estimation of a frequency.
Danish: Vedrørende ordlyden af underafsnittet Tabel over bivirkninger foretog indehaveren af markedsføringstilladelsen en fuldstændig revision af bivirkningstabellen og ændrede mange af hyppighedstallene, i de fleste tilfælde som følge af, at adskillige bivirkninger hidrørte fra oplysninger efter markedsføring, og at der manglede en nævner til beregning af hyppigheden.
English: In addition, the MAH clarified as requested why conjunctivitis, depression and hearing loss were not included in the ADR table.
Danish: Desuden præciserede indehaveren af markedsføringstilladelsen på anmodning, hvorfor konjunktivitis, depression og høretab ikke var omfattet af bivirkningstabellen.
English: With regards to the treatment of rejection, the main concerns reflected by the CHMP related to the switch from tacrolimus, treatment of humoral rejections with Cyclosporin and in case of chronic allograft injury, as this has been seen as chronic rejection.
Danish: Vedrørende behandling af afstødning vedrørte CHMP's største betænkeligheder skift fra tacrolimus, anvendelse af ciclosporin til behandling af humoral afstødning og kronisk beskadigelse af allotransplantatet, der er blevet betragtet som kronisk afstødning.
English: In line with the overall above mentioned strategy, the MAH proposed an indication wording which is already approved as proposed in 21 EU national labels.
Danish: I overensstemmelse med den nævnte overordnede strategi foreslog markedsføringstilladelsesindehaveren den ordlyd af indikationen, der i forvejen er godkendt som ansøgt i 21 nationale produktinformationer i EU.
English: The MAH agreed to correct this and proposed a wording for Sandimmum and Sandimmum Neoral which was acceptable to the CHMP.
Danish: Indehaveren af markedsføringstilladelsen indvilligede i at rette dette og foreslog en ordlyd for Sandimmun og Sandimmun Neoral, der kunne godtages af CHMP.
English: To ensure that the Core Safety Information of the updated CDSs remains in line with the agreed CSP information, newly incorporated safety information into the CDS was proposed by the MAH for consideration into the agreed CSP, hence for the harmonized Eu SmPC safety related sections.
Danish: For at de centrale sikkerhedsoplysninger i de opdaterede centrale datablade fortsat skal være i overensstemmelse med de vedtagne centrale sikkerhedsoplysninger, foreslog indehaveren af markedsføringstilladelsen, at de nye oplysninger i det centrale datablad også blev indarbejdet i de vedtagne centrale sikkerhedsoplysninger og dermed i de harmoniserede sikkerhedsrelaterede afsnit af EU-produktresuméet.
English: Section 5.1 - Pharmacodynamic Properties
Danish: Punkt 5.1 - Farmakodynamiske egenskaber
English: Concerning the sub-sections on infections, renal toxicity and hepatotoxicity, monitoring ciclosporin levels in transplant patients, hypertension, blood lipids increased, live-attenuated vaccines and interactions, wordings were proposed by the MAH and intensively discussed and revisited as per CHMP requests.
Danish: For underafsnittene om infektioner, renal toksicitet og hepatotoksicitet, overvågning af koncentrationen af ciclosporin hos transplantationspatienter, hypertension, forhøjede blodlipider, levende svækkede vacciner og interaktioner blev markedsføringstilladelsesindehaverens forslag til ordlyden indgående drøftet og eftergået i overensstemmelse med CHMP's anmodninger.
English: The MAH acknowledged that food affects the absorption of ciclosporin both from the Sandimmun formulation and, to a lesser extent, from the Sandimmun Neoral formulation.
Danish: Indehaveren af markedsføringstilladelsen vedgik, at fødeindtagelse påvirker absorptionen af ciclosporin både for Sandimmun-formuleringen og i mindre grad for Sandimmun Neoral-formuleringen.
English: Based on the above the CHMP considers the benefit/risk ratio of Sandimmun Neoral to be favourable and the harmonised PI to be approvable.
Danish: På ovenstående grundlag finder CHMP, at benefit/risk-forholdet for Sandimmun Neoral og relaterede navne er positivt, og at de harmoniserede produktinformationer kan godkendes.
