FrancophonIA/ELRC3.0 huggingface dataset:
English: Following the conclusion of these procedures, the PRAC was of the view that the concerns regarding the combination products may also be of relevance for the mono-component products and the Danish Health and Medicines Authority therefore initiated a review under Article 31 of Directive 2001/83/EC to assess the impact of the HPS2-THRIVE data on the benefitrisk balance of these products and to give its recommendation on whether their marketing authorisations should be maintained, varied, suspended or revoked and if the supply of the medicinal product should be prohibited.
Croatian: Nakon zaključivanja ovih postupaka, PRAC je bio mišljenja da zabrinutost u vezi s kombiniranim lijekovima može također biti od značaja za monokomponentne lijekove, te je stoga danska Agencija za zdravstvo i lijekove započela pregled u skladu s člankom 31. Direktive 2001/83/EZ s ciljem ocjenjivanja učinka podataka ispitivanja HPS2-THRIVE na omjer koristi i rizika ovih lijekova i davanja preporuke o tome treba li se odobrenje za stavljanje u promet ovih lijekova zadržati, izmijeniti, privremeno oduzeti ili oduzeti, te treba li zabraniti isporuku lijekova.
English: The PRAC also took into account the views of the European experts consulted in an Ad-Hoc expert meeting, according to which acipimox has a role as lipid-lowering therapy in well-defined settings and indications, such as the treatment of severe hypertriglyceridaemia but only as a second or third line agent.
Croatian: PRAC je također uzeo u obzir mišljenja europskih stručnjaka koji su konzultirani u ad-hoc stručnoj skupini, prema kojima acipimoks ima ulogu terapije koja snižava lipide u dobro definiranom okruženju i indikacijama, poput liječenja ozbiljne hipertrigliceridemije, no samo kao sredstvo druge ili treće linije terapije.
English: The preliminary results of the HPS2-THRIVE study showed that the study did not meet its primary endpoint (reduction of the risk of major vascular events such as heart attack and stroke) as well as a statistically significant increase in the incidence of non-fatal but serious adverse events in the nicotinic acid/laropiprant group compared to the placebo group.
Croatian: Preliminarni rezultati ispitivanja HPS2-THRIVE pokazali su da ispitivanje nije udovoljilo svojoj preliminarnoj završnoj točci (smanjenju rizika od velikih vaskularnih događaja poput infarkta miokarda i moždanog udara) kao i statistički značajno povećanje incidencije nesmrtonosnih, no ozbiljnih nuspojava u grupe koja je uzimala nikotinsku kiselinu/laropiprant u usporedbi s grupom koja je uzimala placebo.
English: On 19 December 2012, the European Medicines Agency was made aware of preliminary results from a large randomised clinical study (Heart Protection Study 2-Treatment of HDL to Reduce the Incidence of Vascular Events - HPS2-THRIVE) designed to assess the incremental benefit of extended release nicotinic acid (ERN)/laropiprant (LRPT) versus placebo in over 25,673 high-risk patients.
Croatian: Dana 19. prosinca 2012. Europska agencija za lijekove upoznata je s preliminarnim rezultatima velikog randomiziranog kliničkog ispitivanja (Ispitivanje preventivne zaštite srca 2 - Liječenje HDL-a s ciljem smanjivanja broja incidencija srčanih događaja - HPS2-THRIVE) osmišljenog kako bi se ocijenila inkrementalna korist odgođenog otpuštanja nikotinske kiseline (ERN)/laropipranta (LRPT) u odnosu na placebo u više od 25 673 visokorizičnih bolesnika.
English: The CMDh considered the below PRAC recommendation dated 7 November 2013 with regard to substances related to nicotinic acid (acipimox) indicated for the treatment of lipid disorders.
Croatian: CMDh je razmotrio niže navedenu preporuku PRAC-a od 7. studenog 2013. u vezi s tvarima povezanima s nikotinskom kiselinom (acipimoksom) indiciranima za liječenje poremećaja lipida.
