natgillin/translations-raw huggingface dataset:
CHMP tog desuden stilling til Kantos Masters egnethed til MART-behandlingen (hvad angår dets komponenter og dets formulering).
The CHMP also took into account the suitability of Kantos Master (in terms of its components and its formulation) for the MART approach.
Den daglige vedligeholdelsesdosis i begge arme af undersøgelsen var 200 µg ekstrafint beclometason, som er klinisk ækvivalent med 500 µg ikke-ekstrafint beclometason.
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.
• udvalget bemærkede, at der ikke var sammenlignet med standardbehandling svarende til GINA-retningslinjerne.
• The Committee noted that there was no comparison with the standard of care, according to the GINA guideline.
Virkningen af Kantos Master i MART var desuden signifikant i forhold til det gennemsnitlige antal administrationer af redningsmedicin ved inklusion i undersøgelsen (>0 og ≤1, >1 og ≤2 og >2 i de tre grupper) (omtrent samme risikoforhold på henholdsvis 0,51, 0,64 og 0,52).
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).
For yderligere at eftervise, at patienterne i MART-behandlingsarmen ikke blev overbehandlet eller underbehandlet, og for at underbygge resultaterne af undersøgelse CT07 udførte indehaveren af markedsføringstilladelsen en post hoc-dataanalyse og henviste til supplerende støttende data.
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.
Begge komponenter (beclometasondipropionat og formoterolfumarat) er påvist at være effektive ved eksacerbationer af astma på grund af deres antiinflammatoriske og bronkodilaterende virkning, og deres virkning øges, hvis de gives i kombination.
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.
Skønt der blev iagttaget et fald i den gennemsnitlige dosis inhalationskortikosteroid ved inklusion i undersøgelsen, var der bedring i den gennemsnitlige FEV1 hos begge patientgrupper i indkøringsperioden og yderligere bedring i løbet af behandlingsperioden på 48 uger, idet ændringen fra baseline til undersøgelsens slutning var ca. 100 ml i begge grupper.
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.
CHMP fandt derfor, at den positive terapeutiske virkning af MART med Kantos Master er godtgjort hos patienter, som fik reduceret den daglige dosis af inhalationskortikosteroid, og hos patienter, som ikke fik nogen nedtrapning (dvs. den undergruppe, der fik op til 500 µg dagligt ved inklusionen og under behandlingen).
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).
Endvidere har formoterol hurtigere indsættende bronkodilaterende virkning end andre langtidsvirkende beta2-agonister såsom salmeterol og er derfor velegnet til akut lindring af bronkospasme.
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.
CHMP bemærkede, at der ikke blev sammenlignet med standardbehandling i henhold til GINA-retningslinjerne.
The CHMP noted that there was no comparison with the standard of care, according to the GINA guideline.
Disse resultater var uafhængige af den pågældende type fast kombination af inhalationskortikosteroid/langtidsvirkende beta2-agonist (budesonid/formoterol eller salmeterol/fluticason) og uafhængige af, om vedligeholdelsesdosis af sammenligningspræparatet var den samme eller op til den dobbelte.
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.
Formålet med MART-tilgangen er at mindske forekomsten af eksacerbationer af astma gennem "tidlig intervention", hvorved forstås, at der ved symptomforværring gives supplerende doser af inhalationskortikosteroid plus formoterolfumarat (GINA-retningslinjer fra 20111).
The aim of the MART approach is to reduce the rate of asthma exacerbations by “early intervention”, i.e. by giving additional doses of ICS plus FF in response to an increase in symptoms (2011 GINA Guidelines1).
Denne behandlingstilgang, hvor der anvendes en vedligeholdelsesdosis af en fast kombination af et inhalationskortikosteroid og en langtidsvirkende beta2-agonist samt ved symptomforværring supplerende doser af samme kombination i stedet for en separat korttidsvirkende beta2-agonist, kaldes "vedligeholdelses- og behovsbehandling" ("Maintenance And Reliever Therapy" (MART)).
This treatment approach of using a maintenance dose of a fixed combination of ICS and LABA and additional doses of the same combination in case of symptom worsening instead of a separate short acting beta2-agonist (SABA) is called “Maintenance And Reliever Therapy” (MART).
Det primære endepunkt er et klinisk vigtigt mål for langsigtet astmakontrol og var klart til fordel for Kantos MART sammenlignet med Kantos plus en kortvirkende beta2-agonist.
The primary endpoint is a clinically important measure of the long-term asthma control, and was clearly in favour of Kantos MART in comparison with Kantos plus SABA treatment.
Udvalget fandt imidlertid, at intet tydede på, at patienterne i sammenligningsgruppen var underbehandlede, da patienterne i begge grupper havde udvist klinisk fordel af vedligeholdelsesbehandlingen
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.