English: Finally the MAH was also requested to update this section with more information concerning the inhibitory potential of ciclosporin on other transporters than Pgp.
Danish: Endelig blev indehaveren af markedsføringstilladelsen anmodet om at ajourføre dette afsnit med flere oplysninger om ciclosporins potentiale for at hæmme andre transportproteiner end P-gp.
English: The MAH considered that the information included in the proposed harmonized label provided relevant information to the prescribing physician to optimize patient management.
Danish: Indehaveren af markedsføringstilladelsen fandt, at oplysningerne i den foreslåede produktinformation var relevante for den ordinerende læge med henblik på optimering af patientbehandlingen.
English: As recorded in the minutes of the prereferral meeting held on 27 July 2011, regarding the approach to label harmonisation, the Agency agreed with the MAH's proposal to use the SmPC wording that is common in the majority of the Members States, the Sandimmun and Sandimmun Neoral CDSs as justified by the review of legacy studies and literature references.
Danish: Som anført i referatet af det forberedende møde inden indbringelsen den 27. juli 2011 tilsluttede agenturet sig markedsføringstilladelsesindehaverens forslag om til harmonisering af produktinformationen at anvende den ordlyd af produktresuméet, der er fælles for størstedelen af medlemsstaterne, og de centrale datablade for Sandimmun og Sandimmun Neoral, således som dette begrundes ved gennemgangen af ældre undersøgelser og litteraturhenvisninger.
English: Extensive information was provided by the MAH, including the dosages used in clinical studies that supported the approval of Sandimmun and Sandimmun Neoral in the bone marrow transplant indications.
Danish: Indehaveren af markedsføringstilladelsen fremlagde omfattende oplysninger, herunder doseringerne i de kliniske undersøgelser, der var grundlag for godkendelsen af Sandimmun og Sandimmun Neoral til indikationerne ved knoglemarvstransplantation.
English: The MAH proposed wordings for the sub-sections Summary of the safety profile, Doses/side effects, Infections and infestations and Neoplasms, Other ADRs from post-marketing experience.
Danish: Indehaveren af markedsføringstilladelsen foreslog en ordlyd til underafsnittene Sammenfatning af sikkerhedsprofilen, Doser/bivirkninger, Infektioner og parasitangreb samt Andre bivirkninger fra erfaringerne efter markedsføring.
English: The MAH proposed the CSP wording as the harmonized SmPC text for all sections except the additional text regarding interactions with bosentan/ ambrisentan and anthracycline antibiotics.
Danish: Indehaveren af markedsføringstilladelsen foreslog at anvende ordlyden fra de centrale sikkerhedsoplysninger som harmoniseret tekst til alle afsnit i produktresuméet bortset fra den supplerende tekst om interaktioner med bosentan/ambrisentan og antibiotika i antracyclingruppen.
English: Section 4.8 - Undesirable Effects
Danish: Punkt 4.8 - Bivirkninger
English: The CHMP also requested the MAH to provide more detailed information that could help the dose adjustments.
Danish: CHMP anmodede desuden indehaveren af markedsføringstilladelsen om at fremlægge mere detaljerede oplysninger som grundlag for dosisjusteringer.
English: The MAH proposed a wording for recommendations related to the switch between Sandimmun and Sandimmun Neoral in accordance with the approved wording of 9 countries.
Danish: Indehaveren af markedsføringstilladelsen foreslog en ordlyd af anbefalingerne for skift mellem Sandimmun og Sandimmun Neoral svarende til den godkendte ordlyd i 9 lande.
English: The CHMP requested the MAH to clarify the discrepancy in the shelf life term; the CHMP was concerned by the different shelf-life periods.
Danish: CHMP anmodede indehaveren af markedsføringstilladelsen om at afklare uoverensstemmelsen i angivelsen af holdbarheden, da CHMP var betænkelig ved de forskellige opbevaringstider.
English: The MAH proposed the following wording for the posology: “The dose ranges given for oral administration are intended to serve as guidelines only.
Danish: Indehaveren af markedsføringstilladelsen foreslog følgende ordlyd til doseringen: “De angivne dosisintervaller for oral administration er kun vejledende.
