natgillin/translations-raw huggingface dataset:
2 af de behandlingsrelaterede uønskede hændelser, der havde dødelig udgang, ansås for at være forbundet med forsøgslægemidlet i den eksperimentelle gruppe (pneumoni og aspiration) vs. ingen i kontrolgruppen.
Of those, 2 TEAE leading to deaths were considered related to study treatment in the investigational arm (pneumonia and aspiration) vs none in the control arm.
Sammenholdt med den aktuelt anbefalede dosering af olaratumab (15 mg/kg på dag 1 og 8 i hver 3ugers serie) blev der anvendt en støddosis på 20 mg/kg på dag 1 og 8 i serie 1 for at minimere antallet af patienter, der blev eksponeret for subterapeutiske olaratumab-serumniveauer, uden øget risiko for toksicitet, baseret på farmakokinetik og matchet case-kontrolanalyse ud fra eksponeringsrelaterede kvartilresultater.
Compared to the currently recommended posology of olaratumab (15 mg/kg on days 1 and 8 of each 3 week cycle), a loading cycle of 20 mg/kg on day 1 and day 8 of cycle 1 was used, to minimize the number of patients exposed to sub-therapeutic olaratumab serum levels without an increased risk of toxicity, based on PK and matched case-control analysis by exposure quartiles results.
For at bekræfte virkningen og sikkerheden ved olaratumab var indehaveren af markedsføringstilladelsen specifikt forpligtet til senest i januar 2020 at indsende den kliniske studierapport fra et randomiseret, dobbeltblindet fase III-bekræftelsesstudie til sammenligning af doxorubicin plus olaratumab versus doxorubicin hos patienter med fremskredent eller metastatisk bløddelssarkom (studie I5B-MCJGDJ [JGDJ]; ANNOUNCE), herunder eksplorative biomarkørdata.
In order to confirm the efficacy and safety of olaratumab, the marketing authorisation holder was required to submit as specific obligation, by January 2020, the clinical study report of a phase III randomised double-blind confirmatory study comparing doxorubicin plus olaratumab versus doxorubicin in patients with advanced or metastatic soft tissue sarcoma (Study I5B-MCJGDJ [JGDJ]; ANNOUNCE), including exploratory biomarker data.
Overordnet set sås der ingen fordel ved tilføjelse af Lartruvo til doxorubicin hos patienter med fremskredent bløddelssarkom i ANNOUNCE-studiet.
In summary, no benefit of adding Lartruvo to doxorubicin in patients with advanced STS was observed in the ANNOUNCE study.
Forekomsten af dødsfald, der skyldes uønskede hændelser i forbindelse med behandling, eller som indtraf inden for 30 dage efter den sidste dosis forsøgslægemiddel, var 5 (1,9 %) vs. 3 (1,2 %) (den eksperimentelle gruppe: lungeemboli hos 2 patienter og akut respirationssvigt, aspiration og pneumoni hos én patient hver; kontrolgruppen: cerebrovaskulær hændelse, iskæmisk slagtilfælde og sepsis, hver hos én patient).
Death due to AEs on therapy or within 30 days from the last dose of study drug were 5 (1.9%) vs 3 (1.2%) (investigational arm: pulmonary embolism in 2 subjects, acute respiratory failure, aspiration and pneumonia in one patient each; control arm: cerebrovascular accident, ischemic stroke and sepsis, each in one patient).
I LMS-populationen var den objektive responsrate i kontrolgruppens favør (ingen statistisk signifikans), og sygdomskontrolraten var i kontrolgruppens favør (statistisk signifikant).
In the LMS population, ORR was in favour of the control arm (no statistical significance) and DCR was statistically significant in favour of the control arm.
ANNOUNCE-studiet gav ikke anledning til nye sikkerhedsmæssige betænkeligheder.
No new safety concerns arose from the ANNOUNCE study.
Der sås heller ingen forskel i samlet overlevelse i LMS-populationen.
No difference was seen in OS in the LMS population either.
