FrancophonIA/ELRC3.0 huggingface dataset:
English: Opinion following an Article 35 referral for all veterinary medicinal products containing active substances belonging to the class of flukicides for which no maximum residue limit has been established in milk and which are intended for use in ruminants EMA/759491/2012
Estonian: Arvamus pärast artikli 350F kohast esildist flukitsiidide klassi toimeaineid sisaldavate veterinaarravimite kohta, millel puuduvad jääkide piirnormid piimas ja mis on näidustatud kasutamiseks toidupiima tootvatel mäletsejatel EMA/759491/2012
English: The CVMP was therefore requested to give its opinion as to whether measures are necessary to ensure that the use, during the non-lactating period, of veterinary medicinal products containing clorsulon, closantel, nitroxinil, rafoxanide and triclabendazole, would not lead to residues in milk that, combined with residues of these flukicidal substances from other foodstuffs, would result in consumer exposure exceeding the acceptable daily intake.
Estonian: Sel põhjusel küsiti veterinaarravimite komitee arvamust, kas on vaja võtta meetmeid, millega tagada klorsulooni, klosanteeli, nitroksiniili, rafoksaniidi ja triklabendasooli sisaldavate veterinaarravimite (millel puuduvad jääkide piirnormid piimas) kasutamisel mittelakteerival perioodil jääkide selline kontsentratsioon piimas, mis ei ületaks koos flukitsiidijääkidega, mis pärinevad muudest toiduainetest, tarbijatel aktsepteeritavat ööpäevast kogust.
English: Oral explanations were given by a group of marketing authorisation holders on 8 February 2012.
Estonian: Teine müügiloa hoidjate rühm esitas suulised selgitused 8. veebruaril 2012.
English: The issues considered during the reexamination related to the recommended amendments of section 4.11 Withdrawal period(s) of the summaries of product characteristics for the veterinary medicinal products containing nitroxinil that are administered to cattle.
Estonian: Arvamuse taasläbivaatamise menetluses arutati toimeainet nitroksiniili sisaldavate, veistel kasutamiseks ette nähtud veterinaarravimite omaduste kokkuvõtte lõigu 4.11 „Keeluajad” soovitatavaid muudatusi.
English: On 14 June 2012 the CVMP adopted a final opinion confirming the recommendation, included in its opinion of 8 March 2012, that variations are necessary in the marketing authorisations for the veterinary medicinal products containing clorsulon, closantel, nitroxinil, rafoxanide or triclabendazole as a single active substance and for the veterinary medicinal products administered as pour-on to cattle containing triclabendazole and moxidectin in order to amend the summaries of product characteristics and package leaflets in line with recommended by the CVMP changes in the product information.
Estonian: 14. juunil 2012 võttis veterinaarravimite komitee vastu lõpliku arvamuse, mis kinnitas 8. märtsi 2012 arvamuses antud soovitust muuta ainsa toimeainena klorsulooni, klosanteeli, nitroksiniili, rafoksaniidi ja triklabendasooli sisaldavate veterinaarravimite ning triklabendasooli ja moksidektiini sisaldavate, veistel kasutamiseks ette nähtud kriipsulahuste ravimi omaduste kokkuvõtteid ning pakendi infolehti vastavalt veterinaarravimite komitee soovitatud tooteteabe muudatustele.
English: Based on the evaluation of the available data, the CVMP adopted, on 8 March 2012, an opinion recommending variations of the marketing authorisations for the veterinary medicinal products containing clorsulon, closantel, nitroxinil, rafoxanide or triclabendazole as a single active substance and for the veterinary medicinal products administered as pour-on to cattle containing triclabendazole and moxidectin.
Estonian: Olemasolevate andmete hindamise alusel võttis veterinaarravimite komitee 8. märtsil 2012 vastu arvamuse, milles soovitas muuta ainsa toimeainena klorsulooni, klosanteeli, nitroksiniili, rafoksaniidi ja triklabendasooli sisaldavate veterinaarravimite ning triklabendasooli ja moksidektiini sisaldavate, veistel kasutamiseks ette nähtud kriipsulahuste müügilubasid.
English: The detailed grounds for the re-examination request were submitted by MERIAL on 2 May 2012.
