FrancophonIA/ELRC3.0 huggingface dataset:
English: Both registries were part of the risk management plan (RMP) of the respective products.
Danish: Begge registre indgik i risikostyringsplanen for de pågældende lægemidler.
English: RODIN/PedNet study
Danish: RODIN/PedNet undersøgelsen
English: The amendments to the relevant sections of the Summary of Product Characteristics and package leaflet are set out in Annexes I and III.
Danish: Ændringerne af de pågældende afsnit i produktresuméet og indlægssedlen fremgår af bilag I og III.
English: EUHASS study
Danish: EUHASS-undersøgelsen
English: • Quality data
Danish: • Data vedrørende kvalitet
English: Therefore, the European Commission (EC) initiated a procedure under Article 20 of Regulation (EC) No 726/2004 and requested the Agency to assess available data and its impact on the benefit-risk balance of the medicinal products concerned and to give its opinion as to whether the marketing authorisations should be maintained, varied, suspended or revoked.
Danish: Europa-Kommissionen indledte derfor en procedure i henhold til artikel 20 i forordning (EF) nr. 726/2004 og anmodede agenturet om at vurdere de foreliggende data og deres betydning for benefit/risk-forholdet for de pågældende lægemidler og fremsætte en udtalelse om, hvorvidt markedsføringstilladelserne burde opretholdes, ændres, suspenderes eller inddrages.
English: Annex IV Scientific conclusions and grounds for variation to the terms of the marketing authorisations
Danish: Bilag IV Videnskabelige konklusioner og begrundelse for ændring af betingelserne for markedsføringstilladelserne
English: - the RODIN (Research of Determinants of Inhibitor development)/PedNet registry; and
Danish: - RODIN-registeret (Research of Determinants of Inhibitor development)/PedNet registry, og
English: One patient was lost to follow up and one patient developed a low-titre inhibitor during post study follow-up.
Danish: Én patient var tabt for opfølgning, og én patient dannede inhibitor med lav titer under opfølgningen efter undersøgelsen.
English: The PRAC noted that all parameters were within specification and that there is no correlation between changes and inhibitor events.
Danish: PRAC konstaterede, at alle parametre var inden for specifikationen, og at der ikke var nogen korrelation mellem ændringerne og hændelserne med inhibitorer.
English: • Observational studies
Danish: • Observationsundersøgelser
English: In this study, the incidence of inhibitor development ranged from 28.2% to 37.7% for all FVIII products.
Danish: I denne undersøgelse var forekomsten af inhibitordannelse mellem 28,2 % og 37,7 % for alle FVIII-lægemidler.
English: These studies were either sponsored or supported by the MAH.
Danish: Disse undersøgelser var enten sponsoreret eller støttet af indehaveren af markedsføringstilladelsen.
English: Overall summary of the scientific evaluation of Kogenate Bayer and Helixate NexGen
Danish: Samlet resumé af den videnskabelige vurdering af Kogenate Bayer og Helixate NexGen
English: The EUHASS study was established in 2008 as an adverse event reporting system for patients with inherited bleeding disorders, including Haemophilia A, in Europe.
Danish: EUHASS-undersøgelsen blev igangsat i 2008 som en ordning til bivirkningsindberetning for patienter med medfødte blødningsforstyrrelser, herunder hæmofili A, i Europa.
English: The PRAC noted that the Factor VIII gene mutation profile of these study population (in studies 200021EU and 100074US) reflects the typical distribution seen in patients with severe haemophilia A, indicating that there was no bias in patient recruitment.
Danish: PRAC bemærkede, at faktor VIII-genmutationsprofilen for patientpopulationen i disse undersøgelser (200021EU og 100074US) afspejler den typiske fordeling hos patienter med svær hæmofili A som tegn på, at der ikke var skævhed i patientrekrutteringen.
English: Development of inhibitors against FVIII is the most significant complication of replacement therapy for haemophilia A. These antibodies inactivate the pro-coagulant activity of FVIII and inhibit patients' response to FVIII replacement therapy which may result in life-threatening bleedings and sequelae.