ANNOUNCE (I5B-MC-JGDJ) er et randomiseret, dobbeltblindet, placebo-kontrolleret fase 3-studie til undersøgelse af olaratumab plus doxorubicin versus placebo plus doxorubicin hos patienter med lokalt fremskredent eller metastatisk bløddelssarkom.
ANNOUNCE (I5B-MC-JGDJ) was a randomized, double-blind, placebo-controlled, phase 3 trial of olaratumab plus doxorubicin versus placebo plus doxorubicin in patients with locally advanced or metastatic soft tissue sarcoma.
I alt 509 voksne patienter med fremskredent eller metastatisk bløddelssarkom, der ikke var modtagelige over for kurativ behandling i form af kirurgi eller stråleterapi (234 af patienterne havde leiomiosarkom (LMS)), blev randomiseret i forholdet 1:1 - og stratificeret ud fra antallet af tidligere systemiske behandlinger for fremskreden/metastatisk sygdom, histologisk tumortype og ECOGperformancestatus - til den eksperimentelle gruppe (n = 258; LMS n = 119) med olaratumab plus doxorubicin eller til kontrolgruppen (n = 251; LMS n = 114) med placebo plus doxorubicin.
Overall, 509 adult patients with advanced or metastatic soft tissue sarcoma not amenable to treatment with surgery or radiotherapy with curative intent (of those 234 were leiomiosarcoma, LMS) were randomized 1:1, stratified by number of prior systemic therapies for advanced/metastatic disease, histological tumour type, and ECOG PS, to the investigational arm (n=258; LMS n=119) with olaratumab plus doxorubicin or the control arm (n=251; LMS n=114) with placebo plus doxorubicin.
Der sås ingen signifikant forskel i progressionsfri overlevelse mellem behandlingsgrupperne i LMS-populationen.
No significant difference in PFS between the treatment arms in the LMS population was found.
Forekomsten af behandlingsrelaterede uønskede hændelser, der førte til seponering, var næsten den samme i de to grupper (4,3 % vs. 4,4 %).
Frequency of patients with TEAE leading to treatment discontinuation was similar in both arms (4.3% vs 4.4%).
Lartruvo blev godkendt på grundlag af et åbent, randomiseret, klinisk fase 1b/2-studie af doxorubicinnaive patienter med fremskredent bløddelssarkom, der ikke var modtagelige over for behandling med kirurgi og stråleterapi (studie JGDG).
Lartruvo was authorised based on a single open-label, randomised phase 1b/2 clinical trial which enrolled doxorubicin-naïve subjects with advanced soft tissue sarcoma not amenable to treatment with surgery and radiotherapy (study JGDG).
Forekomsten af behandlingsrelaterede uønskede hændelser var generelt sammenlignelige i de to behandlingsgrupper (98,1 % vs. 99,2 %).
The rate of TEAE was overall similar in both treatment arms (98.1% vs 99.2%).
Der foreligger ingen data om uønskede hændelser justeret i forhold til eksponering.
No data on AE adjusted by exposure are available.
I alt 6 patienter i den eksperimentelle gruppe udviklede en anafylaktisk reaktion vs. ingen i kontrolgruppen.
Overall, 6 patients in the investigational vs none in the control arm developed an anaphylactic reaction.
Den mediane progressionsfri overlevelse var 5,42 måneder i den eksperimentelle gruppe og 6,77 måneder i kontrolgruppen (HR = 1,231 [95 %-KI: 1,009-1,502]; p = 0,042).
The median PFS was 5.42 months in the investigational arm and 6.77 months in the control arm (HR=1.231 [95% CI: 1.009, 1.502]; p=0.042).
Forekomsten af hændelser af alle grader i kategorien af hændelser af særlig interesse var 18,3 % i den eksperimentelle gruppe og 13,7 % i kontrolgruppen, idet der i de fleste tilfælde var tale om perifert ødem (13,2 vs. 9,2 %) og ødem (1,2 % vs. 0 %).
The incidence for all grades of events in the cardiac dysfunction AESI category was 18.3% in the investigational arm and 13.7% in the control arm, the majority being events of peripheral oedema (13.2 vs 9.2%) and oedema (1.2% vs 0%).