Estonian: 2. mail 2012 esitas MERIAL arvamuse taasläbivaatamise nõude üksikasjalikud põhjendused.
English: Opinion following an Article 351 referral for all veterinary medicinal products containing active substances belonging to the class of flukicides for which no maximum residue limit has been established in milk and which are intended for use in ruminants producing milk for human consumption
Estonian: kohast esildist flukitsiidide klassi toimeaineid sisaldavate veterinaarravimite kohta, millel puuduvad jääkide piirnormid piimas ja mis on näidustatud kasutamiseks toidupiima tootvatel mäletsejatel
English: The referral procedure was initiated on 13 December 2012.
Estonian: Esildismenetlus algas 13. detsembril 2012.
English: Additional supportive data
Estonian: Täiendavad toetavad andmed
English: • The Committee considered the referral under article 13(2) of Regulation No 1234/2008
Estonian: • inimravimite komitee arutas määruse (EÜ) nr 1234/2008 artikli 13 lõike 2 kohast esildist;
English: Study CT07
Estonian: Uuring CT07
English: As the reference and concerned Member States were not able to reach an agreement in respect of the variation, on 23 November 2012, Germany triggered a referral under Article 13 of Commission Regulation EC No 1234/2008.
Estonian: Et viiteliikmesriik ja asjaomased liikmesriigid ei jõudnud muudatuse osas kokkuleppele, algatas Saksamaa 23. novembril 2012 Euroopa Komisjoni määruse (EÜ) nr 1234/2008 artikli 13 kohase esildise.
English: Kantos Master has received marketing authorisation in the European Union through the Mutual Recognition Procedure (MRP).
Estonian: Kantos Master on saanud Euroopa Liidus müügiloa vastastikuse tunnustamise menetluse kaudu.
English: Global Strategy for Asthma Management and Prevention, Global Initiative for Asthma (GINA) 2011.
Estonian: 1 Global Strategy for Asthma Management and Prevention, Global Initiative for Asthma (GINA) 2011. http://www.ginasthma.org/
English: On the basis of the questions raised by Sweden the points to be considered by the CHMP were:
Estonian: Rootsi tõstatatud küsimuste alusel hindas inimravimite komitee järgmist:
English: Overall summary of the scientific evaluation of Kantos Master and associated names (see Annex I)
Estonian: Ravimi Kantos Master ja sarnaste nimetuste (vt I lisa) teadusliku hindamise üldkokkuvõte Taustteave
English: The concept of this “early intervention” is clearly advocated in the 2011 GINA guidelines1 where it is stated that “The benefit in preventing exacerbations appears to be the consequence of early intervention at a very early stage of a threatened exacerbation”.
Estonian: Varajase sekkumise ravikontseptsiooni soovitati selgesti ka GINA 2011. a ravijuhendis1, milles on öeldud, et „kasulikkus ägenemisjuhtude ennetamisena on seotud varajase sekkumisega eeldatava ägenemise väga varajases staadiumis”.
English: The similar particle size of the two components also leads to co-deposition in the same regions of the lung, favouring a synergistic interaction.
Estonian: Mõlema toimeaine sarnane osakeste suurus tagab samuti ravimi toimeainete ühise jõudmise samasse kopsupiirkonda, mis soodustab sünergistlikku koostoimet.
English: A post hoc analysis was conducted with two subgroups of patients in order to demonstrate that both groups of patients in the study CT07 were not overtreated or undertreated.
Estonian: Post hoc-analüüs korraldati kahes patsientide alamrühmas ja selle eesmärk oli tõendada, et uuringu CT07 kummagi rühma patsiendid ei olnud ala- ega üleravitud.
English: The disease severity was based on lung function (FEV1) and use of rescue medication at entry to the study.
Estonian: Haiguse raskuse hinnang põhines kopsutalitluse (FEV1) ja leevendusravimi kasutamisel enne uuringu algust.
English: However, it has never been demonstrated that a small increase in total ICS dose would have an impact on the lung function or on the clinical outcomes.
Estonian: Samas ei ole näidatud, et inhaleeritava kortikosteroidi üldannuse väike suurenemine mõjutaks kopsutalitlust või ravi kliinilist tulemust.