English: • The PRAC considered the procedure under Article 31 of Directive 2001/83/EC resulting from pharmacovigilance data for nicotinic-acid and related substances initiated by Denmark and decided to restrict the scope of the procedure to products containing acipimox, the only high-dose nicotinic acid-related substance indicated in lipid disorders authorised in the EU;
Croatian: • je PRAC razmotrio postupak u skladu s člankom 31. Direktive 2001/83/EZ koji je proizašao iz podataka u području farmakovigilancije za nikotinsku kiselinu i povezane tvari, a koji je pokrenula Danska, te je odlučio ograničiti područje postupka na lijekove koji sadrže acipimoks, jedinu tvar povezanu s velikom dozom nikotinske kiseline koja je indicirana za poremećaje lipida i odobrena za primjenu u EU-u;
English: • The PRAC reviewed the totality of the available data, including studies and publications on acipimox, the MAH responses as well as relevant data on nicotinic acid, including the AIM-HIGH and HPS2-THRIVE studies;
Croatian: • je PRAC pregledao sve dostupne podatke, uključujući i ispitivanja i publikacije o acipimoksu, odgovore nositelja odobrenja kao i relevantne podatke o nikotinskoj kiselini, uključujući i ispitivanja AIM-HIGH i HPS2-THRIVE;
English: Most identified adverse events are already reflected in the acipimox product information and the PRAC considered that the available data did not identify any new safety information which impacts the benefit-risk balance of acipimox, with the exception of a potential risk of muscle toxicity, which was addressed by adding a warning to the product information.
Croatian: Većina identificiranih nuspojava već je navedena u informacijama o lijeku za acipimoks te PRAC smatra da dostupni podaci nisu identificirali nove sigurnosne informacije koje utječu na omjer koristi i rizika acipimoksa, uz iznimku mogućeg rizika od mišićne toksičnosti, koji je spomenut dodavanjem upozorenja u informacije o lijeku.
English: Nevertheless, the PRAC considered that the efficacy of acipimox in lowering blood lipids in patients with some forms of hyperlipoproteinaemia is demonstrated.
Croatian: Bez obzira na navedeno, PRAC je zaključio da je utvrđena djelotvornost acipimoksa u snižavanju lipida u krvi u bolesnika s određenim oblicima hiperlipoproteinemije.
English: A review of all available data was undertaken by the Pharmacovigilance Risk Assessment Committee (PRAC) to assess the above safety concerns and their impact on the benefit-risk balance of the centrally authorised combination products Tredaptive, Trevaclyn and Pelzont.
Croatian: Povjerenstvo za ocjenu rizika na području farmakovigilancije (PRAC) pregledalo je sve dostupne podatke s ciljem ocjene prethodno navedenih sigurnosnih pitanja i njihovog učinka na omjer koristi i rizika za kombinirane lijekove Tredaptive, Trevaclyn i Pelzont koji su središnje odobreni.
English: • The PRAC considered that the available safety data identified a potential risk of muscle toxicity, for which a warning was added to the product information.
Croatian: • je PRAC zaključio da je dostupnim podacima o sigurnoj primjeni identificiran potencijalan rizik od mišićne toksičnosti, za što je dodano upozorenje u informacije o lijeku.
English: The safety data available for acipimox, including data on nicotinic acid obtained from HPS2-THRIVE, showed that the safety profile of acipimox is well characterised.
Croatian: Podaci o sigurnoj primjeni dostupni za acipimoksom, uključujući podatke o nikotinskoj kiselini koji su prikupljeni tijekom ispitivanja HPS2-THRIVE, dokazuju da je sigurnosni profil acipimoksa dobro okarakteriziran.