Danish: Dannelse af inhibitorer af FVIII er den vigtigste komplikation ved substitutionsbehandling af hæmofili A. Disse antistoffer inaktiverer den prokoagulante aktivitet af FVIII og hæmmer patientens respons på FVIII-substitutionsbehandling, hvilket kan medføre livstruende blødninger og sequelae.
English: In 2006, an EMA expert meeting1 on FVIII products and inhibitor development concluded that there was a need to collect comparable clinical data on the immunogenicity of recombinant and plasmaderived FVIII products as a long-term objective.
Danish: I 2006 konkluderedes det på et EMA-ekspertmøde1 om FVIII-lægemidler og dannelse af inhibitorer, at der som langsigtet målsætning var behov for at indsamle sammenlignelige kliniske data om immunogeniciteten af rekombinante og plasmaderiverede FVIII-lægemidler.
English: In addition, upon request from the PRAC, the MAH provided analyses of the overall results on the observed inhibitor incidence in the light of the study design and patient selection.
Danish: På anmodning af PRAC forelagde indehaveren af markedsføringstilladelsen desuden analyser af de samlede resultater vedrørende den iagttagne forekomst af inhibitorer på baggrund af undersøgelsernes design og patientudvælgelse.
English: According to the MAH, since the Marketing Authorisations, 42 changes in the manufacturing process of KOGENATE Bayer have been introduced.
Danish: Ifølge indehaveren af markedsføringstilladelsen at der er siden udstedelse af markedsføringstilladelsen foretaget 42 ændringer i fremstillingsprocessen for KOGENATE Bayer.
English: As a consequence, the marketing authorisation holder (MAH) for Kogenate Bayer and Helixate NexGen supported two EU registries:
Danish: Indehaveren af markedsføringstilladelsen for Kogenate Bayer og Helixate NexGen støttede derfor to EU-registre:
English: Overall, 9 out of 60 (15%) developed inhibitors.
Danish: I alt var der inhibitordannelse hos 9 ud af 60 (15 %).
English: In support of the above mentioned clinical data, the MAH provided information with regards to the manufacturing process (i.e. growth condition, purification) of Kogenate Bayer /Helixate Nexgen and discussed any change which took place since the studies 200021EU and 100074US.
Danish: Til støtte for ovennævnte kliniske data fremlagde indehaveren af markedsføringstilladelsen oplysninger om fremstillingsprocessen (dvs. vækstbetingelser og oprensning) for Kogenate Bayer og Helixate NexGen og redegjorde for alle ændringer, der har fundet sted siden undersøgelse 200021EU og 100074US.
English: Following the provisions under Article 20 of Regulation (EC) No 726/2004, the CHMP, having considered the PRAC recommendation dated 5 December 2013, is of the opinion that the marketing authorisations for Kogenate Bayer and Helixate NexGen should be varied as recommended by the PRAC.
Danish: I henhold til bestemmelserne i artikel 20 i forordning (EF) nr. 726/2004 og efter gennemgang af PRAC's anbefaling af 5. december 2013 er CHMP af den opfattelse, at markedsføringstilladelserne for Kogenate Bayer og Helixate NexGen bør ændres som anbefalet af PRAC.
English: Haemophilia centres in Western Europe and major haemophilia centres in North America enrolled a total of 60 PUPs/MTPs without pre-existing inhibitors in two studies (200021EU and 100074US).
Danish: Hæmofilicentre i Vesteuropa og større hæmofilicentre i Nordamerika indrullerede i alt 60 tidligere ubehandlede patienter/minimalt behandlede patienter uden præeksisterende inhibitorer i to undersøgelser (200021EU og 100074US).
English: • The PRAC considered the procedure under Article 20 of Regulation (EC) No 726/2004 for Kogenate Bayer and Helixate NexGen.
Danish: • PRAC behandlede proceduren i henhold til artikel 20 i forordning (EF) nr. 726/2004, for Kogenate Bayer og Helixate NexGen,
English: In patients given KOGENATE Bayer/Helixate NexGen, 64 out of 183 developed an inhibitor (37.7%), of which 40 had a high-titre inhibitor (25.2%).
