FrancophonIA/ELRC3.0 huggingface dataset:
English: From a GCP perspective and in terms of the data generated which support the CMC and non-clinical data, TEC062 cannot be considered a failed study.
Danish: som støtter CMC-dataene og de ikke-kliniske data, kan TEC062 ikke betragtes som en mislykket undersøgelse.
English: As the CHMP considered that free AUC is the most important PK parameter and that the dominant pharmacodynamic driver of microbiological and clinical outcome is AUC/MIC, the Applicant concluded that the most important PK/PD parameter for assessing microbiological and clinical outcome is the free AUC/MIC.
Danish: Da CHMP var af den opfattelse, at det frie AUC er det vigtigste farmakokinetiske parameter, og at den vigtigste farmakodynamiske årsag til mikrobiologiske og kliniske resultater er AUC/MIC, konkluderede ansøgeren, at det vigtigste farmakokinetiske og farmakodynamiske parameter for vurderingen af mikrobiologiske og kliniske resultater er det frie AUC/MIC.
English: Question 1 - The differences in composition between the two products and the resulting differences between the AUC values do not clearly demonstrate that Teicoplanin Hospira and the reference product Targocid are essentially similar.
Danish: Spørgsmål 1 - Forskellene i de to lægemidlers sammensætning og de heraf følgende forskelle i AUCværdierne viser ikke tydeligt, at der er en væsentlig lighed mellem Teicoplanin Hospira og referencelægemidlet Targocid.
English: However, the validity and sensitivity of free AUC and PK/PD parameters in the evaluation of a generic product have not been established, and this approach contravenes the CHMP guideline on the Investigation of Bioavailability and Bioequivalence.
Danish: Validiteten og følsomheden af det frie AUC og de farmakokinetiske og farmakodynamiske parametre ved vurderingen af et generisk lægemiddel er dog ikke blevet fastslået, og denne tilgang er i strid med CHMP's retningslinjer for undersøgelse af biotilgængelighed og bioækvivalens.
English: Regarding the available literature concluding that Teicoplanin should be treated as a whole regardless of the relative levels of subcomponents, the CHMP is of the opinion that this would have been considered during the development of the Ph.Eur.
Danish: Hvad angår den tilgængelige litteratur, hvor det konkluderes, at teicoplanin bør behandles som en helhed uanset de relative niveauer af underkomponenter, er CHMP af den opfattelse, at man ville have taget højde for dette ved udarbejdelsen af monografien i Den Europæiske Farmakopé.
English: The Applicant also provided a briefing document stating that other endpoints, including pharmacodynamics, protein binding and analysis of the PK and PD of the principal sub-components, were measured in the study as it is believed that only free drug (non-protein bound teicoplanin) contributes to pharmacodynamic activity.
Danish: Ansøgeren fremsendte ligeledes et informationsdokument, hvor der stod, at andre effektmål, herunder farmakodynamik, proteinbinding og analyse af de vigtigste underkomponenters farmakokinetik og farmakodynamik, blev målt i undersøgelsen, eftersom man mener, at det kun er det frie lægemiddel (ikke-proteinbundet teicoplanin), der bidrager til den farmakodynamiske aktivitet.
English: Results from animal studies do not supersede comparative PK data from a clinical study in the evaluation of abridged products.
Danish: Resultaterne fra dyreforsøg overflødiggør ikke komparative farmakokinetiske data fra en klinisk undersøgelse ved vurderingen af lægemidler under den forkortede procedure.
English: The Applicant considered the AUC/MIC ratio individually for all 5 subcomponents, for the free drug, as teicoplanin is extensively protein bound, and the biological activity of the preparation mainly results from the free drug component.
Danish: Ansøgeren betragtede AUC/MIC-forholdet individuelt for alle 5 underkomponenter og for det frie lægemiddel, eftersom teicoplanins proteinbinding er omfattende, og præparatets biologiske aktivitet hovedsagelig skyldes den frie lægemiddelkomponent.