English: Having reviewed all the available data, including studies and publications on acipimox as well as data on the related substance nicotinic acid, including the AIM-HIGH and HPS2-THRIVE studies, the PRAC considered the efficacy of acipimox in the treatment of certain well-defined lipid disorders to be demonstrated and that acipimox therefore remains a treatment alternative in the management of lipid disorders characterised by elevated plasma levels of triglycerides (Fredrickson type IV hyperlipoproteinaemia), or both triglycerides and cholesterol
Croatian: Nakon pregleda svih dostupnih podataka, uključujući i ispitivanja i publikacije o acipimoksu kao i podataka u vezi s tvari nikotinskom kiselinom, uključujući i ispitivanja AIM-HIGH i HPS2-THRIVE, PRAC je zaključio da je dokazana djelotvornost acipimoksa u liječenju određenih dobro definiranih poremećaja lipida, te da acipimoks stoga ostaje alternativa za liječenje u upravljanju poremećajima lipida za koje su karakteristične povišene razine triglicerida u plazmi (hiperlipoproteinemija tip IV prema Fredrickson klasifikaciji) ili povišene razine triglicerida i kolesterola u plazmi (hiperlipoproteinemija tip IIb prema Fredrickson klasifikaciji).
English: Having reviewed the list of EU products containing nicotinic acid or related substances, the PRAC noted that acipimox is the only high-dose substance indicated in lipid disorders still authorised in the EU and the scope of the procedure was therefore restricted to acipimox-containing products.
Croatian: Nakon pregleda popisa lijekova koji sadrže nikotinsku kiselinu ili povezane tvari za EU, PRAC je uočio da je acipimoks jedina tvar koja je u velikoj dozi indicirana za poremećaje lipida u EU-u te je stoga predmet postupka ograničen na lijekove koji sadrže acipimoks.
English: It was noted that acipimox was of particular use in patients who either do not tolerate a statin or do not achieve triglyceride goals with statin therapy alone and could therefore be used as an alternative or adjunct treatment to reduce triglyceride levels in these patients.
Croatian: Uočeno je da je acipimoks bio posebno djelotvoran u bolesnika koji nisu podnosili statin ili onih koji samo s terapijom statinom nisu postigli ciljne vrijednosti triglicerida, te su se stoga može koristiti kao alternativna ili dodatna terapija za snižavanje razina triglicerida u ovih bolesnika.
English: However, taking into account the available data as well as the current use of the product and on the basis of expert advice, the PRAC was of the opinion that acipimox should only be used to reduce triglyceride levels in patients who either do not tolerate statin or fibrates or who do not achieve triglyceride goals with statin or fibrate therapy alone and should therefore be used as an alternative or adjunct treatment to reduce triglyceride levels in these patients.
Croatian: No, uzimajući u obzir dostupne podatke kao i aktualnu primjenu lijekova, te na temelju savjeta stručnjaka, mišljenje je PRAC-a da se acipimoks treba koristiti samo za snižavanje razina triglicerida u bolesnika koji ne podnose statin ili fibrate ili koji nisu postigli ciljne razine triglicerida samo s terapijom statina ili fibrata, te se stoga treba primjenjivati kao alternativna ili dodatna terapija za snižavanje razina triglicerida u ovih bolesnika.
English: • The PRAC considered that acipimox is efficacious in reducing triglyceride levels in patients with hypertriglyceridaemia (Fredrickson type IV hyperlipoproteinaemia) and with hypercholesterolaemia and hypertriglyceridaemia (Fredrickson type IIb hyperlipoproteinaemia) but only, on the basis of available evidence including current medical knowledge on the use of acipimox, as a second or third line agent in patients who have not responded adequately to other treatments such as statin or fibrate treatment;
Croatian: • je PRAC zaključio da je acipimoks djelotvoran u snižavanju razina triglicerida u bolesnika s hipertrigliceridemijom (hiperlipoproteinemija tip IV prema Fredrickson klasifikaciji) i s hiperkolesterolemijom i hipertrigliceridemijom (hiperlipoproteinemija tip IIb prema Fredrickson klasifikaciji) no samo, na temelju dostupnih dokaza uključujući aktualna medicinska saznanja o primjeni acipimoksa, kao lijek druge ili treće linije terapije u bolesnika koji nisu primjereno odgovorili na druga liječenja poput liječenja statinom ili fibratom;
English: The CMDh, having considered the PRAC recommendation pursuant to article 107k of Directive 2001/83/EC dated 7 November 2013, reached a position on the variation to the terms of the marketing authorisations of acipimox for which the relevant sections of the summary of product characteristics and package leaflets are set out in Annex III.