Der sås ingen statistisk signifikant forskel i objektiv responsrate eller sygdomskontrolrate i ITTpopulationen mellem den eksperimentelle gruppe og kontrolgruppen, og begge rater var i kontrolgruppens favør.
No statistically significant difference in ORR or DCR in the ITT population was observed between the investigational arm and control arms, and both rates favoured the control arm.
Der sås en signifikant forskel i progressionsfri overlevelse i ITT-populationen i henhold til investigators vurdering, men det var i kontrolgruppens favør.
There was a significant difference in PFS in the ITT population based on investigator assessment, but in favour of the control arm.
I ITT-populationen var den mediane samlede overlevelse 20,37 måneder i den eksperimentelle gruppe og 19,75 måneder i kontrolgruppen (HR = 1,047 [95 %-KI: 0,841-1,303]; p = 0,69), og KM-kurverne for samlet overlevelse var fuldstændigt overlappende, hvilket tyder på, at tilføjelsen af Lartruvo til doxorubicin ikke havde nogen gavnlig effekt på den samlede overlevelse.
In the ITT population, the median OS was 20.37 months in the investigational arm and 19.75 months in the control arm (HR=1.047 [95% CI: 0.841, 1.303]; p=0.69), and the OS KM curves are completely overlapping, indicating that adding Lartruvo to doxorubicin had no favourable effect on OS. Further OS analyses showed that in most subgroups HR estimates ranged from 0.9 to 1.1, consistent with the overall OS results.
Den eneste signifikante forskel i progressionsfri overlevelse, der blev konstateret, sås i ITT-populationen, men i kontrolgruppens favør.
The only significant difference found in PFS was in the ITT population, but in favour of the control arm.
Der blev oftere rapporteret om hjertearytmier i den eksperimentelle gruppe (alle grader: 12,8 % vs. 9,6 %; grad ≥ 3: 2,7 % vs. 0,8 %).
Cardiac arrhythmia events were more commonly reported in the investigational arm (any grade 12.8% vs 9.6%; grade >=3 2.7% vs 0.8%).
Med hynsyn til PDGFR-β sås der ingen signifikant sammenhæng mellem PDGFR-β-status og responset på olaratumab, hvad angår samlet overlevelse eller progressionsfri overlevelse.
With regard to PDGFR-β, no significant association was found between PDGFR-β status and response to olaratumab in terms of OS or PFS. PDGFR-β did not seem to have a clear prognostic role in STS either.
en uafhængig vurdering; 6,6 vs. 4,1 måneder, hazard ratio (HR) 0,672 [95 %-KI: 0,442-1,021], p = 0,0615 iht.
In this trial, treatment with olaratumab in combination with doxorubicin resulted in an improvement in progression-free survival (PFS) (8.2 vs. 4.4 months according to independent assessment; 6.6 vs. 4.1 months, hazard ratio (HR) 0.672 [95% CI: 0.442, 1.021], p = 0.0615 according to investigator assessment) and overall survival (OS) (26.5 months vs. 14.7 months, HR = 0.463; p = 0.0003).
Febril neutropeni var den hyppigst forekommende alvorlige uønskede hændelse; hyppigheden var sammenlignelig i de to grupper (12,8 % vs. 13,3 %).
Few more SAE (38.9% vs 34.9%) occurred in the investigational arm than in the control arm. Febrile neutropenia was the most frequently SAE occurring with similar frequency in both arms (12.8% vs 13.3%).
De rå data blev gjort tilgængelige som separat dokumentation.
The raw data were made available as separate documentation.
Produkterne til anvendelse hos hunde har siden december 2011 været godkendt i referencemedlemsstaten, Tjekkiet, hvor produktet til katte blev godkendt i maj i 2012.
The presentations for use in dogs have already been authorised in the reference Member State, the Czech Republic, since December 2011 and the cat product was more recently authorised there in May 2012.