English: On 20 January 2012, the MAH submitted a type II variation via the MRP for Kantos Master and associated names (DE/H/0873/001/II/024), to request the inclusion of “Maintenance and reliever therapy taken as regular maintenance treatment and as needed in response to asthma symptoms”.
Estonian: 20. jaanuaril 2012 esitas müügiloa hoidja ravimi Kantos Master ja sarnaste nimetuste vastastikuse tunnustamise menetluse kaudu II tüüpi muudatuse taotluse (DE/H/0873/001/II/024), et lisada ravimile näidustus „astma säilitus- ja leevendusravi kasutamisel tavapärase säilitusravina ning vajaduse korral astmasümptomite tekkimisel”.
English: This comparability has also been confirmed in a comparative clinical study between Kantos Master and associated names (Foster 10/6) and Symbicort 200/6 (budesonide/formoterol)3.
Estonian: Seda võrreldavust on kinnitanud ka ravimit Kantos Master ja sarnaseid nimetusi (Foster 10/6) ning ravimit Symbicort 200/6 (budesoniid/formoterool) võrrelnud kliiniline uuring3.
English: Although a reduction to the mean ICS dose was observed in patients at entry to the study, the results showed that the mean FEV1 improved in both groups of patients during the run-in period and further improvement were observed during the 48-week treatment period, with a change from baseline to the end of the study of about 100mL in both groups.
Estonian: Kuigi uuringusse kaasamisel täheldati patsientidel inhaleeritava kortikosteroidi keskmise annuse vähenemist, näitasid uuringu tulemused, et keskmine FEV1 paranes mõlemas patsiendirühmas juba uuringu alguses ja edasist paranemist täheldati kogu 48-nädalase raviperioodi vältel, kusjuures muutus võrreldes lähtetasemega oli uuringu lõpus mõlemas ravirühmas u 100 ml.
English: In both more severe (defined by FEV1 < 70%) and less severe groups (FEV1 ≥ 70%), Kantos Master in MART was significantly efficacious (similar hazard ratio of 0.65 and 0.61, respectively).
Estonian: Nii raske (määratletud kui FEV1 <70%) kui ka vähem raske (FEV1 ≥70%) astmaga patsientide alamrühmades oli ravimi Kantos Master MARTraviskeem oluliselt efektiivne (riskisuhe vastavalt 0,65 ja 0,61).
English: • The Committee is of the opinion that the data of the pivotal study CT07 indicated a significant reduction in the risk of severe exacerbations of asthma and significant longer time to exacerbation can be obtained when Kantos Master dose is given as needed.
Estonian: • komitee on arvamusel, et keskne registreerimisuuring CT07 näitas astma raskete ägenemisjuhtude riski olulist vähenemist ja oluliselt pikemat aega ägenemise tekkeni ravimi Kantos Master annuse võtmisel vajaduse järgi;
English: Therefore, the CHMP recommended the granting of the variation to the terms of the marketing authorisations for the medicinal products referred to in Annex I for which the valid Summary of Product Characteristics, labelling and package leaflet remain as per the final versions achieved during the Coordination group procedure as mentioned in Annex III.
Estonian: soovitas inimravimite komitee muuta I lisas nimetatud ravimite müügilubade tingimusi, mille jaoks lepiti koordineerimisrühma menetluses kokku ravimi omaduste kokkuvõtte, märgistuse ja pakendi infolehe lõplikud versioonid, mis on esitatud III lisas.
English: In addition, both components have been developed as an extrafine formulation, which means they reach the most peripheral airways where most of the inflammatory process takes place during asthma exacerbation.
Estonian: Peale selle on mõlemad toimeained välja töötatud ülipeene ravimvormina, st mõlemad toimeained jõuavad kuni kõige perifeersemate hingamisteedeni, kus esineb astma ägenemise korral põletikust enamik.
English: It was also observed that the group of patients using Kantos Master as reliever took on average approximately 80µg more of BDP per day which is equivalent to less than one extra inhaler actuation per day.
Estonian: Samuti leiti uuringus, et patsiendid, kes kasutasid leevendusravimina Kantos Masterit, vajasid u 80 µg/d rohkem beklometasoondipropionaati, mis vastab vähem kui ühele täiendavale ravimi inhalatsiooniannusele ööpäevas.