Croatian: Nakon razmatranja preporuke PRAC-a u skladu s člankom 107.k Direktive 2001/83/EZ od 7. studenoga 2013., CMDh je donio svoje mišljenje o izmjeni uvjeta odobrenja za stavljanje u promet acipimoksa, čiji su važni dijelovi sažetka opisa svojstava lijekova i uputa o lijeku navedeni u Dodatku III.
English: Based on the available data, acipimox was considered to be efficacious in reducing triglyceride levels in patients with hypertriglyceridaemia (Fredrickson type IV hyperlipoproteinaemia) and significantly superior to placebo in patients with hypercholesterolaemia and hypertriglyceridaemia (Fredrickson type IIb hyperlipoproteinaemia).
Croatian: Na temelju dostupnih podataka, smatralo se da je acipimoksom djelotvoran u snižavanju razina triglicerida u bolesnika koji boluju od hipertrigliceridemije (hiperlipoproteinemija tip IV prema Fredrickson klasifikaciji), te je značajno superiorniji u odnosu na placebo u bolesnika koji boluju od hiperkolesterolemije i hipertrigliceridemije (hiperlipoproteinemija tip IIb prema Fredrickson klasifikaciji).
English: The PRAC concluded that the benefit-risk balance of acipimox-containing products remains favourable under normal conditions of use, subject to the agreed changes to the product information.
Croatian: PRAC je zaključio da omjer koristi i rizika lijekova koji sadrže acipimoks ostaje povoljan u normalnim uvjetima primjene, podložno usuglašenim izmjenama u informacijama o lijeku.
English: The PRAC, as a consequence, concluded that the benefit-risk balance of the medicinal products containing acipimox identified in Annex I remains favourable, subject to the agreed changes to the product information.
Croatian: Slijedom navedenog PRAC je zaključio da omjer koristi i rizika lijekova koji sadrže acipimoks, a koji su identificirani u Dodatku I, ostaje povoljan, podložno usuglašenim izmjenama informacija o lijeku.
English: Proc Natl Acad Sci U S A. 2015 Jan 6;112(1):E56-64.
Croatian: Proc Natl Acad Sci U S A. 6. siječnja 2015.; 112(1):E56-64.
English: Several tests for chromosome damage were positive.
Croatian: Nekoliko je testova oštećenja kromosoma bilo pozitivno.
English: In addition all products should have in place a risk management plan.
Croatian: Osim toga, za sve lijekove treba uspostaviti plan upravljanja rizikom.
English: No new significant information was identified regarding this risk.
Croatian: U pogledu tog rizika nisu utvrđene nove značajne informacije.
English: This resulted in a value which was more than 25,000 times lower than the AUC in a woman treated orally with an equal dose (single oral dose 500 mg).
Croatian: Rezultat toga bila je vrijednost koja je više od 25 000 puta niža od AUC-a u žena liječenih peroralno primjenom jednake doze (jedna oralna doza od 500 mg).
English: Although several limitations exist, the study suggests that there was some transgenerational effect.
Croatian: Iako postoji nekoliko ograničenja, ispitivanje upućuje na postojanje određenog transgeneracijskog učinka.
English: For the following risk minimisation measures, the CMDh clarified that:
Croatian: U pogledu mjera minimizacije rizika u nastavku, CMDh je pojasnio sljedeće:
English: The PRAC re-iterate that a single version of educational materials is disseminated in each member state, where appropriate.
Croatian: PRAC još jednom ističe potrebu distribucije jedinstvene verzije edukacijskih materijala u svakoj državi članici gdje je to potrebno.
English: However, tests for gene mutations were negative.
Croatian: Međutim, ispitivanja genskih mutacija bila su negativna.
English: In addition to the boxed text this may include a symbol/pictogram, with the details to be adapted at national level.