Danish: Hos patienter, der fik Kogenate Bayer og Helixate NexGen, dannede 64 ud af 183 inhibitor (37,7 %), heraf dannede 40 inhibitor med høj titer (25,2 %).
English: These two interventional studies were carried out as prospective, uncontrolled trials, for treatment of bleeding episodes in 37 PUPs and 23 MTPs with residual FVIII:C < 2 IU/dl.
Danish: Begge undersøgelser var interventionelle, prospektive, ukontrollerede undersøgelser vedrørende behandling af blødningsepisoder hos 37 tidligere ubehandlede patienter og 23 minimalt behandlede patienter med tilbageværende FVIII:C < 2 IE/dl.
English: • The PRAC considered though that the frequency for inhibitor development in PUPs should be amended from “common” to “very common” in the section 4.8 of the SmPC and also recommended that the product information should be updated to reflect the most recent results from the RODIN study.
Danish: • PRAC fandt imidlertid, at den angivne hyppighed af inhibitordannelse hos tidligere ubehandlede patienter i afsnit 4.8 af produktresuméet burde ændres fra “almindelig” til “meget almindelig”, og anbefalede desuden, at produktinformationen ajourføres, så den afspejler de seneste resultater fra RODIN-undersøgelsen,
English: Five out of 37 (14%) PUP and 4 out of 23 (17%) MTP patients treated with Helixate NexGen developed inhibitors within 20 ED (exposure days).
Danish: 5 ud af 37 (14 %) tidligere ubehandlede patienter og 4 ud af 23 (17 %) minimalt behandlede patienter, der var behandlet med Helixate NexGen, dannede inhibitor i løbet af 20 eksponeringsdage.
English: The PRAC was of the view that the available data are consistent with the general experience that most inhibitors develop within the first 20 EDs and that the overall data does not provide evidence that factor VIII products differ from each other in terms of inhibitor development in PUPs.
Danish: PRAC fandt, at de foreliggende data stemte overens med de almindelige erfaringer, nemlig at de fleste inhibitorer dannes i løbet af de første 20 eksponeringsdage, og at de samlede data ikke giver evidens for indbyrdes forskelle mellem faktor VIII-lægemidler, hvad angår inhibitordannelse hos tidligere ubehandlede patienter.
English: In this context, the PRAC noted that Kogenate Bayer and Helixate Nexgen is potency labelled based on an one-stage clotting assay, in accordance with the approved quality documentation for the product, and not the chromogenic assay as per the European Pharmacopeia.
Danish: I denne forbindelse bemærkede PRAC, at potensmærkningen af Kogenate Bayer og Helixate NexGen sker på grundlag af et ettrins-koagulationsassay i henhold til den godkendte dokumentation af produktets kvalitet, ikke det kromogene assay i henhold til den europæiske Farmakopé.
English: • MAH sponsored and supported clinical trials
Danish: • Kliniske undersøgelser, der er sponsoreret og støttet af indehaveren af markedsføringstilladelsen
English: In one observational study, the incidence of inhibitor development in previously untreated patients with severe haemophilia A was 64/183 (37.7%) with Helixate NexGen (followed up to 75 exposure days).
Danish: I en observationsundersøgelse forekom inhibitordannelse hos tidligere ubehandlede patienter med svær hæmofili A hos 64/183 (37 og 7 %) med Helixate NexGen (ved opfølgning indtil 75 eksponeringsdage).
English: Finally in support of the above mentioned clinical data, the MAH provided quality data with regards to the manufacturing process for Kogenate Bayer and Helixate Nexgen.
Danish: Til støtte for ovennævnte kliniske data forelagde indehaveren af markedsføringstilladelsen endelig data vedrørende kvalitet i forbindelse med fremstillingsprocessen for Kogenate Bayer og Helixate NexGen.
English: Post-hoc analysis of the RODIN study showed that PUPs with severe haemophilia A given Kogenate Bayer were more likely to develop inhibitor than those given another recombinant antihaemophilic factor VIII (adjusted hazard ratio, 1.60; 95%-CI: 1.08 -2.37).