Da Kantos Master indeholder formoterol og beclometason, fandt udvalget på baggrund af resultaterne af den forelagte undersøgelse, at de offentliggjorte data er relevante for det ansøgte regime.
As Kantos Master contain formoterol and beclometasone and in view of the results of the study, the Committee considered the published data to be relevant in the applied regimen.
Undersøgelsen viste, at risikoen for en svær eksacerbation af astma blev reduceret med 36 % (SI: [18 %; 51 %]) i den gruppe, der fik Kantos Master ved behov, i forhold til den gruppe, der fik salbutamol.
The results of the study have shown that the risk of experiencing a severe asthma exacerbation was reduced by 36% (CI: 18% - 51%) in the group taking Kantos Master as reliever compared to the
Dette tydede på, at vedligeholdelsesbehandling med inhalationskortikosteroid/langtidsvirkende beta2-agonist var adækvat til kontrol af både lungefunktion og symptomer.
This suggested that the ICS-LABA maintenance therapy was adequate to control both lung function and symptoms.
CHMP var derfor af den opfattelse, at Kantos Masters positive virkning på eksacerbationer ikke blev opnået alene ved en stigning i den daglige dosis inhalationskortikosteroid, men gennem den rettidige dosering af en lille dosis beclometasondipropionat sammen med bronkodilatoren ved forværring af symptomerne.
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.
Den 20. januar 2012 indgav indehaveren af markedsføringstilladelsen en type IIændringsansøgning via den gensidige anerkendelsesprocedurer for Kantos Master og relaterede navne (DE/H/0873/001/II/024) om godkendelse af indikationen "vedligeholdelses- og behovsbehandling af astmasymptomer".
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”.
Der blev foretaget endnu en supplerende analyse af undersøgelse CT07 hos patienter med svær astma, da det antoges, at eventuel underbehandling med Kantos Master i MART ville være lettest at konstatere hos den population, som kræver højere doser inhalationskortikosteroid til astmakontrol.
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.
For eksempel var dosis af budesonid i SMILE-undersøgelsen2 (400 µg dagligt) på linje med den dosis inhalationskortikosteroid, der blev givet i undersøgelse CT07 (ækvivalent med 500 µg ikkeekstrafint beclometason).
For instance, in the SMILE study2, the dose of budesonide (400µg/day) was in line with the ICS dose administrated in the study CT07 (500µg BDP non-extrafine equivalent).
Begrundelser for ændringen af betingelserne for markedsføringstilladelserne Ud fra følgende betragtninger:
Grounds for the variation to the terms of the marketing authorisations
Det var derfor CHMP's opfattelse, at virkningen af Kantos Master i MART ikke skyldtes underbehandling af sammenligningsarmen i undersøgelse CT07, og at vedligeholdelsesbehandling med Kantos Master, én inhalation to gange dagligt, var til væsentlig klinisk fordel for disse patienter.
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.
Ved inklusionen i undersøgelsen fik patienterne en højere gennemsnitsdosis af inhalationskortikosteroid (mellem 700 µg og 1 100 µg, angivet som den deklarerede dosis beclometasondipropionat eller en hermed ækvivalent dosis) end i løbet af den kliniske undersøgelse (i den gruppe, der fik Kantos Master som behovsbehandling, og den gruppe, der fik salbutamol, var inhalationskortikosteroiddosis henholdsvis ca. 701,2 µg/dag og 480,8 µg/dag, i alle tilfælde givet som en del af kombinationen inhalationskortikosteroid/langtidsvirkende beta2-agonist).
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).
Den gruppe, der fik Kantos Master som behovsbehandling, fik i gennemsnit ca. 80 µg beclometason yderligere dagligt, hvilket svarer til mindre end én ekstra aktivering af inhalatoren dagligt.
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.
Til påvisning af virkningen af Kantos Master og relaterede navne til vedligeholdelses- og behovsbehandling af astmasymptomer forelagde indehaveren af markedsføringstilladelsen data fra en randomiseret, dobbeltblindet fase III-hovedundersøgelse med dobbelt placebo og to parallelle arme (undersøgelse CT07).
In order to demonstrate the efficacy of Kantos Master and associated names as maintenance treatment and as needed in response to symptoms of asthma, the MAH submitted data from a phase III pivotal clinical study, randomised, double blind, double dummy, two arms parallel group (Study CT07).
Den hovedundersøgelse, der var forelagt sammen med ansøgningen til støtte for sikkerheden og virkningen af Kantos Master til vedligeholdelses- og behovsbehandling (MART) af astmasymptomer, dokumenterer ikke på tilfredsstillende vis, at MART-regimet var ikke-inferiørt i forhold til standardbehandlingen, da kontrolgruppen reelt ikke blev behandlet i henhold til standardbehandlingen.
