FrancophonIA/ELRC3.0 huggingface dataset:
English: Based on the concerns raised, the following questions were posed to the Applicants/ MAHs as part of the consolidated CHMP List of Questions, the responses to which were the basis of the CHMP reassessment of the benefit/risk balance:
Slovenian: Na temelju spornih vprašanj so predlagateljem/imetnikom dovoljenj za promet z zdravilom zastavili naslednja vprašanja, ki so bila del konsolidiranega seznama vprašanj CHMP, odgovori nanje pa so bili osnova za ponovno oceno razmerja med koristmi in tveganji:
English: With reference to heart failure mortality, the MAHs have submitted a limited amount of new data since this issue was last assessed, namely results from a further clinical study, an updated literature review and an updated review of their safety database.
Slovenian: Glede smrtnosti zaradi odpovedi srca so imetniki dovoljenj za promet z zdravilom predložili omejeno količino podatkov, ki bi bili novejši od tistih, pridobljenih ob zadnjemu ocenjevanju tega spornega vprašanja in so se v glavnem nanašali na nadaljnjo klinično študijo, posodobljen pregled literature in posodobljen pregled njihove podatkovne baze o varnosti zdravila.
English: The numbers involved are relatively small, there is no consistent pattern for heart failure deaths over the longer term, and there is some unreliability in selecting this as a cause of death.
Slovenian: Predstavljena števila so relativno nizka, dolgoročno ni doslednega vzorca umrljivosti zaradi odpovedi srca, prav tako pa je prisotne tudi nekaj nezanesljivosti pri izbiri odpovedi srca za vzrok smrti.
English: A reduction in risk of objective disease progression was seen across most patient groups but was most evident in those at highest risk of disease progression.
Slovenian: Tveganje za objektivno napredovanje bolezni se je zmanjšalo v večini skupin bolnikov, a najočitneje pri bolnikih z največjim tveganjem za napredovanje bolezni.
English: - In view of the available data, the CHMP concluded that a potential association between the use of bicalutamide 150 mg and heart failure cannot be ruled out and therefore considered that the need to further study cardiovascular morbidity and mortality remains.
Slovenian: - Glede na razpoložljive podatke je CHMP zaključil, da morebitne povezave med uporabo bikalutamida 150 mg in srčno odpovedjo ni mogoče izključiti in je zato mnenja, da potreba po nadaljnjem raziskovanju kardiovaskularne obolevnosti in smrtnosti ostaja.
English: FI - Finland Peseri Trading Limited El Greco House
Slovenian: Peseri Trading Limited El Greco House
English: At 7.4 years median follow up, 27.4% and 30.7% of all CASODEX and placebo-treated patients, respectively, had experienced objective disease progression.
Slovenian: Po mediano 7,4 leta spremljanja se je objektivno napredovanje bolezni pojavilo pri 27,4% vseh bolnikov, ki so dobivali CASODEX, in pri 30,7% vseh bolnikov, ki so dobivali placebo.
English: AT - Austria Astra Zeneca Österreich GmbH Schwarzenbergplatz 7
Slovenian: Astra Zeneca Österreich GmbH Schwarzenbergplatz 7
English: A more specific target population is hard to define from the EPC data, and the general term “high risk” better accommodates wide differences in local practice and inevitable changes in the standard of care, and takes into account the many variables in the individual patient which may contribute to risk of progression.
Slovenian: Iz podatkov o EPC je težko opredeliti še bolj specifično ciljno populacijo, tako da splošni izraz „visoko tveganje“ bolj odgovarja velikim razlikam v lokalni praksi in neizbežnim spremembam v standardu oskrbe, pri tem pa upošteva mnoge spremenljivke pri posameznem bolniku, ki lahko prispevajo k tveganju za napredovanje bolezni.
English: These results should of course be balanced against the well-known tolerability issues of Casodex (bicalutamide).
Slovenian: Seveda bi bilo treba te rezultate pretehtati ob upoštevanju dobro znanih težav s prenašanjem zdravila Casodex (bikalutamid).
English: Further, the referral concerned only the locally advanced prostate cancer indication based on the Early Prostate Cancer study programme, and the directly related wording in sections 4.1 and 5.1 of the SPC.