English: Safety data obtained from clinical study and non-clinical toxicity study The Applicant stated that the dosing regimen of teicoplanin is predictable, therefore dose-dependent toxicity is not of concern under standard clinical use.
Danish: Sikkerhedsdata fra den kliniske undersøgelse og den ikke-kliniske toksicitetsundersøgelse Ansøgeren anførte, at teicoplanins doseringsregimen er forudsigeligt, og at dosisafhængig toksicitet derfor ikke giver anledning til bekymring i forbindelse med almindelig klinisk brug.
English: The Applicant concluded that there are many recent references recommending that the dose of teicoplanin is adjusted based on the monitoring of blood levels and that the guidance in the proposed SPC provides a solid baseline for managing patients requiring teicoplanin.
Danish: Ansøgeren konkluderede, at der er mange nye referencer, som anbefaler, at teicoplanindosen justeres efter monitoreringen af blodniveauerne, og at vejledningen i det foreslåede produktresumé giver en korrekt baseline for håndteringen af patienter, der har behov for teicoplanin.
English: It was considered that Teicoplanin Hospira and Targocid are comparable in terms of overall active drug content, but differ in the composition of the TA-2 subcomponents, resulting in major objections.
Danish: Det blev vurderet, at Teicoplanin Hospira og Targocid er sammenlignelige, når det gælder det totale indhold af aktivt lægemiddel, men at de er forskellige med hensyn til sammensætningen af TA2underkomponenterne, hvilket gav anledning til væsentlige indsigelser.
English: The Applicant discussed the variation in subcomponent levels and stated that bioequivalence or essential similarity for Teicoplanin is best assessed by comparing the sum of free AUC/MIC for the subcomponents.
Danish: Ansøgeren redegjorde for variationen i underkomponentniveauerne og anførte, at teicoplanins bioækvivalens eller væsentlige lighed bedst kan vurderes ved at sammenligne summen af det frie AUC/MIC for underkomponenterne.
English: Due to the differences in systemic exposure between Teicoplanin Hospira and Targocid and because the effect of the subcomponent differences on tissue drug concentrations was not measured, the CHMP concluded that bioequivalence could not be demonstrated.
Danish: Som følge af forskellene på Teicoplanin Hospira og Targocid, hvad den systemiske eksponering angår, og fordi underkomponentforskellenes effekt på lægemidlets vævskoncentrationer ikke blev målt, konkluderede CHMP, at der ikke kunne påvises bioækvivalens.
English: The free drug AUC/MIC for the sum of TA2 subcomponents for Teicoplanin Hospira was within 2% of the Targocid value and the totality of the pre-clinical MIC studies combined with the mouse thigh study and the identical bactericidal serum titres give re-assurance that the microbiological activity of the two products is the same and that pharmacodynamically, the two products can be considered equivalent.
Danish: Det frie lægemiddels AUC/MIC for summen af TA2underkomponenterne for Teicoplanin Hospira lå inden for 2 % af Targocid-værdien, og de samlede prækliniske MIC-undersøgelser kombineret med lårundersøgelsen hos mus og det identiske baktericide serum giver sikkerhed for, at de to lægemidlers mikrobiologiske aktivitet er den samme, og at de to lægemidler kan betragtes som ækvivalente set ud fra et farmakodynamisk synspunkt.
English: Finally, the in vitro MIC studies performed by the Applicant are not sensitive enough to detect any differences between the two products since in vitro anti-bacterial activity is independent of lipophilicity, tissue distribution and clearance of the subcomponents.
Danish: Endelig er de MIC-undersøgelser in vitro, som ansøgeren har foretaget, ikke følsomme nok til at spore nogen forskelle på de to lægemidler, eftersom den antibakterielle aktivitet in vitro er uafhængig af underkomponenternes lipofilicitet, vævsdistribution og clearance.