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.
Ved inklusionen fik den ene gruppe en dosis inhalationskortikosteroid på højst 500 µg, og den anden gruppe fik en dosis inhalationskortikosteroid på over 500 µg.
One arm of patients were treated with an entry ICS dose of 500 µg or less and another arm had an entry ICS dose of more than 500 µg.
I undersøgelse CT07 sammenlignedes virkningen af Kantos Master og relaterede navne, givet som både vedligeholdelses- og behovsbehandling, med Kantos Master, givet som vedligeholdelsesbehandling sammen med den korttidsvirkende beta2-agonist salbutamol som behovsbehandling, ved delvis kontrolleret eller ukontrolleret astma i en behandlingsperiode på 48 uger.
The study CT07 compared the efficacy of Kantos Master and associated names given as both maintenance and reliever therapy and Kantos Master given as maintenance therapy with salbutamol (short acting beta2 -agonist SABA) as reliever therapy in partially controlled or uncontrolled asthmatics, over a 48 weeks treatment.
Hos begge undergrupper var MART med Kantos Master signifikant overlegent over salbutamol hvad angår forlængelse af tiden til de første svære eksacerbationer og reduktion af det gennemsnitlige årlige antal svære eksacerbationer.
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.
CHMP fandt dog ingen tegn på, at patienterne i sammenligningsgruppen var underbehandlede, da der var iagttaget klinisk fordel af vedligeholdelsesbehandlingen hos begge patientgrupper.
However, the CHMP 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.
Kantos Master i MART havde signifikant virkning både i gruppen med sværere sygdom (defineret ved FEV1 < 70 %) og gruppen med mindre svær sygdom (FEV1 ≥ 70 %) (lignende risikoforhold, henholdsvis 0,65 og 0,61).
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).
• udvalget konkluderede på baggrund af alle foreliggende data, at benefit/risk-forholdet for Kantos Master og relaterede navne er positivt til "vedligeholdelses- og behovsbehandling ved astmasymptomer"
• 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.
Kantos Master er en fastdosiskombination af inhalationskortikosteroidet beclometasondipropionat og den langtidsvirkende beta2-agonist formoterolfumarat.
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.
• udvalget gennemgik alle de foreliggende data til støtte for sikkerheden og virkningen af Kantos Master og relaterede navne ved "vedligeholdelses- og behovsbehandling af astmasymptomer"
• 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”.
CHMP tog desuden hensyn til litteraturdata, hvor MART-princippet underbygges ved anvendelse af et inhalationskortikosteroid og en langtidsvirkende beta2-agonist.
The CHMP also took note of literature data where the principle of MART is substantiated with the use of an ICS and LABA.
• udvalget tog hensyn til litteraturdata, hvor MART-princippet underbygges ved anvendelse af et inhalationskortikosteroid og en langtidsvirkende beta2-agonist.
• The Committee took note of literature data where the principle of MART is substantiated with the use of an ICS and LABA.
CHMP fandt, at de data, som indehaveren af markedsføringstilladelsen forelagde, var tilstrækkelige som dokumentation for anvendelsen af Kantos Master og relaterede navne til vedligeholdelses- og behovsbehandling (MART) af astmasymptomer.
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.
Pakningsstørrelse
Packaging
Særnavn Styrke Lægemiddelform Indgivelsesvej Emballage
Pharmaceutical Form
Den 20. oktober 2015 EMA/499012/2015
20 October 2015 EMA/499012/2015
Efter afkøling skilles den æteriske olie fra vandet og kan derved opsamles.
After cooling, the essential oil separates from the water and can be collected.
Mens hudpræparater kan anvendes af personer i alle aldre, frarådes det at anvende præparater til indtagelse gennem munden til børn og unge (under 18 år).
While the skin preparations can be used by people of all ages, the medicines to be taken by mouth are not recommended in children and adolescent (under 18 years of age).
Kommenolie EMA/499012/2015
Caraway oil EMA/499012/2015
Kommenolie er fællesnavnet for den æteriske olie fra frugterne af planten Carum carvi L. Planten dyrkes eller indsamles for at udvinde olien til medicinsk brug.
Caraway oil is the common name for the essential oil obtained from the fruit of the plant Carum carvi L. The plant is cultivated or gathered to obtain the oil for medicinal use.
Ansøgninger om godkendelse af lægemidler, der indeholder kommenolie, skal indsendes til de nationale lægemiddelmyndigheder, som vurderer ansøgningen om plantelægemidlet og tager hensyn til HMPC's videnskabelige konklusioner.
