natgillin/translations-raw huggingface dataset:
• Patients given Vectibix in combination with FOLFIRI lived for 16.2 months in a study of 1,186 previously treated patients compared with 13.9 months in patients receiving FOLFIRI alone.
• V študiji s 1 186 predhodno zdravljenimi bolniki so tisti, ki so prejemali zdravilo Vectibix skupaj s shemo FOLFIRI, živeli 16,2 meseca v primerjavi s tistimi, ki so prejemali samo shemo FOLFIRI in so živeli 13, 9 meseca.
• Around 59% of patients who received Vectibix plus FOLFIRI in a study of 154 previously untreated had some reduction in signs of cancer.
• V študiji s 154 predhodno nezdravljenimi bolniki so se pri 59 % tistih, ki so prejemali zdravilo Vectibix skupaj s shemo FOLFIRI, znaki rakavega obolenja nekoliko zmanjšali.
Some studies also report an association with lower doses.
Nekatere študije poročajo tudi o povezavi z nižjimi odmerki.
• The PRAC also concluded that there was need for further risk minimisation measures such as information to healthcare professionals.
• PRAC je prav tako zaključil, da so potrebni dodatni ukrepi za zmanjšanje tveganja, na primer informacije za zdravstvene delavce.
Major vascular events were increased by about one third by a coxib (rate ratio [RR] 1.37, 95% confidence interval [CI] 1.14-1.66; p=0.0009) or diclofenac (1.41, 1.12-1.78; p=0.0036), mainly due to an increase in major coronary events (coxibs: 1.76, 1.31-2.37; p=0.0001; diclofenac: 1.70, 1.19-2.41; p=0.0032).
Večji vaskularni dogodki so se povečali za približno tretjino pri koksibu (razmerje stopnje [RS] 1,37, 95-odstotni interval zaupanja [IZ] 1,14−1,66; p = 0,0009) ali pri diklofenaku (1,41, 1,12−1,78; p = 0,0036), v glavnem zaradi povečanja števila večjih koronarnih dogodkov (koksibi: 1,76, 1,31−2,37; p = 0,0001; diklofenak: 1,70, 1,19−2,41; p = 0,0032).
This review was conducted by the Pharmacovigilance Risk Assessment Committee (PRAC).
Pregled je izvedel Odbor za oceno tveganja na področju farmakovigilance (PRAC).
Diclofenac is a non-steroidal anti-inflammatory drug (NSAID).
Diklofenak je nesteroidno protivnetno zdravilo (NSAID).
Key elements for a direct healthcare professional communication were agreed, together with the timelines for distribution.
Dogovorili so se o ključnih elementih za neposredno komunikacijo z zdravstvenimi delavci in o časovnem načrtu za distribucijo;
Overall summary of the scientific evaluation of diclofenac containing medicinal products (systemic formulations) (see Annex I)
Splošni povzetek znanstvenega vrednotenja zdravil, ki vsebujejo diklofenak (sistemske formulacije) (glejte Prilogo I)
These are appropriately reflected in the product information.
Omenjeni neželeni učinki so ustrezno navedeni v informacijah o zdravilu.
The PRAC concluded that diclofenac is effective in reducing inflammation and pain.
PRAC je zaključil, da je diklofenak učinkovit pri zmanjšanju vnetja in bolečine.
Therefore in accordance with Articles 31 and 32 of Directive 2001/83/EC, the PRAC recommends the variation of the marketing authorisations for all medicinal products referred to in Annex I and for which the amendments to the product information are set out in annex III of the recommendation.
V skladu s členoma 31 in 32 Direktive 2001/83/ES zato PRAC priporoča spremembo dovoljenj za promet za vsa zdravila, ki so navedena v Prilogi I in za katera so spremembe informacij o zdravilu navedene v Prilogi III priporočila.
The available information on the dose effect of diclofenac is limited.
Razpoložljive informacije o razmerju odmerek/učinek za diklofenak so omejene.