Ansøgninger om markedsføringstilladelse blev indgivet i de berørte medlemsstater via den gensidige anerkendelsesprocedure.
Applications for marketing authorisation were submitted to the concerned Member States using the mutual recognition procedure.
Indehaveren af markedsføringstilladelsen fremhævede punkt 3.5 i afsnit III i direktiv 2009/9/EF, der fastslår, at: “Erfaringer efter markedsføring af andre produkter, der indeholder samme bestanddele, er af særlig betydning, og ansøgerne bør lægge særlig vægt på dette spørgsmål”.
The MAH highlighted paragraph 3.5 of Title III of Directive 2009/9/EC which states that: “Post-marketing experience with other products containing the same constituents is of particular importance and applicants shall put a special emphasis on this issue.”
Virkningsvarigheden af aktuelt godkendte spot-on produkter indeholdende fipronil varierer fra 4 til 8 uger for lopper og 1 til 4 uger for forskellige flåtarter.
The duration of efficacy for currently authorised fipronil-containing spot-on products varies from 4-8 weeks for fleas and 1-4 weeks for different tick species.
Betingelsen for ophævelse af suspenderingen af markedsføringstilladelserne er beskrevet i bilag III.
The condition for lifting the suspension of the marketing authorisations is described in Annex III.
Liste over veterinærlægemidlernes navne, lægemiddelformer, styrker, dyrearter, administrationsvej og indehaver af markedsføringstilladelse i medlemsstaterne
List of the names, pharmaceutical form, strengths of the veterinary medicinal product, animal species, route of administration, marketing authorisation holder in the Member States
De nationale kompetente myndigheder sikrer med referencemedlemsstaten som koordinerende instans, at indehaveren af markedsføringstilladelserne opfylder følgende betingelser:
National Competent Authorities, coordinated by the reference Member State, shall ensure that the following condition is fulfilled by the marketing authorisation holder:
Disse forskelle kan i det mindste delvis tilskrives formuleringens indvirkning på hastigheden og/eller omfanget af den dermale absorption og fordeling af fipronil.
These differences may at least partly be attributable to the effect of the formulation on the rate and/or extent of dermal absorption and distribution of fipronil.
Fiprex er en spot-on formulering, der indeholder fipronil som det aktive stof (farmakoterapeutisk gruppe: ektoparasiticider til topisk anvendelse).
Fiprex is a spot-on formulation containing fipronil as the active substance (pharmacotherapeutic group: ectoparasiticides for topical use).
INN Styrke Lægemiddelfor m
INN Strength Pharmaceutical form
Markedsføringstilladelsesindehaverens begrundelse for fornyet overvejelse af CVMP's udtalelse af 11. december 2013 vedrørte de faktorer, der skal tages i betragtning ved fastlæggelse af en “almindelig anvendelse inden for veterinærmedicin af de virksomme stoffer i veterinærlægemidler”, i hovedsagen i overensstemmelse med overskrifterne i afsnit III af bilag I til direktiv 2001/82/EF (direktiv 2009/9/EF).
The MAH's grounds for re-examination of the CVMP opinion of 11 December 2013 focused on the factors to be taken into account to establish a “well-established veterinary medicinal use of constituents of veterinary medicinal products”, largely following the headings contained under Title III of Annex I to Directive 2001/82/EC (Directive 2009/9/EC).
Trods forskelle i formulering og dosis mellem Fiprex og andre spot-on produkter indeholdende fipronil, som er omtalt i den publicerede litteratur, blev det godtaget, at sådanne produkter sædvanligvis tåles godt og har en bred sikkerhedsmargin.
Despite differences in formulation and dose between Fiprex and other fipronil-containing spot-on products cited in the published literature, it is accepted that such products are generally well tolerated and have a wide margin of safety.
Markedsføringstilladelsesindehaverens hovedargument var, at den insekticide virkning er stor hos både hunde og katte uafhængigt af formuleringen; produkterne er effektive i op til 8 uger hos hunde og i op til 5 uger hos katte.