Slovenian: Poleg tega se je nanašal samo na indikacijo v zvezi z lokalno napredovalim rakom prostate, ki temelji na programu preučevanja zgodnjega raka prostate, in na besedilo, neposredno povezano s tem, ki se nahaja v poglavju 4.1 in 5.1 Povzetka glavnih značilnosti zdravila.
English: The majority of patients with heart failure had confounding factors at study entry, and the causality assessment of investigators for all deaths ascribed to heart failure was “not related”.
Slovenian: Večina bolnikov z odpovedjo srca je imela pri vstopu v študijo zmedene faktorje, tako da je bila ocena preiskovalcev o vzročnosti pri vseh primerih smrti zaradi domnevne odpovedi srca „ni povezave“.
English: The requested additional analyses of the EPC trial data confirm an increased risk for deaths coded as heart failures (however, with no overall excess risk in the cardiovascular system), an increased risk of urogenital symptoms (including gynaecomastia and breast pain) mainly during the first year of intake, and further indicate the absence of an adverse effect on thromboembolic events during the follow-up (supported by a pattern of events inconsistent with hormonal effects).
Slovenian: Zahtevane dodatne analize podatkov preizkušanj EPC potrjujejo povečano tveganje smrti, označenih kot odpovedi srca (vendar brez celotnega prekomernega tveganja v kardiovaskularnem sistemu), povečano tveganje pojava urogenitalnih simptomov (vključno z ginekomastijo in bolečinami v prsih) predvsem med prvim letom jemanja, poleg tega pa še odsotnost neželenega učinka na tromboembolične dogodke med spremljanjem po koncu študije (podpira ga vzorec dogodkov, ki niso skladni z učinki hormonov).
English: For these reasons, the CHMP considers that the progression-free survival results are important and can be considered on their merits.
Slovenian: Zaradi omenjenih razlogov CHMP misli, da so rezultati o preživetju brez napredovanja bolezni pomembni in jih je treba preveriti same po sebi.
English: FI - Finland Helm Pharmaceuticals GmbH Nordkanalstr.
Slovenian: Helm Pharmaceuticals GmbH Nordkanalstr.
English: In addition, the survival advantage observed in patients with locally advanced disease receiving radiotherapy appears to be consistent with that seen in previous studies, and a synergistic effect with radiotherapy is plausible.
Slovenian: Poleg tega se zdi prednost v preživetju pri bolnikih z lokalno napredovalo boleznijo, ki so prejemali radioterapijo, dosledna s preživetjem, ki so ga opazili v prejšnjih študijah, tako da je sinergijski učinek z radioterapijo verjeten.
English: DA - Denmark AstraZeneca A/S Roskildevej 22
Slovenian: AstraZeneca A/S Roskildevej 22
English: EL - Greece Astrazeneca SA 4 Theotocopoulou & Astronauton 151 25 Marousi-Athens
Slovenian: 4 Theotocopoulou & Astronauton 151 25 Marousi-Athens
English: In view of the concerns related to safety and efficacy for bicalutamide 150 mg the National Competent Authority (NCA) in Belgium considered it to be in the interest of public health to perform a new benefit/risk assessment.
Slovenian: Zaradi zadržkov glede varnosti in učinkovitosti bikalutamida 150 mg je pristojni nacionalni organ (NCA) v Belgiji zaključil, da bi bila izvedba nove ocene tveganj in koristi v interesu javnega zdravja.
English: FR - France AstraZeneca 1, place Renault 92844 Rueil-Malmaison Cedex
Slovenian: 1, place Renault 92844 Rueil-Malmaison Cedex
English: Following their own review of these data carried out in 2004 and due to their resulting concerns over the benefit/risk balance of bicalutamide 150 mg in locally advanced prostate cancer, the Belgian Regulatory Authority suspended their national Marketing Authorisation for Casodex (bicalutamide) 150 mg in August
Slovenian: Na podlagi lastnega pregleda teh podatkov, opravljenega leta 2004, in zaradi posledičnih zadržkov glede razmerja med koristmi in tveganji bikalutamida 150 mg pri lokalno napredovalem raku prostate, je belgijski regulativni organ avgusta leta 2005 začasno razveljavil dovoljenje za promet z zdravilom Casodex (bikalutamid) 150 mg.