Annex II Scientific conclusions and grounds for variation to the terms of the marketing authorisations
Znanstveni zaključki in podlaga za spremembo pogojev dovoljenj za promet z zdravilom
Another evaluation conducted by the CHMP in 20122 considered all available published evidence to date from meta-analysis of clinical trials and observational studies, and also epidemiological studies.
V drugi oceni, ki jo je odbor CHMP izvedel leta 20122, so upoštevali vse dotedanje razpoložljive objavljene dokaze iz metaanaliz kliničnih preskušanj in opazovalnih študij ter epidemioloških študij.
• The PRAC considered that diclofenac containing medicinal products are effective in their approved indications.
• PRAC je menil, da so zdravila, ki vsebujejo diklofenak, učinkovita pri odobrenih indikacijah;
The PRAC considered that the recommendation for update of the product information should be applicable to all medicinal products containing diclofenac (systemic formulations), regardless of dose.
PRAC je menil, da bi moralo priporočilo za posodobitev informacij o zdravilu veljati za vsa zdravila, ki vsebujejo diklofenak (sistemske formulacije), ne glede na odmerek.
Furthermore, a proactive communication of these new measures through a direct healthcare professional communication (DHPC) was recommended.
Odbor je priporočil tudi proaktivno obveščanje o teh novih ukrepih z neposrednim sporočilom za zdravstveno osebje.
Risk minimisation measures (in the form of contraindications and warnings in the product information) were implemented at the time for Cox-2 inhibitors.
Takrat so uvedli ukrepe za zmanjšanje tveganja (v obliki kontraindikacij in opozoril v informacijah o zdravilu) za zaviralce Cox-2.
The data available (in particular data from the MEDAL1 programme) suggested that the risk of arterial thrombotic events with diclofenac was similar to that for coxibs, but firm conclusions could not be drawn and further epidemiological studies were needed to obtain additional data.
Razpoložljivi podatki (zlasti podatki iz programa MEDAL1) so pokazali, da je bilo tveganje za pojav arterijskih trombotičnih dogodkov pri diklofenaku podobno tveganju pri koksibih, vendar trdnih sklepov ni bilo mogoče sprejeti in potrebne so bile nadaljnje epidemiološke študije za pridobitev dodatnih podatkov.
A new review was considered necessary and was initiated to address the cardiovascular safety concerns for diclofenac and their impact on the benefit-risk balance of diclofenac containing medicinal products (systemic formulations).
Potreben je bil nov pregled, ki so ga nato sprožili, da bi ocenili pomisleke glede srčno-žilne varnosti za diklofenak in njihov vpliv na razmerje med koristmi in tveganji za zdravila, ki vsebujejo diklofenak (sistemske formulacije).
The PRAC acknowledged the conclusions of previous reviews with regards to the cardiovascular safety of diclofenac.
PRAC je potrdil sklepe predhodnih pregledov glede srčno-žilne varnosti diklofenaka.
Recognised risks associated with NSAID treatment in general, and with diclofenac treatment in particular, include serious gastrointestinal effects including PUB (perforation, ulcer, bleeding), cardio-renal effects, hepatic effects and skin reactions (including Stevens Johnson syndrome and toxic epidermal necrolysis).
Med znana tveganja, ki so na splošno povezana z zdravljenjem z nesteroidnimi protivnetnimi zdravili in zlasti povezana z zdravljenjem z diklofenakom, spadajo resni gastrointestinalni učinki, vključno s PUK (perforacija, ulkus, krvavitev), kardiorenalni učinki, učinki na jetra in kožne reakcije (vključno s StevensJohnsonovim sindromom in toksično epidermalno nekrolizo).
In 2006 it was concluded that a small increase in the absolute risk of thrombotic events could not be excluded for NSAIDs as a class, especially when used at high-doses and long-term therapy, although the risk was considered to be higher for the selective cyclooxygenase-2 (Cox-2) inhibitors (also known as coxibs) compared to NSAIDs.