Danish: Post hoc-analyse af RODIN-undersøgelsen viste, at de tidligere ubehandlede patienter med svær hæmofili A, der fik Kogenate Bayer, var mere tilbøjelige til inhibitordannelse end de, der fik en anden rekombinant antihæmofilifaktor VIII (justeret risikoforhold 1,60; 95 % SI: [1,08; 2,37]).
English: No update of the RMP was considered necessary by the PRAC.
Danish: PRAC fandt det ikke nødvendigt at ajourføre risikostyringsplanen.
English: However, the data presented by the MAH indicate that there are no significant changes in the posttranslational modifications, aggregation profile, specific activity or excipients since MA of Kogenate Bayer that might have increased the risk for inhibitor development over time.
Danish: De data, der er forelagt af markedsføringstilladelsesindehaveren, viser imidlertid, at der efter udstedelsen af markedsføringstilladelsen for Kogenate Bayer ikke har været nævneværdige ændringer i posttranslationelle ændringer, aggregationsprofil, specifik aktivitet eller hjælpestoffer, som kan have øget risikoen for gradvis inhibitordannelse.
English: The objective of the RODIN/Pednet study was to examine the inhibitor development in PUPs with severe haemophilia A given recombinant or plasma-derived FVIII products.
Danish: RODIN/PedNet-undersøgelsen vedrørte inhibitordannelsen hos tidligere ubehandlede patienter med svær hæmofili A, der fik rekombinante eller plasmaderiverede FVIII-lægemidler.
English: In view of the above, the PRAC agreed that the current evidence does not confirm an increased risk of developing antibodies against Kogenate Bayer and Helixate NexGen when compared with other factor VIII products in PUPs with the bleeding disorder haemophilia A. However the PRAC considered that the frequency for inhibitor development in PUPs should be amended from “common” to “very common” in the section 4.8 of the SmPC and also recommended that the product information should be updated with results from the RODIN study as part of the routine risk minimisation activities.
Danish: På ovenstående baggrund fandt PRAC, at den nuværende evidens ikke bekræfter en højere risiko for dannelse af antistoffer mod Kogenate Bayer og Helixate NexGen end mod andre faktor VIII-lægemidler hos ikke tidligere behandlede patienter med blødningsforstyrrelsen hæmofili A. PRAC fandt imidlertid at angivelsen af hyppigheden af inhibitordannelse hos ikke tidligere behandlede patienter i afsnit 4.8 i produktresuméet burde ændres fra “almindelig” til “meget almindelig”, og anbefalede, at produktoplysningerne endvidere ajourføres med resultater fra RODIN-undersøgelsen som led i de rutinemæssige risikominimeringsaktiviteter.
English: The CHMP considered the below PRAC recommendation dated 5 December 2013 with regards to the procedure under Article 20 of Regulation (EC) No 726/2004 for Kogenate Bayer and Helixate NexGen.
Danish: CHMP behandlede nedenstående anbefaling af 5. december 2013 fra Det Rådgivende Udvalg for Risikovurdering inden for Lægemiddelovervågning (PRAC) vedrørende proceduren i henhold til artikel 20 i forordning (EF) nr. 726/2004 for Kogenate Bayer og Helixate NexGen.
English: Kogenate Bayer and Helixate NexGen are full-length recombinant human antihaemophilic factor VIII (octocog alfa) produced in baby hamster kidney (BHK) cells.
Danish: Kogenate Bayer og Helixate NexGen er rekombinant human antihæmofilifaktor VIII af fuld længde (octocog alfa), der produceres i nyreceller fra nyfødte hamstere.
English: • The PRAC noted that the efficacy of Kogenate Bayer/Helixate NexGen is not questioned and, on the basis of the available data, concluded that the current results do not confirm an increased risk of developing antibodies against Kogenate Bayer and Helixate NexGen when compared with other factor VIII products in PUPs with the bleeding disorder haemophilia A.