English: London W1K 1LN
Slovenian: London W1K 1LN United Kingdom
English: 15 Stanhope Gate London, W1K 1LN United Kingdom
Slovenian: 15 Stanhope Gate London, W1K 1LN United Kingdom tableta
English: EAU guidelines suggest the use of prophylactic breast radiation, tamoxifen or aromatase inhibitors to manage these symptoms, although they are not licensed in this use.
Slovenian: V smernicah EAU je predlagano, da bi za urejanje teh simptomov uporabljali obsevanje prsi, tamoksifen ali zaviralce aromataze, čeprav slednji niso odobreni za uporabo v te namene.
English: In conclusion, the heart failure data remain a concern and are inconclusive, but do not significantly alter the benefit/risk balance in locally advanced prostate cancer patients.
Slovenian: Podatki o odpovedi srca ostajajo s tem sporni in ne omogočajo jasnega zaključka, vendar ne pomenijo znatne spremembe razmerja med koristmi in tveganji pri bolnikih z lokalno napredovalim rakom prostate.
English: - The Committee considered the referral made under article 31 of Directive 2001/83/EC, as amended, for medicinal products containing bicalutamide 150 mg.
Slovenian: - Odbor je upošteval napotitev v skladu s členom 31 Direktive 2001/83/ES z vsemi dopolnili za zdravila, ki vsebujejo bikalutamid 150 mg.
English: Note: This Annex III (Amendments to the Summary of Product Characteristics) is the one that was Annexed to the Commission Decision on this Article 31 referral for bicalutamide 150 mg containing medicinal products.
Slovenian: Opomba: Ta Dodatek III (Spremembe Povzetka glavnih značilnosti zdravila) je identičen tistemu, ki je bil priložen odločbi Komisije v zvezi z napotitvenim postopkom, sproženim v skladu s členom 31, za zdravila, ki vsebujejo bikalutamid 150 mg.
English: Watchful waiting
Slovenian: Oprezno čakanje
English: Other aspects of the SPC and the other indication for bicalutamide 150 mg, which is approved in some EU member states, were not within the scope of the referral.
Slovenian: Drugi vidiki Povzetka glavnih značilnosti zdravila in druga indikacija za bikalutamid 150 mg, odobrena v nekaterih državah članicah EU, niso bili predmet te napotitve.
English: Gynaecomastia may not resolve spontaneously following cessation of therapy, particularly after prolonged treatment.
Slovenian: Spontan izzven ginekomastije po končanem zdravljenju ni nujen, kar velja še posebej za dolgotrajno zdravljenje.
English: - The outcome of the 4th analysis of the EPC data should be provided to the RMS and the NCAs where bicalutamide 150 mg is authorised.
Slovenian: - Izide četrte analize podatkov o EPC bi moral predložiti RMS in nacionalnim pristojnim organom, kjer je bikalutamid 150 mg odobren.
English: How does the company justify the absence of adjustment for tests of multiplicity in the analysis of the EPC results?
Slovenian: Kako družba utemeljuje odsotnost prilagajanj za teste multiplikativnosti pri analizi rezultatov za zgodnji rak prostate?
English: - A new pharmacoepidemiological study(ies) should be undertaken to get a better understanding of cardiovascular risk.
Slovenian: - Imetnik mora opraviti novo farmakoepidemiološko študijo (ali študije), ki bodo pripomogle k boljšemu razumevanju kardiovaskularnega tveganja.
English: The scope of the referral included all pending Marketing Authorisation applications as well as all Marketing Authorisations for medicinal products containing 150 mg bicalutamide.
Slovenian: Napotitveni postopek se je nanašal na vse vloge za izdajo dovoljenja za promet, ki so bile v postopku odobritve, kot tudi na dovoljenja za promet za zdravila, ki vsebujejo 150 mg bikalutamida.
English: After the Commission Decision, the Member State competent authorities will update Annex III as required.
Slovenian: Pristojne oblasti držav članic bodo posodobile Dodatek III v skladu z zahtevami, ko bo podana odločba Komisije.
English: It seems intuitive that for good prognosis patients who have also received treatment of curative intent, the addition of bicalutamide might confer less benefit than in other patients.