English: The Applicant undertook an extensive testing program to characterise the activity of Teicoplanin Hospira versus Targocid against a series of clinically relevant species and demonstrated essential similarity between Teicoplanin Hospira and Targocid for all individual strains and species.
Danish: Ansøgeren iværksatte et omfattende testprogram for at bestemme Teicoplanin Hospiras aktivitet i forhold til Targocid over for en række klinisk relevante arter og påviste en væsentlig lighed mellem Teicoplanin Hospira og Targocid for alle individuelle stammer og arter.
English: The Applicant concluded that taking into account the teicoplanin subcomponents and their relative amounts, lipophilicity and MIC's, numerous experts believe that in a clinical setting, teicoplanin should be treated as a whole, regardless of the relative levels of subcomponents, due to the differences in PK characteristics being small.
Danish: Ansøgeren konkluderede, at når man tager teicoplanins underkomponenter og deres relative mængder, lipofilicitet og MIC'er i betragtning, er mange eksperter af den opfattelse, at teicoplanin i klinisk sammenhæng bør behandles som en helhed uanset de relative niveauer af underkomponenter, eftersom forskellene i de farmakokinetiske egenskaber er små.
English: The CHMP also noted that the PK parameters of the subcomponents are unknown in children and that composition differences may lead to more pronounced PK differences in children, as literature data indicates differences in PK properties in adults and children.
Danish: CHMP bemærkede ligeledes, at underkomponenternes farmakokinetiske parametre er ukendte hos børn, og at sammensætningsforskelle kan føre til mere udtalte farmakokinetiske forskelle hos børn, eftersom litteraturdata indikerer, at der er forskelle i de farmakokinetiske egenskaber hos voksne og børn.
English: The CHMP assessed the studies and concluded that the MIC results were similar between Teicoplanin Hospira and the originator and that no difference in antibacterial activity or in effectiveness was observed.
Danish: CHMP vurderede undersøgelserne og konkluderede, at MIC-resultaterne var næsten de samme for Teicoplanin Hospira og originallægemidlet, og at der ikke var observeret nogen forskelle i antibakteriel aktivitet eller virkning.
English: - Teicoplanin Hospira does not meet the originator specifications with respect to the individual glycopeptides subcomponents and has shown to be bio-inequivalent to the originator
Danish: - Teicoplanin Hospira opfylder ikke originallægemidlets specifikationer med hensyn til de enkelte glykopeptidunderkomponenter og har vist sig ikke at være bioækvivalent med originallægemidlet,
English: The CHMP acknowledges that the specifications of the innovator are confidential however, analysing innovator product batches will provide insight into the variability of innovator subcomponent levels and achieving specifications within this variability range would ensure equivalence.
Danish: CHMP anerkender, at originallægemidlets specifikationer er fortrolige, men en analyse af originallægemiddelbatcher vil give indsigt i variabiliteten i originallægemidlets underkomponentniveauer, og en opnåelse af specifikationerne inden for dette variabilitetsområde ville sikre ækvivalens.
English: The Applicant claimed essential similarity to the innovator product Targocid, despite acknowledging differences in the profile of glycopeptides.
Danish: Ansøgeren hævdede, at der var en væsentlig lighed med originallægemidlet Targocid, men anerkendte, at der var forskelle med hensyn til glykopeptidprofilen.
English: The Applicant conducted a bioequivalence study to provide further information on the PK/PD and to demonstrate similar safety and efficacy.
Danish: Ansøgeren foretog en bioækvivalensundersøgelse for at give yderligere oplysninger om farmakokinetik/farmakodynamik og for at påvise en lignende sikkerhed og virkning.
English: The Applicant then defined the active ingredient by referring to the INN and the pharmacopoeial monographs, concluding that Teicoplanin Hospira meets all of the criteria necessary to define it as a generic of the originator product.