Croatian: Osim teksta u okviru može se dodati i simbol/piktogram, a detalje treba prilagoditi na nacionalnoj razini.
English: • The Pharmacovigilance Risk Assessment Committee (PRAC) considered the procedure under Article 31 of Directive 2001/83/EC for medicinal products containing substances related to valproate.
Croatian: • Odbor za procjenu rizika u području farmakovigilancije (PRAC) razmotrio je postupak u skladu s člankom 31. Direktive 2001/83/EZ za lijekove koji sadrže tvari povezane s valproatom.
English: This guide should be handed over to the patient.
Croatian: Ovaj vodič trebalo bi uručiti bolesnicama.
English: The PRAC requested the conduct of a retrospective observational study to further characterise this theoretical risk.
Croatian: PRAC je zatražio provođenje retrospektivnog opservacijskog ispitivanja kako bi se dodatno opisao ovaj teoretski rizik.
English: They also provided experience from clinical practice on the management of women who wish to become pregnant or are pregnant.
Croatian: Također su prikupljena iskustva iz kliničke prakse u pogledu liječenja žena koje žele zatrudnjeti ili su trudne.
English: Having reviewed the PRAC recommendation, the CMDh agrees with the PRAC overall conclusions and grounds for recommendation.
Croatian: Nakon što je pregledao preporuku PRAC-a, CMDh je suglasan s općim znanstvenim zaključcima i razlozima za preporuku PRAC-a.
English: The medicinal products will continue to be listed in the additional monitoring list.
Croatian: Predmetni lijekovi i dalje će biti navedeni na popisu lijekova pod dodatnim praćenjem.
English: There is no clear evidence that mitochondrial dysfunction caused by valproate is associated with the development of autism.
Croatian: Ne postoje jasni dokazi da je disfunkcija mitohondrija prouzročena valproatom povezana s razvojem autizma.
English: In the previous European review (2014)3, several educational measures for patients and healthcare professionals (HCPs) were recommended.
Croatian: U prethodnom pregledu lijeka (2014.)3 preporučeno je nekoliko edukacijskih mjera za bolesnike i zdravstvene radnike.
English: Genetic changes can be divided in gene mutations and chromosome aberrations.
Croatian: Genske promjene mogu se podijeliti na genske mutacije i kromosomske aberacije.
English: From these consultations it was evident that the specialists are aware of the risks discussed, but the information is not adequately reaching the patients timely and effectively.
Croatian: To je savjetovanje pokazalo da su specijalisti svjesni rizika o kojima se raspravljalo, ali da informacije ne dolaze do bolesnika na odgovarajući način, pravovremeno ni učinkovito.
English: The PRAC adopted a recommendation on 08 February 2018 which was then considered by the CMDh, in accordance with Article 107k of Directive 2001/83/EC.
Croatian: PRAC je 8. veljače 2018. donio preporuku koju je zatim razmatrala Koordinacijska grupa za postupak međusobnog priznavanja i decentralizirani postupak za humane lijekove (CMDh) u skladu s člankom 107.k Direktive 2001/83/EZ.
English: The PRAC is of the opinion that the currently available data do not warrant further investigation regarding the potential association between mitochondrial dysfunction and autism.
Croatian: PRAC smatra da trenutačno dostupni podatci ne opravdavaju provođenje dodatnog istraživanja moguće povezanosti disfunkcije mitohondrija i autizma.
English: Every effort should be made to switch to appropriate alternative treatment prior to conception, and before contraception is discontinued.
Croatian: Treba uložiti sve potrebne napore za prelazak na odgovarajuće alternativno liječenje prije začeća i prije prekida primjene kontracepcije.
English: The PRAC therefore recommends that other tests could be performed (e.g. in vitro mouse lymphoma assay) to further explore this hypothesis.
Croatian: PRAC stoga preporučuje provođenje novih ispitivanja (npr. in vitro test mišjeg limfoma) kako bi se ta hipoteza dodatno istražila.