Slovenian: Zdi se samoumevno, da bi lahko imel dodatek bilakutamida pri bolnikih z dobro napovedjo, ki so prejemali tudi zdravljenje kurativnega značaja, manj koristnih učinkov kot pri drugih bolnikih.
English: - The Committee considered that bicalutamide 150 mg is effective in the treatment of locally advanced prostate cancer; however the CHMP considered that the therapeutic indication should be restricted to treatment of patients at high risk of disease progression.
Slovenian: - Odbor je upošteval, da je bikalutamid 150 mg učinkovit pri zdravljenju lokalno napredovalega raka prostate, vendar pa je bil CHMP mnenja, da bi morale biti indikacije za zdravljenje omejene na zdravljenje bolnikov z visokim tveganjem za napredovanje bolezni.
English: Regarding the heart failure deaths, the allocation of cause of death is known to be unreliable, and very few post-mortems were done.
Slovenian: Kar se tiče primerov smrti zaradi odpovedi srca, je ugotavljanje vzroka za smrt ugotovljeno nezanesljivo, opravili pa so tudi le majhno število obdukcij.
English: The EPC study was an empirical design, that is to say, it generally compared Casodex (bicalutamide) to the standard of care in each region involved.
Slovenian: Študija EPC je temeljila na empiričnem načrtu, kar pomeni, da je na splošno primerjala Casodex (bikalutamid) s standardno nego, značilno za vsako regijo, vključeno v študijo.
English: At the initial authorisation of the early prostate cancer indication, the data for overall survival were too immature to allow an analysis, however it makes sense to subsequently analyse this endpoint in the same subgroups, and there are favourable trends in overall survival for patients with locally advanced disease receiving Casodex (bicalutamide) alone, and for patients also receiving radiotherapy.
Slovenian: V času začetne odobritve za indikacijo zgodnjega raka prostate so bili podatki za celotno preživetje še preveč nerazviti, da bi omogočali analizo, vendar pa je naknadna analiza te končne točke v istih podskupinah smiselna, saj obstajajo koristni trendi pri celotnem preživetju bolnikov z lokalno napredovalo boleznijo, ki prejemajo zdravilo Casodex (bikalutamid) bodisi samostojno ali v kombinaciji z radioterapijo.
English: When the EPC programme was initiated more than 8 years ago, the aim was to document the benefit of early bicalutamide therapy versus placebo as monotherapy or adjuvant therapy to surgery or radiotherapy.
Slovenian: Ob začetku programa EPC pred več kot osmimi leti je bil cilj dokumentirati primerjavo koristnih učinkov zgodnjega zdravljenja z bikalutamidom glede na placebo, uporabljenega kot monoterapija ali adjuvantno zdravljenje h kirurgiji ali radioterapiji.
English: How does the company justify that the placebo arm did not receive an adequate treatment according to the present standard of care and why this is not taken into account in the analysis of the EPC results?
Slovenian: Kako družba utemeljuje dejstvo, da placebo skupina glede na veljavne standarde nege ni prejela ustreznega zdravljenja in zakaj to ni bilo upoštevano pri analizi rezultatov za zgodnji rak prostate?
English: AT - Austria Genericon Pharma Ges.m.b.H.
Slovenian: Genericon Pharma Ges.m.b.H.
English: Benefit is generally a function of risk progression and in patients with locally advanced disease; benefit is reduced after surgery or in cases where radiotherapy is likely to be curative.
Slovenian: Koristni učinki so navadno funkcija napredovanja tveganja in so opazni pri bolnikih z lokalno napredovalo boleznijo; koristni učinki se zmanjšajo po kirurškemu posegu ali tam, kjer bo radioterapija po vsej verjetnosti imela zdravilen učinek.
English: AMENDMENTS TO THE SUMMARY OF PRODUCT CHARACTERISTICS
Slovenian: SPREMEMBE POVZETKA GLAVNIH ZNAČILNOSTI ZDRAVILA
English: In particular, there is a statistically significant and clinically meaningful improvement in progression-free survival in the patients with locally advanced prostate cancer who received Casodex (bicalutamide) as compared to placebo (58% versus 69% progressors in patients who were not receiving adjuvant surgery or radiotherapy).