Any applications for the licensing of medicines containing caraway oil have to be submitted to the national authorities responsible for medicinal products, which will assess the application for the herbal medicine and take into account the scientific conclusions of the HMPC.
Lægemidler med kommenolie må ikke anvendes til patienter, der er allergiske (overfølsomme) overfor kommenolie eller andre planter fra skærmplantefamilien (f.eks. fennikel, anis, selleri, koriander og dild).
Caraway oil medicines must not be used in people who are hypersensitive (allergic) to caraway oil or other plants of the same Apiaceae (Umbelliferae) family (e.g. fennel, anise, celery, coriander and dill).
Yderligere oplysninger om HMPC's vurdering af lægemidler, der indeholder kommenolie, herunder detaljerede oplysninger om udvalgets konklusioner, findes under "All documents" på Det Europæiske Lægemiddelagenturs websted: ema.europa.eu/Find medicine/Herbal medicines for human use.
Further information on the HMPC assessment of caraway oil medicines, including details of the Committee's conclusions, can be found under the tab ‘All documents' on the Agency's website: ema.europa.eu/Find medicine/Herbal medicines for human use.
EU's medlemsstater tager hensyn til HMPC's konklusioner, når de vurderer ansøgninger om godkendelse af plantelægemidler, der indeholder kommenolie.
The HMPC conclusions are taken into account by EU Member States when evaluating applications for the licensing of herbal medicines containing caraway oil.
Yderligere oplysninger om risici forbundet med lægemidler, der indeholder kommenolie, herunder passende forholdsregler, som skal følges med henblik på sikker anvendelse, findes i monografien under fanebladet "All documents" på Det Europæiske Lægemiddelagenturs websted: ema.europa.eu/Find medicine/Herbal medicines for human use.
Further information on the risks associated with caraway oil medicines, including the appropriate precautions for their safe use, can be found in the monograph under the tab ‘All documents' on the Agency's website: ema.europa.eu/Find medicine/Herbal medicines for human use.
Detaljerede anvisninger for, hvordan lægemidler kommenolie, skal anvendes, og hvem der kan bruge dem, findes i indlægssedlen i lægemiddelpakningen.
Detailed instructions on how to take caraway oil medicines and who can use them can be found in the package leaflet that comes with the medicine.
Dette er et sammendrag af Komiteen for Plantelægemidlers (HMPC) videnskabelige konklusioner angående den medicinske anvendelse af kommenolie.
This is a summary of the scientific conclusions reached by the Committee on Herbal Medicinal Products (HMPC) on the medicinal uses of caraway oil.
Oplysninger om europæisk anvendelse og godkendelse af lægemidler, der indeholder kommenolie, skal indhentes fra de relevante nationale myndigheder i EU's medlemsstater.
Information on the use and licensing of caraway oil medicines in EU Member States should be obtained from the relevant national authorities.
Hvis symptomerne varer længere end 2 uger ved samtidig brug af kommenolie, bør der søges råd hos en læge eller på apoteket.
If symptoms last for more than 2 weeks during the use of caraway oil medicines, the patient should consult a doctor or qualified healthcare practitioner.
Plantelægemidler med kommenolie fås normalt i flydende form til indtagelse gennem munden og i halvfast form (såsom salve) til påføring på huden.
Herbal medicines containing caraway oil preparations are usually available in liquid forms to be taken by mouth and in semi-solid forms (such as ointments) to be applied to the skin.
Kommenolie
Caraway oil
HMPC har i sin vurdering taget til efterretning, at der ikke foreligger tilstrækkelige kliniske data, men har derimod taget hensyn til den veldokumenterede og langvarige anvendelse af kommenolie til ovenstående formål.
The HMPC noted the insufficient clinical data on the effects of caraway oil in patients, but took into account the well documented use of this herbal medicine for the above-mentioned use.
Dette sammendrag er ikke en praktisk vejledning i, hvordan plantelægemidler, der indeholder kommenolie, anvendes.
This summary is not intended to provide practical advice on how to use medicines containing caraway oil.
Hvad er kommenolie?
What is caraway oil?
Hvordan godkendes lægemidler, der indeholder kommenolie, i EU?
How are caraway oil medicines approved in the EU?
Nærmere oplysninger om de informationer der indgår i HMPCs vurdering, findes i HMPC's vurderingsrapport.
For further information, see the HMPC assessment report.
Andre oplysninger om lægemidler, der indeholder kommenolie
Other information about caraway oil medicines
Kommenolie udvindes ved at lede damp gennem de tørrede frugter.
Caraway oil is obtained by a current of steam through the dried fruit.
Hvilken dokumentation underbygger den medicinske anvendelse af lægemidler med kommenolie?
What evidence supports the use of caraway oil medicines?