Danish: Herefter definerede ansøgeren det aktive stof ved at henvise til det internationale fællesnavn og farmakopéernes monografier, og ansøgeren konkluderede, at Teicoplanin Hospira opfylder alle de kriterier, der er nødvendige for at definere det som en generisk form af originallægemidlet.
English: Accordingly, the Applicant argued that the sum of free AUC/MIC of the subcomponents is substantiating comparable activity between the generic and the innovator.
Danish: Følgelig fremførte ansøgeren, at summen af underkomponenternes frie AUC/MIC underbygger en sammenlignelig aktivitet mellem det generiske lægemiddel og originallægemidlet.
English: Therefore, PK/PD relationships for antimicrobials are based on free drug.
Danish: Derfor er de farmakokinetiske og farmakodynamiske forhold for antimikrobielle stoffer baseret på frit lægemiddel.
English: In addition, the use of MIC values from 1984 published data is not supported and correlating PK/PD with clinical outcome and the probability of achieving certain targets is not accepted for abridged products.
Danish: Hertil kommer, at brugen af MIC-værdier fra data offentliggjort i 1984 ikke er underbygget, og at sætte farmakokinetik og farmakodynamik i sammenhæng med det kliniske resultat og sandsynligheden for at nå visse mål er ikke accepteret for lægemidler under den forkortede procedure.
English: The results of the phase I study failed to demonstrate PK equivalence for total drug exposure.
Danish: Resultaterne af fase I-undersøgelsen kunne ikke påvise farmakokinetisk ækvivalens for den totale lægemiddeleksponering.
English: The Applicant stated that generic applicants do not have access to the specifications of the originator products and that it therefore attempted to develop an API containing subcomponents at levels similar to that seen in Targocid.
Danish: Ansøgeren gjorde opmærksom på, at ansøgere om markedsføringstilladelser for generiske lægemidler ikke har adgang til specifikationerne for originallægemidler, og at ansøgeren derfor forsøgte at udvikle et aktivt stof med underkomponenter, hvis niveauer svarer til Targocids.
English: However, AUC 0-tlast and AUC 0-inf were lower for Teicoplanin Hospira, indicating that PK equivalence was not shown for the total (bound plus unbound) drug exposure.
Danish: AUC 0-tlast og AUC 0-inf var dog lavere for Teicoplanin Hospira, hvilket indikerede, at den farmakokinetiske ækvivalens ikke var påvist for den totale lægemiddeleksponering (bundet og ubundet lægemiddel).
English: The CHMP was also of the opinion that the study conducted by the Applicant did not demonstrate bioequivalence between Teicoplanin Hospira and Targocid and that the MIC studies are not sensitive enough to detect differences between the two products in the case of teicoplanin, since in vitro anti-bacterial activity is independent of lipophilicity, tissue distribution and clearance of the subcomponents, i.e. differences in systemic exposure.
Danish: CHMP var ligeledes af den opfattelse, at den undersøgelse, som ansøgeren havde foretaget, ikke påviste bioækvivalens mellem Teicoplanin Hospira og Targocid, og at MIC-undersøgelserne ikke er følsomme nok til at spore forskelle mellem de to lægemidler i teicoplanins tilfælde, eftersom den antibakterielle aktivitet in vitro er uafhængig af underkomponenternes lipofilicitet, vævsdistribution og clearance, dvs. forskelle i den systemiske eksponering.
English: The CHMP was of the opinion that compliance with the specifications of the European Pharmacopoeia does not automatically imply that Teicoplanin Hospira is a generic of Targocid and maintained that demonstrating this is crucial for approval.
Danish: CHMP var af den opfattelse, at overensstemmelse med specifikationerne i Den Europæiske Farmakopé ikke automatisk betyder, at Teicoplanin Hospira er en generisk form af Targocid, og CHMP fastholdt, at en påvisning af dette er afgørende for at opnå godkendelse.