Slovenian: Opaziti je statistično značilno in klinično pomembno izboljšanje preživetja brez napredovanja bolezni pri bolnikih z lokalno napredovalim rakom prostate, ki so prejemali zdravilo Casodex (bikalutamid), glede na tiste, ki so prejemali placebo (58 % napram 69 % bolnikov z napredovanjem bolezni in ki niso prejemali adjuvantne kirurgije ali radioterapije).
English: As regards the multiplicity issue raised, it is considered appropriate to look at subgroups from a statistical viewpoint, as they have helped to narrow the indication to patients with a more favourable benefit/risk balance for bicalutamide 150 mg.
Slovenian: Kar se tiče vprašanja multiplikativnosti, se zdi primerno pregledati podskupine iz statističnega stališča, saj so pri bikalutamidu 150 mg pomagale zožiti indikacijo na bolnike z bolj ugodnim razmerjem med koristmi in tveganji.
English: CASODEX (Bicalutamide) 150 mg was studied as a treatment for patients with localised (T1-T2, N0 or NX, M0) or locally advanced (T3-T4, any N, M0; T1-T2, N+, M0) non-metastatic prostate cancer in a combined analysis of 3 placebo controlled double-blind studies in 8113 patients, where CASODEX was given as immediate hormonal therapy or as adjuvant to radical prostatectomy or radiotherapy, (primarily external beam radiation).
Slovenian: CASODEX (bikalutamid) 150 mg je bil preučevan kot terapija za bolnike z lokaliziranim (T1-T2, N0 ali NX, M0) ali lokalno napredovalim (T3-T4, katerikoli N, M0; T1-T2, N+, M0) nemetastatskim rakom prostate v kombinirani analizi treh s placebom kontroliranih, dvojno slepih študij pri 8113 bolnikih.
English: How does the company justify the indication of bicalutamide 150 mg for locally advanced prostate cancer knowing the absence of statistically significant overall survival and the important side effects?
Slovenian: Kako družba utemeljuje indikacijo bikalutamida 150 mg za lokalno napredovali rak prostate, če ve, da so statistično značilno celotno preživetje in pomembni neželeni učinki odsotni?
English: ET - Estonia Astrazeneca UK Ltd. Stanhope Gate 15
Slovenian: Astrazeneca UK Ltd. Stanhope Gate 15
English: AMENDMENTS TO BE INCLUDED IN THE RELEVANT SECTION OF THE SUMMARY OF PRODUCT CHARACTERISTICS FOR BICALUTAMIDE 150MG CONTAINING MEDICINAL PRODUCTS
Slovenian: SPREMEMBE, KI BODO VKLJUČENE V USTREZEN ODSTAVEK POVZETKOV GLAVNIH ZNAČILNOSTI ZDRAVIL, KI VSEBUJEJO BIKALUTAMID 150 MG
English: With reference to the adequacy of treatment in the placebo group in the EPC studies, given that at the time of initiation of these studies there was no widely agreed standard of care in locally advanced prostate cancer (something which remains the case), the empirical design of the studies, which compared Casodex (bicalutamide) 150mg or placebo when given as an adjunct to “standard care” is considered reasonable.
Slovenian: Z ozirom na primernost zdravljenja v placebo skupini v študijah EPC in glede na dejstvo, da v času uvajanja teh študij ni bilo široko sprejetega standarda nege lokalno napredovalega raka prostate (to še vedno velja), velja empirična zasnova študij, v katerih so primerjali dajanje zdravila Casodex (bikalutamid) 150 mg ali placeba kot dodatek „standardni negi“, za sprejemljivo.
English: FI - Finland Ratiopharm GmbH Graf-Arco-Strasse 3
Slovenian: Ratiopharm GmbH Graf-Arco-Strasse 3
English: Its authorised indications include the treatment of patients with locally advanced prostate cancer, as an immediate therapy either alone or as adjuvant to treatment by radical prostatectomy or radiotherapy.
Slovenian: Odobrene indikacije vključujejo takojšnje zdravljenje bolnikov z lokalno napredovalim rakom prostate, bodisi samostojno bodisi kot adjuvans k zdravljenju z radikalno prostatektomijo ali radioterapijo.