Danish: • PRAC bemærkede, at virkningen af Kogenate Bayer og Helixate NexGen ikke er draget i tvivl, og konkluderede af de foreliggende data, at de nuværende resultater ikke bekræfter en højere risiko for dannelse af antistoffer mod Kogenate Bayer og Helixate NexGen end over for andre faktor VIII-lægemidler hos tidligere ubehandlede patienter med blødningsforstyrrelsen hæmofili A,
English: Kogenate Bayer/Helixate NexGen are indicated for treatment and prophylaxis of bleeding in patients with hemophilia A (congenital factor VIII deficiency).
Danish: Kogenate Bayer og Helixate NexGen er indiceret til behandling og forebyggelse af blødning hos patienter med hæmofili A (kongenit faktor VIII-mangel).
English: The MAH will continue to support the RODIN/PedNet registry as well as the EUHASS registry, as per current obligations defined in the RMP, to further investigate individual risk factors for inhibitor development and risk mitigation in PUPs.
Danish: Indehaveren af markedsføringstilladelsen skal fortsat støtte RODIN/PedNet-registeret samt EUHASSregisteret i overensstemmelse med de gældende forpligtelser i risikostyringsplanen med henblik på yderligere undersøgelse af de enkelte risikofaktorer for inhibitordannelse samt risikonedsættelse hos ikke tidligere behandlede patienter.
English: • The PRAC considered the publication of the results of the RODIN/PedNet study, the preliminary findings from the European Haemophilia Safety Surveillance System (EUHASS) registry and all available data submitted from clinical trials, observational studies, published literature and quality data for Kogenate Bayer and Helixate NexGen with regards to its potential risk of inhibitor development in previously untreated patients (PUPs).
Danish: • PRAC tog i betragtning de offentliggjorte resultater af RODIN/PedNet-undersøgelsen, de indledende resultater fra det europæiske register til sikkerhedsovervågning ved hæmofili (EUHASS) og alle foreliggende data fra kliniske undersøgelser, observationsundersøgelser, den publicerede litteratur og data vedrørende kvaliteten af Kogenate Bayer og Helixate NexGen, hvad angår den potentielle risiko for inhibitordannelse hos tidligere ubehandlede patienter,
English: The PRAC considered results from the publication of the RODIN/PedNet study, the preliminary findings from the European Haemophilia Safety Surveillance System (EUHASS) registry and all available data submitted from clinical trials, observational studies, published literature as well as quality data for Kogenate Bayer and Helixate NexGen with regards to its potential risk of inhibitor development in previously untreated patients (PUPs) and minimally treated patients (MTPs).
Danish: PRAC tog stilling til resultaterne fra offentliggørelsen af RODIN/PedNet-undersøgelsen, de indledende resultater fra det europæiske register til sikkerhedsovervågning ved hæmofili (EUHASS) og alle tilgængelige data fra de forelagte kliniske undersøgelser, observationsundersøgelser, den publicerede litteratur samt data vedrørende kvaliteten af Kogenate Bayer og Helixate NexGen, hvad angår den potentielle risiko for inhibitordannelse hos tidligere ubehandlede patienter og minimalt behandlede patienter.
English: The MAH also submitted data from four interventional clinical trials and six observational studies, which investigated the safety and efficacy of Kogenate Bayer/Helixate NexGen in haemophilia A patients, including studies 200021EU and 100074US in PUPs and minimally treated patients (MTPs).
Danish: Indehaveren af markedsføringstilladelsen forelagde desuden data fra fire interventionelle kliniske undersøgelser og seks observationsundersøgelser vedrørende sikkerheden og virkningen af Kogenate Bayer og Helixate NexGen hos patienter med hæmofili A, herunder undersøgelse 200021EU og http://www.ema.europa.eu/docs/en_GB/document_library/Report/2009/11/WC500015512.pdf
English: The efficacy of Kogenate Bayer/Helixate NexGen is recognised and the PRAC reviewed the data related to inhibitor development in PUPs and MTPs.
Danish: Virkningen af Kogenate Bayer og Helixate NexGen er anerkendt, og PRAC gennemgik dataene vedrørende inhibitordannelse hos tidligere ubehandlede patienter og minimalt behandlede patienter.