English: The daily doses of Neoral should always be given in two divided doses.” The MAH's statement “The dose ranges given for oral administration are intended to serve as guidelines only” is endorsed by the CHMP.
Danish: Den daglige dosis af Sandimmun Neoral bør altid fordeles på to separate doser.” Markedsføringstilladelsesindehaverens erklæring “De angivne dosisintervaller for oral administration er kun vejledende” kan godkendes af CHMP.
English: The MAH addressed this concern; based on the submitted data the CHMP agreed with the MAH that the common practice is to change to another agent in case of rejection.
Danish: Indehaveren af markedsføringstilladelsen imødekom dette; på grundlag af de forelagte data enedes CHMP og indehaveren af markedsføringstilladelsen om, at det er normal praksis at skifte til et andet middel i tilfælde af afstødning.
English: • the scope of the referral was the harmonisation of the summary of products characteristics, labelling and package leaflet
Danish: • indbringelsen vedrørte harmoniseringen af produktresuméet, etiketteringen og indlægssedlen,
English: The MAH proposed a wording on which the CHMP agreed with the exception of one minor comment, which was taken into consideration subsequently by the MAH.
Danish: Indehaveren af markedsføringstilladelsen foreslog en ordlyd, som CHMP tilsluttede sig bortset fra en mindre betydningsfuld kommentar, der efterfølgende blev taget i betragtning af indehaveren af markedsføringstilladelsen.
English: The MAH is of the view that the efficacy of ciclosporin in bone marrow transplantation and GVHD is well established from the data in the original MAA, published clinical studies and extensive clinical use.
Danish: Indehaveren af markedsføringstilladelsen anser virkningen af ciclosporin ved knoglemarvstransplantation og GVHD for at være almindeligt anerkendt på grundlag af data i den oprindelige ansøgning om markedsføringstilladelse, publicerede kliniske undersøgelser og udbredt klinisk anvendelse.
English: In response to the CHMP'S request, the MAH adjusted information by adding cautious reference to blood level monitoring options for non-transplant indications and additionally stressing the practice protocols for transplantation indications.
Danish: For at imødekomme CHMP's anmodning ændrede indehaveren af markedsføringstilladelsen teksten, så den nævner mulighederne for overvågning af blodkoncentrationen ved ikke-transplantationsindikationerne og fremhæver praksisprotokollerne for transplantationsindikationerne.
English: In addition, the CHMP requested the MAH to provide a clear rationale for having slightly different description of pharmacodynamic section in Sandimmun (both oral and injection) vs Sandimmun Neoral versions of SmPCs.
Danish: Desuden anmodede CHMP indehaveren af markedsføringstilladelsen om at give et klart rationale for, at der var anvendt en lidt forskellig beskrivelse af farmakodynamikken i de to versioner af produktresuméet for henholdsvis Sandimmun (både den orale formulering og injektionspræparat) og Sandimmun Neoral.
English: The wording was reviewed accordingly.
Danish: Ordlyden blev revideret i henhold hertil.
English: • Aplastic Anemia
Danish: • Aplastisk anæmi
English: In addition, a clarification of the B/R of ciclosporin in prevention of graft rejection after nonmyloablative stem cell transplantation was also requested by the CHMP; the CHMP reviewed the MAH's position and considered unnecessary to specify myeloablative vs. non-myeloablative stem cell transplantation in the Ciclosporin indication.
Danish: CHMP anmodede desuden om en afklaring af benefit/risk-forholdet for ciclosporin til forebyggelse af transplantatafstødning efter ikke-myeloablativ stamcelletransplantation; efter gennemgang af markedsføringstilladelsesindehaverens standpunkt fandt CHMP det overflødigt at specificere myeloablativ versus ikke-myeloablativ stamcelletransplantation i indikationen for ciclosporin.
English: The MAH proposed wording was in line with the overall strategy undertaken to propose a harmonized wording based on the most commonly approved label across the EU community.
Danish: Markedsføringstilladelsesindehaverens forslag til ordlyden var på linje med den anvendte overordnede strategi om at foreslå en harmoniseret ordlyd baseret på den mest udbredte godkendte ordlyd i EU.