English: Protein binding was assessed, showing that the unbound fraction for each sub-component was essentially similar for Targocid and Teicoplanin Hospira and confirming that the individual protein binding values for the subcomponents did not vary with the different component composition.
Danish: Proteinbindingen blev vurderet og viste, at den ubundne fraktion for hver underkomponent i det væsentlige var ens for Targocid og Teicoplanin Hospira, og den bekræftede, at de enkelte proteinbindingsværdier for underkomponenterne ikke varierede med den forskellige komponentsammensætning.
English: The pharmacokinetics of teicoplanin has been determined for both the total complex and for the individual components and analyses of the subcomponents confirmed that the pharmacokinetics of the individual TA2 subcomponents are the same for Teicoplanin Hospira and Targocid.
Danish: Teicoplanins farmakokinetik er blevet fastlagt både for det totale kompleks og for de enkelte komponenter, og analyser af underkomponenterne bekræftede, at de enkelte TA2underkomponenters farmakokinetik er den samme for Teicoplanin Hospira og Targocid.
English: Content (concentration)
Danish: Styrke LægemiddelformIndgivelsesvej Indhold (koncentration)
English: The Applicant considers that the achieved product is in line with the published EDQM teicoplanin monograph, but stated that only the originator MAH was invited to comment on this monograph, and that comments submitted by Hospira were not accepted.
Danish: Ansøgeren er af den opfattelse, at det fremstillede lægemiddel er i overensstemmelse med den offentliggjorte EDQM-monografi for teicoplanin, men gjorde opmærksom på, at kun indehaveren af markedsføringstilladelsen for originallægemidlet blev opfordret til at kommentere denne monografi, og at bemærkninger fra Hospira ikke blev accepteret.
English: The CHMP requested the Applicant to further discuss their claim that Teicoplanin Hospira is a generic of Targocid.
Danish: CHMP bad ansøgeren om en yderligere redegørelse for påstanden om, at Teicoplanin Hospira er en generisk form af Targocid.
English: The nature of the active substance and the fermentation process used may lead to subcomponent differences, affecting the lipophilicity of the drug and as such the PK and indeed, the PK data indicates that for AUC, bioequivalence could not be shown.
Danish: Det aktive stofs karakter og den anvendte fermenteringsproces kan føre til underkomponentforskelle, der har indflydelse på lægemidlets lipofilicitet og dermed på farmakokinetikken, og de farmakokinetiske data indikerer da også, at bioækvivalensen ikke kunne påvises for AUC.
English: In conclusion, the CHMP noted that although complying with the European Pharmacopoeia monograph, the quality of Teicoplanin Hospira is different from the innovator subcomponents as Teicoplanin Hospira does not meet the originator specifications with respect to the individual glycopeptides subcomponents.
Danish: CHMP bemærkede således, at selv om Teicoplanin Hospira er i overensstemmelse med monografien i Den Europæiske Farmakopé, er Teicoplanin Hospiras kvalitet forskellig fra originallægemidlets underkomponenter, eftersom Teicoplanin Hospira ikke opfylder originallægemidlets specifikationer med hensyn til de enkelte glykopeptidunderkomponenter.
English: The Applicant considered that the PK results for whole teicoplanin demonstrated that Cmax and Tmax of Teicoplanin Hospira and Targocid were essentially similar, and the 90% CI for Cmax was within the acceptance range for bioequivalence.
Danish: Ansøgeren var af den opfattelse, at de farmakokinetiske resultater for det samlede teicoplanin viste, at Cmax og Tmax for Teicoplanin Hospira og Targocid i det væsentlige var ens, og at et konfidensinterval på 90 % for Cmax lå inden for det acceptable område for bioækvivalens.
English: The CHMP considers that with respect to pharmacodynamics, the study demonstrated that serum bactericidal activity was similar for both the Teicoplanin Hospira and Targocid and that the free drug proportion for each sub-component was similar for the two products.