English: The 4 issues raised in the referral concern the analyses of the Early Prostate Cancer Programme (EPC): - the lack of an overall survival benefit versus adverse events in ‘locally advanced prostate cancer'; - statistical concerns regarding multiplicity; - the standard of care for the placebo group in the relevant studies; - the number of deaths due to cardiac failure.
Slovenian: Štiri sporna vprašanja v napotitvenem postopku so bila: - pomanjkanje koristnega učinka za celotno preživetje napram neželenim učinkom pri „lokalno napredovalemu raku prostate“; - statistični zadržki glede multiplikativnosti; - standard oskrbe za skupino, ki je prejemala placebo, v zadevnih študijah; - število smrti zaradi odpovedi srca.
English: At that time, the RMS concluded that Casodex (bicalutamide) 150 mg should not be used in the treatment of ‘localised' prostate cancer, however, it was concluded that the benefit/risk balance remained positive for selected patients in ‘locally advanced' prostate cancer, as immediate therapy either alone or as adjuvant to treatment by radical prostatectomy or radiotherapy.
Slovenian: Takrat je referenčna država članica zaključila, da zdravila Casodex (bikalutamid) 150 mg ne bi smeli uporabljati za zdravljenje „lokaliziranega“ raka prostate, vendar pa je zaključila tudi, da je razmerje med koristmi in tveganji ostalo pozitivno za izbrane bolnike z „lokalno napredovalim“ rakom prostate in pri uporabi za takojšnje zdravljenje bodisi samostojno ali kot adjuvans k zdravljenju z radikalno prostatektomijo ali radioterapijo.
English: The aim of the study should be to estimate the incidence of heart failure, cardiovascular morbidity and mortality in patients with prostate cancer, compared to the general population.
Slovenian: Cilj te študije bi moral biti ocenjevanje pojavnosti odpovedi srca, kardiovaskularne obolevnosti in smrtnosti pri bolnikih z rakom prostate v primerjavi s splošno populacijo.
English: The aim of the study is to estimate the incidence of heart failure, cardiovascular morbidity and mortality in patients with prostate cancer, compared to the general population.
Slovenian: Cilj te študije je oceniti pojavnost odpovedi srca, kardiovaskularne obolevnosti in smrtnosti pri bolnikih z rakom prostate v primerjavi s splošno populacijo.
English: 4.1 Therapeutic indications [Invented name] 150mg is indicated either alone or as adjuvant to radical prostatectomy or radiotherapy in patients with locally advanced prostate cancer at high risk for disease progression (see section 5.1).
Slovenian: [Izmišljeno ime zdravila] 150 mg je indiciran bodisi kot monoterapija ali kot adjuvantna terapija poleg radikalne prostatektomije ali radioterapije pri bolnikih z lokalno napredovalim rakom prostate z visokim tveganjem za napredovanje bolezni (glejte poglavje 5.1).
English: The results should be reported to the RMS and the NCAs where bicalutamide 150 mg is authorised.
Slovenian: O rezultatih mora poročati RMS in nacionalnim pristojnim organom, kjer je bikalutamid 150 mg odobren.
English: How can the company rule out any role of bicalutamide 150 mg in the increased mortality due to heart failure in the Casodex arm of the EPC trial?
Slovenian: Kako lahko družba izključi kakršnokoli vlogo bikalutamida 150 mg v povišani smrtnosti zaradi odpovedi srca v skupini, ki je v preizkušanju za zgodnji rak prostate prejemala zdravilo Casodex?
English: The SPC has been amended accordingly and notes in section 5.1 that, for patients with locally advanced disease “A reduction in risk of objective disease progression… was most evident in those at highest risk of disease progression.
Slovenian: Povzetek glavnih značilnosti zdravila je bil ustrezno dopolnjen, tako da poglavje 5.1 vsebuje opombo, da je bilo pri bolnikih z lokalno napredovalo boleznijo „znižanje tveganja objektivnega napredovanja bolezni... najbolj očitno pri tistih, katerih tveganje za napredovanje bolezni je bilo največje.
English: In view of this, the benefit-risk profile for the use of CASODEX is not considered favourable in this group of patients.
Slovenian: Razmerje med koristjo in tveganjem uporabe zdravila CASODEX v tej skupini zato velja za neugodno.
English: 0.56 (0.40 to 0.78)
Slovenian: 0,56 (0,40 do 0,78)