English: This included the responses submitted by the marketing authorisation holders in writing as well as the outcomes of the scientific advisory groups in neurology and psychiatry.
Croatian: U to su bili uključeni pisani odgovori koje su dostavili nositelji odobrenja za stavljanje lijeka u promet kao i zaključci znanstvenih savjetodavnih skupina za područje neurologije i psihijatrije.
English: Further investigation is recommended by PRAC.
Croatian: PRAC preporučuje dodatna istraživanja.
English: As the injectable formulations are indicated only for short use, the patient card is most likely to be of limited value.
Croatian: Budući da su injektabilne formulacije indicirane samo za kratkoročnu primjenu, vrlo je vjerojatno da će kartica za bolesnika imati ograničenu vrijednost.
English: Therefore, this type of transmission is not likely to occur for valproate.
Croatian: Stoga nije vjerojatno nastupanje takve vrste prijenosa u slučaju valproata.
English: In one experiment it was shown that a change in gene expression (one gene) in male mice after exposure to a histone deacetylases (HDAC) inhibitor (not valproate) was observed also in the offspring of these mice (Jia et al, 2015)1, so possible in principle.
Croatian: Jednim je pokusom dokazano da je promjena u ekspresiji gena (jednog gena) u mužjaka miševa nakon izlaganja inhibitoru histon deacetilaze (HDAC) (ne valproatu) zabilježena i u potomstvu tih miševa (Jia et al, 2015.)1, stoga je to načelno moguće.
English: It can be concluded that it is extremely unlikely that valproate, when used by a male patient, could cause adverse effects to the embryo/foetus by this route.
Croatian: Može se zaključiti da je iznimno mala vjerojatnost da bi valproat primijenjen u muškog bolesnika mogao tim putem prouzročiti štetne učinke na embrionalni/fetalni razvoj.
English: This may be particularly important as the prescribers of IV formulations of valproate are expected to be different from the usual prescribers targeted during the implementation of additional risk minimisation measures.
Croatian: To bi moglo biti osobito važno s obzirom na to da se očekuje da su propisivači intravenskih formulacija valproata različiti od uobičajenih propisivača na koje je usmjerena provedba dodatnih mjera minimizacije rizika.
English: Furthermore, in a literature overview regarding effects on mitochondria, known side effects were described such as liver toxicity, Reye-like syndrome, pancreatitis and immune deficiency (leukopenia).
Croatian: Nadalje, u pregledu literature o učincima na mitohondrije opisane su poznate nuspojave, kao što su toksičnost za jetru, simptomi nalik Reyevu sindromu, pankreatitis i imunodeficijencija (leukopenija).
English: The potential impact of paternal use of valproate, the potential effect on the third generation offspring and the potential effects on mitochondria (mitochondrial toxicity) were discussed.
Croatian: Raspravljalo se o mogućem učinku primjene valproata u očeva, mogućem učinku na treću generaciju potomaka te o mogućim učincima na mitohondrije (mitohondrijska toksičnost).
English: Consequently, the annual risk acknowledgment form is not required for the injectable formulations.
Croatian: Slijedom toga, godišnji obrazac potvrde o upoznatosti s rizikom nije potreban za injektabilne formulacije.
English: Severe chromosome damage is expected to lead to death of sperm cells / reduced fertility and not to transmission of mutations to the offspring.
Croatian: Smatra se da će teška oštećenja kromosoma prouzročiti odumiranje stanica sperme i smanjenu plodnost, a ne prijenos mutacija na potomstvo.
English: In the course of the consultations that PRAC had in this procedure, some additional concerns have arisen, other than the well-known and documented harm to the foetus during in utero exposure.
Croatian: Tijekom savjetovanja koja je PRAC proveo u okviru ovog postupka pojavili su se neki dodatni razlozi za zabrinutost osim dobro poznatog i dokumentiranog oštećenja ploda tijekom in utero izlaganja.
English: It is unknown whether slight chromosome damage might be transmitted to the offspring.
Croatian: Nije poznato mogu li se manja oštećenja kromosoma prenijeti na potomstvo.