English: Post hoc analysis of data from study CT07
Estonian: Uuringu CT07 post hoc-analüüs
English: To further demonstrate that the patients in the MART treatment arm were not overtreated or undertreated and to support the results of the study CT07, the MAH conducted post hoc analysis of data and made reference to additional supportive data.
Estonian: Tõendamiseks, et MART-raviskeemi rühma patsiendid ei olnud ala- ega üleravitud, ja uuringu CT07 tulemuste kinnitamiseks korraldas müügiloa hoidja uuringuandmete post hoc-analüüsi ning viitas täiendavatele toetavatele andmetele.
English: Kantos Master in MART was also significantly efficacious regarding the mean number of rescue medication at entry to the study (>0 and ≤1, >1 and ≤2, and >2) in the three groups (similar hazard ratio of 0.51, 0.64 and 0.52, respectively).
Estonian: Ravimi Kantos Master MARTraviskeem oli efektiivne ka enne uuringut kasutatud keskmise ööpäevase leevendusravimi annuste alusel määratletud kolmes patsiendirühmas (>0 ja ≤1; >1 ja ≤2; >2) (sarnane riskisuhe vastavalt 0,51, 0,64 ja 0,52).
English: In the Symbicort MART development program, marked improvements in asthma control have been obtained when part of the dose was given on an as-needed basis.
Estonian: Symbicorti MART-raviskeemi kliinilise arenduse programmis saavutati astma ohjamise oluline paranemine, kui osa annusest manustati vajaduse järgi.
English: These results were irrespective of the type of fixed ICS/LABA comparator (budesonide/formoterol or salmeterol/fluticasone), and irrespective of whether the maintenance dose of the comparator was similar or up to two fold higher.
Estonian: Need tulemused ei sõltunud võrdluseks kasutatud fikseeritud annusega inhaleeritava kortikosteroidi ja pikatoimelise β2-agonisti kombinatsioonravimi tüübist (budesoniid/formoterool või salmeterool/flutikasoon) ega sellest, kas võrdlusravimi säilitusannus oli sama või kuni kaks korda suurem.
English: Significant improvements were also observed in the secondary efficacy variables (Forced Expiratory Volume in the 1st second (FEV1), asthma symptoms, medication free days etc.) in both treatment arms.
Estonian: Olulist paranemist täheldati mõlemas ravirühmas ka sekundaarsete efektiivsuse näitajate osas (ühe sekundi forsseeritud ekspiratoorne maht (FEV1), astmasümptomite esinemine, leevendusravimita päevad jt).
English: Kantos Master is a fixed-dose combination (FDC) of the inhaled corticosteroid (ICS) beclometasone diproprionate (BDP) and the long-acting beta2-agonist (LABA) formoterol fumarate (FF) which is indicated as regular maintenance treatment of asthma administrated twice daily.
Estonian: Kantos Master on inhaleeritava kortikosteroidi (ICS) beklometasoondipropionaadi (BDP) ja pikatoimelise β2-agonisti (LABA) formoteroolfumaraadi (FF) fikseeritud annustega kombinatsioonravim, mis on näidustatud astma tavapäraseks säilitusraviks manustatatuna kaks korda ööpäevas.
English: Moreover, the onset of action of formoterol as a bronchodilator is faster compared to other LABAs such as salmeterol, and is therefore well suited for the acute relief of bronchospasm.
Estonian: Bronhodilataatorina algab formoterooli toime kiiremini kui teistel pikatoimelistel β2-agonistidel, näiteks salmeteroolil, mistõttu sobib formoterool hästi brohospasmi akuutseks raviks.
English: Both components (BDP and FF) have been shown to be effective in the case of asthma exacerbation due to their anti-inflammatory and bronchodilating effects, and their effects are enhanced if they are administered in combination.
Estonian: Ravimi mõlema toimeaine (beklometasoondipropionaat ja formoteroolfumaraat) osas on tõendatud, et need on astma ägenemisjuhtude korral efektiivsed põletikuvastase ja bronhe laiendava toime tõttu ning et nende toime on tugevam, kui neid manustatakse kombinatsioonina.