The major point put forward by the MAH was that insecticidal activity is high in both dogs and cats, irrespective of the formulation; products are effective for up to 8 weeks in dogs and up to 5 weeks in cats.
Vedrørende klinisk virkning viser den publicerede litteratur, at selv mindre forskelle i formuleringen kan have væsentlig betydning for produktets virkningsvarighed.
In relation to clinical efficacy, the published literature demonstrates that even minor differences in formulation can significantly affect the duration of product efficacy.
Evidens til støtte for virkningen
Evidence in support of efficacy
Østrig1
Austria1
Markedsføringstilladelse udstedt
Marketing authorisation granted
Der har derfor ikke kunnet fastlægges en virkningsprofil for formuleringen af Fiprex spot-on.
It has therefore not been possible to establish the efficacy profile of the formulation for Fiprex spot-on.
Udvalget tilsluttede sig, at det aktive stof, fipronil, har en lav grad af toksicitet, og at der ikke er specifikke sikkerhedsproblemer i forbindelse med spot-on formuleringerne af Fiprex.
The Committee also confirmed that the active substance fipronil has a low order of toxicity and no specific safety concerns exist in terms of the Fiprex spot-on formulations.
Den foreliggende publicerede litteratur gav heller ikke mulighed for at drage en sådan konklusion, da Fiprex er kvalitativt og kvantitativt forskelligt fra andre godkendte produkter indeholdende fipronil.
In addition, the available published literature did not allow for such a conclusion as Fiprex is qualitatively and quantitatively different from other authorised fipronilcontaining products.
Afhængigt af det godkendte produkt kan fipronil desuden anvendes til behandling og forebyggelse af flåtangreb hos hunde.
Depending on the approved product, Fipronil can also be used to treat and prevent tick infestations in dogs.
CVMP konkluderer derfor, at virkningsprofilen for Fiprex ikke kan fastlægges ved ekstrapolation af data fra den publicerede litteratur.
Therefore the CVMP concludes that it is not possible to establish the efficacy profile of Fiprex through extrapolation of data from the published literature.
De af markedsføringstilladelsesindehaveren forelagte lægemiddelovervågningsdata opfylder ikke normer for publicerede data efter markedsføring med peer-review, dvs. kontrollerede eller epidemiologiske undersøgelser i henhold til lovgivningens krav, og kunne derfor ikke tages i betragtning i vurderingen.
The pharmacovigilance data submitted by the MAH did not meet the standard of published, peerreviewed post-marketing data, i.e. controlled studies or epidemiological studies, as required by the legislation, and therefore could not be considered in the frame of this assessment.
CVMP kan derfor ikke konkludere, at resultaterne af markedsføringstilladelsesindehaverens in vitro-undersøgelser kan anvendes på in vivo-situationen eller på den forventede virkning af produkterne.
Consequently, the CVMP cannot conclude that the findings of the MAH's in vitro investigations can be applied to the in vivo situation or to the expected efficacy of the products.
Der er forelagt bibliografiske data vedrørende alle aspekter af produktets sikkerhed og/eller virkning til den ansøgte indikation hos de dyrarter, som lægemidlet er beregnet til, ved den ansøgte administrationsvej og det ansøgte dosisregime.
Bibliographic data has been provided in order to cover all aspects of the safety and/or efficacy assessment of the product for the proposed indication in the target species using the proposed route of administration and dosage regimen.
De indsigende berørte medlemsstater fandt, at godkendelsen af Fiprex kunne udgøre en potentiel alvorlig risiko for dyrs sundhed, da produktets sikkerhed og virkning hos de dyrearter, som lægemidlet er beregnet til, ikke var tilstrækkelig dokumenteret.
The objecting concerned Member States considered that the authorisation of Fiprex may present a potential serious risk to animal health since the target animal safety and efficacy of the product had not been sufficiently demonstrated.
CVMP blev anmodet om at fremsætte en udtalelse om de betænkeligheder, der var rejst af de indsigende berørte medlemsstater, og om benefit/risk-forholdet for Fiprex.
The CVMP was asked to give its opinion on the concerns raised by the objecting concerned Member State and to conclude on the benefit-risk balance for Fiprex.