Danish: CHMP er af den opfattelse, at hvad farmakodynamikken angår, viste undersøgelsen, at den serumbaktericide aktivitet var ens for både Teicoplanin Hospira og Targocid, og at den frie lægemiddelandel for hver underkomponent var næsten den samme for de to lægemidler.
English: The study concluded that the biological activity of Teicoplanin Hospira is equivalent to that of Targocid and therefore confirmed that the minor differences in the composition of individual active components of teicoplanin do not affect the biological activity.
Danish: Konklusionen på undersøgelsen var, at Teicoplanin Hospiras biologiske aktivitet svarer til Targocids, og undersøgelsen bekræftede således, at de små forskelle i sammensætningen af de enkelte aktive komponenter i teicoplanin ikke har indflydelse på den biologiske aktivitet.
English: The Applicant acknowledged that AUC 0-tlast and AUC 0-inf were below the accepted range, indicating that the two preparations were not PK equivalent for total drug exposure.
Danish: Ansøgeren erkendte, at AUC 0-tlast og AUC 0-inf lå under det accepterede område, hvilket indikerede, at de to lægemidler ikke var farmakokinetisk ækvivalente med hensyn til den totale lægemiddeleksponering.
English: teicoplanin formulation, bioequivalence should be shown as the supporting clinical data is not sensitive enough to detect differences between formulations.
Danish: For generiske lægemidler, herunder denne intravenøse teicoplaninformulering, bør bioækvivalens ikke påvises, eftersom de underbyggende kliniske data ikke er følsomme nok til at spore forskellene på formuleringerne.
English: As the additional non-clinical and serum bactericidal data submitted are not sufficient to adequately demonstrate that Teicoplanin Hospira is a generic of Targocid, the CHMP therefore maintained its previous opinion that the current application for this product is not approvable.
Danish: Eftersom de yderligere fremsendte ikke-kliniske data og data for den serumbaktericide aktivitet ikke var tilstrækkelige til at påvise, at Teicoplanin Hospira er en generisk form af originallægemidlet Targocid, fastholdt CHMP således sin tidligere holdning, nemlig at den aktuelle ansøgning for dette lægemiddel ikke kan godkendes.
English: The Applicant discussed the legal basis of their application, stating that it was accepted as such by the RMS and all other member states and considering that the requirements of this legal basis have been met.
Danish: Ansøgeren redegjorde for retsgrundlaget for virksomhedens ansøgning og anførte, at det var godkendt som sådant af referencemedlemsstaten og alle de andre medlemsstater.
English: The Applicant also discussed the data from the neutropenic mouse thigh infection study, arguing that the results clearly show that Teicoplanin Hospira and Targocid were equally effective in reducing bacterial count, confirming that the differences in relative composition of individual components do not affect the biological activity of the product.
Danish: Ansøgeren redegjorde ligeledes for dataene fra lårinfektionsundersøgelsen hos neutropeniske mus, og ansøgeren anførte, at resultaterne tydeligt viser, at Teicoplanin Hospira og Targocid var lige effektive til at reducere bakterieantallet, hvilket bekræfter, at forskellene i den relative sammensætning af de enkelte komponenter ikke har indflydelse på lægemidlets biologiske aktivitet.
English: The CHMP noted the neutropenic mouse study demonstrating efficacy in reducing bacterial count and demonstrating biological equivalence.
Danish: CHMP bemærkede, at undersøgelsen af neutropeniske mus viste en bakteriereducerende virkning og biologisk ækvivalens.
English: The mouse thigh infection model study was considered to be representative of deep seated infections and provides a comparison of the tissue penetration characteristics of Teicoplanin Hospira and Targocid.
Danish: Lårinfektionsundersøgelsen hos neutropeniske mus blev anset for at være repræsentativ for dybtliggende infektioner og giver en sammenligning af Teicoplanin Hospiras og Targocids vævspenetrationsegenskaber.