English: The MAH provided data on the above-mentioned observational studies with regards to the risk of inhibitor development in PUPs receiving FVIII products, including KOGENATE Bayer/Helixate NexGen.
Danish: Indehaveren af markedsføringstilladelsen forelagde data fra de nævnte observationsundersøgelser om risikoen for inhibitordannelse hos tidligere ubehandlede patienter ved behandling med FVIIIlægemidler, herunder Kogenate Bayer og Helixate NexGen.
English: J. Med. 368, 231 (2013)) were made available and seemed to suggest that Kogenate Bayer/Helixate NexGen were associated with an increased risk of inhibitor development in previously untreated patients (PUPs) when compared to another recombinant antihaemophilic factor VIII, after adjustment for confounding factors.
Danish: Da resultaterne af RODIN/PedNet-undersøgelsen (S.C. Gouw et al., N. Engl. J. Med. 368, 231 (2013)) blev tilgængelige, viste de tilsyneladende (efter justering for konfunderende faktorer), at Kogenate Bayer og Helixate NexGen medførte højere risiko for inhibitordannelse hos tidligere ubehandlede patienter end en anden rekombinant antihæmofili faktor VIII.
English: Having noted the above, the PRAC concluded that the benefit-risk balance of Kogenate Bayer and Helixate NexGen indicated as for the treatment and prophylaxis of bleeding in patients with hemophilia A (congenital factor VIII deficiency) remains favourable subject to the changes to the product information agreed.
Danish: I betragtning af ovenstående konkluderede PRAC, at benefit/risk-forholdet for Kogenate Bayer og Helixate NexGen til behandling og forebyggelse af blødning hos patienter med hæmofili A (kongenit faktor VIII-mangel) fortsat er positivt under forudsætning af de vedtagne ændringer af produktinformationen.
English: The PRAC therefore concluded that the benefit-risk balance of Kogenate Bayer and Helixate NexGen indicated as for the treatment and prophylaxis of bleeding in patients with haemophilia A (congenital factor VIII deficiency) remains favourable subject to the changes to the product information agreed.
Danish: konkluderede PRAC, at benefit/risk-forholdet for Kogenate Bayer og Helixate NexGen til behandling og forebyggelse af blødning hos patienter med hæmofili A (kongenit faktor VIII-mangel) fortsat er positivt under forudsætning af de vedtagne ændringer af produktinformationen.
English: In addition, the PRAC noted an update from the on-going EUHASS data, and results showed an inhibitor incidence for Kogenate Bayer and Helixate Nexgen comparable to other products: whereas no adjustment for known risk factors for inhibitor development could be performed due to the study design, the PRAC noted that the 95 % CIs of the point estimates of PUP inhibitor incidence were overlapping substantially between different products.
Danish: Skønt der på grund af undersøgelsens design ikke kunne justeres for kendte risikofaktorer for inhibitordannelse, konstaterede PRAC, at 95 % sikkerhedsintervallerne for punktestimaterne af inhibitorforekomsten hos ikke tidligere behandlede patienter i betydelig grad overlappede mellem forskellige lægemidler.
English: Packaging Content (concentration) Package size
Danish: Indhold koncentration
English: Cyramza received a marketing authorisation valid throughout the EU on 19 December 2014.
Danish: Cyramza fik en markedsføringstilladelse med gyldighed i hele EU den 19. december 2014.
English: Although the effects were modest, the size of the benefit was considered clinically relevant given the normally poor prognosis in these patients.
Danish: Selvom virkningerne var beskedne, anses fordelens størrelse at være klinisk relevant i betragtning af de normalt dårlige prognoser for disse patienter.
English: Further information on Cyramza can be found on the Agency's website: ema.europa.eu/medicines/human/EPAR/cyramza.
Danish: Yderligere information om Cyramza findes på agenturets websted under: ema.europa.eu/medicines/human/EPAR/cyramza.
English: It can only be obtained with a prescription and treatment should be started and supervised by a specialist who has experience in the treatment of cancer.
Danish: Det fås kun på recept, og behandlingen bør iværksættes og overvåges af en læge med erfaring i kræftbehandling.