English: A further additional analysis of the study CT07 has been conducted in patients with severe asthma as it was considered that if under-treatment with Kantos Master in MART occurred, it should be most evident in this population who requires higher ICS doses to control their asthma.
Estonian: Uuringut CT07 analüüsiti ka raske astmaga patsientide osas, sest eeldati, et kui ravimiga Kantos Master toimunud MART-raviskeemi korral esines patsientide alaravimist, oleks see pidanud kõige enam avalduma selles patsiendipopulatsioonis, kes vajavad astma ohjamiseks inhaleeritava kortikosteroidi suuremaid annuseid.
English: As Kantos Master contain formoterol and beclometasone, and in view of the results of the submitted study, the Committee considered the published data to be relevant in the applied regimen.
Estonian: Et Kantos Master sisaldab toimeainetena formoterooli ja beklometasooni ning arvestades esitatud uuringutulemusi, järeldas inimravimite komitee, et avaldatud andmed on taotletava raviskeemi korral asjakohased.
English: This additional analysis further demonstrated that Kantos Master in MART is not associated with under-treatment of patients in case of uncontrolled asthma.
Estonian: See täiendav analüüs näitas, et ravimi Kantos Master MART-raviskeem ei ole seotud ohjamata astmaga patsientide alaravimisega.
English: The patients enrolled in this study were being treated with a higher mean ICS dose at entry to the study (between 700µg and 1100µg, expressed as labelled or BDP equivalent dose respectively) than during the clinical study (ICS dose in the group taking Kantos Master as reliever and in the group taking salbutamol was respectively about 701.2 µg/day and 488.8 µg/day, always given as part of an ICS-LABA combination).
Estonian: Uuringus osalenud patsiendid said enne uuringu algust ravi inhaleeritava kortikosteroidi suurema keskmise annusega (700…1100 µg, väljendatud ravimi märgistusel oleva annusena või ekvivalentse beklometasoondipropionaadi annusena) kui kliinilises uuringus (inhaleeritava kortikosteroidi annus (mida alati manustati inhaleeritava kortikosteroidi ja pikatoimelise β2-agonisti kombinatsioonina) patsientidel, kes kasutasid leevendusravimina Kantos Masterit või salbutamooli, oli vastavalt 701,2 µg/d ja 488,8 µg/d).
English: The CHMP was therefore of the opinion that the effectiveness of Kantos Master in MART was not due to a potential under-treatment of the comparator arm in the study CT07, and that the maintenance administration of Kantos Master at one inhalation twice daily had a clinically significant benefit in these patients.
Estonian: Inimravimite komitee oli seepärast arvamusel, et ravimi Kantos Master MART-raviskeemi efektiivsus ei tulenenud võrdlusrühma võimalikust alaravimisest uuringus CT07 ja säilitusravi Kantos Masteri annusega üks inhalatsioon kaks korda ööpäevas oli uuringus osalenud patsientidel kliiniliselt oluliselt kasulik.
English: The daily maintenance dose, in both arms of the study was 200µg of extrafine beclometasone, which is clinically equivalent to 500µg of non extrafine beclometasone.
Estonian: Säilitusannus oli mõlemas uuringurühmas 200 µg/d ülipeente osakestega beklometasooni, mis on kliiniliselt ekvivalentne 500 µg/d mitteülipeente osakestega beklometasooniga.
English: Literature data
Estonian: Kirjandusandmed
English: The CHMP noted that there was no comparison with the standard of care, according to the GINA guideline.
Estonian: Inimravimite komitee märkis, et uuringus puudus võrdlus GINA ravijuhendile vastava standardraviga.
English: However, the Committee agreed that there was no evidence that patients in the comparator group were under-treated as patients in both group had shown clinical benefit from their maintenance treatment.
Estonian: Samas leidis komitee, et võrdlusrühma patsiente ei saanud pidada alaravituteks, sest mõlema uuringurühma patsientidel täheldati säilitusravi kliinilist kasulikkust.
English: Therefore, the CHMP considered that the positive therapeutic effect of MART with Kantos Master has been demonstrated in patients who had a reduction in the daily ICS dose and in patients who did not have any step down treatment (i.e. the subgroup of patients taking up to 500 µg daily at entry and during treatment).