Fipronil er et ektoparasiticid, som alt efter det godkendte produkt kan anvendes til forebyggelse og behandling af loppeangreb hos hunde og katte, kontrol af loppeforårsaget allergisk dermatitis som led i en behandlingsstrategi og kontrol af angreb af bidende lus.
Fipronil is an ectoparasiticide that, depending on the approved product, can be used to prevent and treat flea infestations in dogs and cats, to control flea allergic dermatitis as part of a treatment strategy and also to control infestations of biting lice.
Flåter er vektorer for sygdomme hos dyr og mennesker, f.eks. Lyme-sygdom.
Ticks are obligate parasites that are vectors for diseases to animals and humans e.g. Lyme disease.
Spanien1
Spain1
Under proceduren var der uenighed mellem referencemedlemsstaten og en berørt medlemsstat, Irland, om den af markedsføringstilladelsesindehaveren forelagte dokumentation for virkningen og sikkerheden hos de dyrearter, som lægemidlet er beregnet til.
During the procedure, there was disagreement between the reference Member State and a concerned Member State, Ireland, on the adequacy of the data presented by the marketing authorisation holder (MAH) in support of efficacy and target animal safety.
Videnskabelige konklusioner og begrundelse for afslag på ansøgning om markedsføringstilladelse og for suspendering af de eksisterende markedsføringstilladelser
Scientific conclusions and grounds for the refusal of the marketing authorisation and for suspension of the existing marketing authorisations
Ifølge indehaveren af markedsføringstilladelsen giver de forelagte publicerede rapporter tilstrækkelig betryggelse vedrørende sikkerheden og virkningen af forskellige spot-on produkter indeholdende fipronil, således at kvantitative forskelle i indholdet af aktivt stof eller kvantitative/kvalitative forskelle i indholdet af hjælpestoffer mellem produkterne ikke vil medføre forskelle i udfaldet hvad angår sikkerhed eller virkning.
According to the MAH, the submitted published reports provided sufficient comfort relating to the safety and efficacy of different fipronil spot-on products, such that any quantitative differences in active ingredient content or quantitative/qualitative differences in excipient content between products would not result in different safety or efficacy outcomes.
Indehaveren af markedsføringstilladelsen redegjorde desuden for undersøgelser, der var forelagt for forskellige generiske produkter og viste, at hvert produkt havde acceptabel virkning i forhold til det oprindelige i EU markedsførte produkt trods forskelle i indholdet af hjælpestoffer.
The MAH further outlined studies submitted on behalf of various generic products, which showed that each product had acceptable efficacy compared to the originator product on the EU market, despite differences in excipient content.
De af markedsføringstilladelsesindehaveren forelagte sikkerhedsdata efter markedsføring (vedrørende periodiske, opdaterede sikkerhedsindberetninger og salgstal) kunne ikke tages i betragtning, da de bl.a. henviste til produkter, som ikke var omfattet af indbringelsesproceduren.
It was not possible to consider the post-authorisation safety data presented by the MAH (related to periodic safety update reports and sales volume data) since these data included reference to products that were not included in the scope of this referral procedure.
Ansøgningen blev indgivet via den gensidige anerkendelsesprocedure, idet det retlige grundlag var almindelig anvendelse (artikel 13, litra a), i direktiv 2001/82/EF).
The application was submitted for a mutual recognition procedure, using the legal basis of well-established use (Article 13a of Directive 2001/82/EC).
Med henblik herpå forelagde indehaveren af markedsføringstilladelsen en sammenligning af forskellene i formulering mellem forskellige produkter indeholdende fipronil og redegjorde for lighederne i deres indikationer.
To this effect, the MAH provided a comparison of the differences in formulation between various fipronil-containing products and outlined the similarities in their indications.
Betingelse for ophævelse af suspenderingen af markedsføringstilladelserne
Condition for lifting the suspension of the marketing authorisations
Sikkerhed hos de dyrearter, som lægemidlet er beregnet til
Target animal safety