Estonian: Inimravimite komitee järeldas seepärast, et MART-raviskeemi positiivne toime ravimi Kantos Master korral on tõendatud nii patsientidel, kelle inhaleeritava kortikosteroidi ööpäevast annust oli juba varem vähendatud, kui ka patsientidel, kellel ei olnud ravi intensiivsust vähendatud (st patsientidel, kes enne uuringut ja uuringu ajal said inhaleeritavat kortikosteroidi ≤500 µg/d).
English: The data from the main pivotal study that were submitted with the application to support safety and efficacy of Kantos Master for the maintenance and reliever therapy taken as regular maintenance treatment and as needed in response to asthma symptoms have not demonstrated that the MART treatment regimen was non-inferior to standard of care treatment, as the control group did not actually receive treatment according to standard of care.
Estonian: Koos muudatustaotlusega esitati ravimi Kantos Master ohutuse ja efektiivsuse toetuseks näidustusel „astma säilitus- ja leevendusravi kasutamisel tavapärase säilitusravina ning vajaduse korral astmasümptomite tekkimisel” põhilise keskse registreerimisuuringu andmed, kuid need ei näidanud, et säilitus- ja leevendusravi raviskeem ei oleks halvem kui standardravi, sest uuringu kontrollrühm ei saanud tegelikult standardravi nõuete kohast ravi.
English: Therefore, the CHMP was of the opinion that the positive effect of Kantos Master on exacerbations was not achieved through a simple increase in daily ICS dose but with the timely delivery of a small dose of BDP together with the bronchodilator, when patient's symptoms worsened.
Estonian: Inimravimite komitee oli seepärast arvamusel, et ravimi Kantos Master positiivne toime astma ägenemisjuhtudele tulenes mitte lihtsalt inhaleeritava kortikosteroidi ööpäevase annuse suurenemisest, vaid patsiendi seisundi halvenemisel beklometasoondipropionaadi väikese annuse õigeaegsest manustamisest koos brohodilataatoriga.
English: • The Committee reviewed all available data, to support the safety and efficacy of Kantos Master and associated names for “maintenance and reliever therapy taken as regular maintenance treatment and as needed in response to asthma symptoms”.
Estonian: • komitee vaatas läbi kõik olemasolevad andmed ravimi Kantos Master ja sarnaste nimetuste ohutuse ja efektiivsuse kohta näidustusel „astma säilitus- ja leevendusravi kasutamisel tavapärase säilitusravina ning vajaduse korral astmasümptomite tekkimisel”;
English: • The Committee concluded, in view of available data that the benefit/risk of Kantos Master and associated names for “maintenance and reliever therapy taken as regular maintenance treatment and as needed in response to asthma symptoms” is positive.
Estonian: • komitee järeldas olemasolevate andmete alusel, et ravimi Kantos Master ja sarnaste nimetuste kasulikkuse ja riski suhe näidustusel „astma säilitus- ja leevendusravi kasutamisel tavapärase säilitusravina ning vajaduse korral astmasümptomite tekkimisel” on positiivne,
English: The CHMP considered that the data provided by the MAH are sufficient to support the use of Kantos Master and associated names in the maintenance and reliever therapy (MART) taken as regular maintenance treatment and as needed in response to asthma symptom.
Estonian: Inimravimite komitee järeldas, et müügiloa hoidja esitatud andmed on piisavad, et toetada ravimi Kantos Master ja sarnaste nimetuste kasutamist astma säilitus- ja leevendusravis (nn MARTraviskeem) kasutamisel tavapärase säilitusravina ning vajaduse järgi astmasümptomite tekkimisel.
English: The results demonstrated that MART with Kantos Master was significantly superior to salbutamol in prolonging the time to first severe exacerbations and in reducing the mean yearly rate of severe exacerbations in both subgroups of patients.
Estonian: Analüüsi tulemuste järgi oli MARTraviskeem ravimiga Kantos Master astma esimese ägenemisjuhu tekkeni kuluva aja pikendamisel ja astma raskete ägenemisjuhtude keskmise aastase esinemissageduse vähendamisel oluliselt parem kui salbutamool patsientide mõlemas alamrühmas.