Leta 2006 je odbor zaključil, da rahlega povečanja absolutnega tveganja za pojav trombotičnih dogodkov ni mogoče izključiti za skupino nesteroidnih protivnetnih zdravil, kar velja zlasti pri uporabi zdravil v visokih odmerkih in za dolgotrajno zdravljenje, čeprav je odbor menil, da je bilo tveganje večje za selektivne zaviralce ciklooksigenaze-2 (Cox-2) (znane tudi pod imenom koksibi) kot za nesteroidna protivnetna zdravila.
Although the data point towards a dose dependent effect on thrombotic risk associated with the use of diclofenac, particularly at high dose, it is difficult to establish a clear cut-off dose above which the risks become significantly increased.
Čeprav podatki kažejo na od odmerka odvisen učinek na trombotično tveganje, povezano z uporabo diklofenaka, zlasti pri visokih odmerkih, je težko določiti natančno mejno vrednost odmerka, po kateri se tveganja znatno povečajo.
The data available today do not allow conclusion on the specific mechanisms underlying the cardiovascular thrombotic risks of diclofenac, although several studies have explored different options and it can be noted that is unlikely that one single mechanism would explain the risk.
Trenutno razpoložljivi podatki ne omogočajo sklepanja o specifičnih mehanizmih, ki so vzrok za srčno-žilna trombotična tveganja diklofenaka, čeprav so v več študijah preučili različne možnosti in je mogoče zabeležiti, da je malo verjetno, da bi tveganje razložili s samo enim mehanizmom.
• The PRAC considered the procedure under Article 31 of Directive 2001/83/EC resulting from pharmacovigilance data, for diclofenac containing medicinal products (systemic formulations).
• PRAC je obravnaval napotitev po členu 31 Direktive 2001/83/ES, ki je bila na podlagi farmakovigilančnih podatkov sprožena za zdravila, ki vsebujejo diklofenak (sistemske formulacije);
Data provided by the MAHs in writing and at an oral explanation and relevant data made available by independent researchers were also considered.
Preučili so tudi podatke, ki so jih predložili imetniki dovoljenja za promet z zdravilom v pisni obliki, njihove ustne obrazložitve in relevantne podatke, ki so jih prispevali neodvisni raziskovalci.
Results of the ‘safety of non-steroidal anti-inflammatory drugs' (SOS) research project funded by the European Commission under the Seventh Framework Programme were considered in the review that concluded that available evidence regarding diclofenac seemed to consistently point towards a less favourable cardiovascular risk profile compared to other NSAIDs, and similar risks as those of Cox-2 inhibitors.
Rezultate raziskovalnega projekta (SOS) o „varnosti nesteroidnih protivnetnih zdravil“, ki je ga v okviru sedmega okvirnega programa financirala Evropska komisija, so preučili v pregledu, v katerem so zaključili, da razpoložljivi dokazi o diklofenaku dosledno kažejo na manj ugoden profil srčno-žilnega tveganja v primerjavi z drugimi nesteroidnimi protivnetnimi zdravili in na tveganja, ki so podobna tveganjem zaviralcev Cox-2.
Evidence available from a new meta-analysis of randomised clinical trials conducted by an independent research group was included in the review.
V pregled so bili vključeni dokazi iz nove metaanalize randomiziranih kliničnih preskušanj, ki jo je izvedla neodvisna raziskovalna skupina.
It was observed that these are similar to those of selective Cox-2 inhibitors.
Ugotovili so, da so tveganja podobna tveganjem selektivnih zaviralcev Cox-2;
Based on the available data to date, the PRAC therefore concluded that the cardiovascular thrombotic risk cannot be excluded across all doses of diclofenac, especially in patients with pre-existing co-morbidities.
Na podlagi razpoložljivih podatkov je odbor PRAC zaključil, da srčno-žilnega trombotičnega tveganja ni mogoče izključiti za vse odmerke diklofenaka, zlasti ne pri bolnikih s predhodno obstoječimi sočasnimi obolenji.
The PRAC therefore recommended an amendment to the product information for diclofenac to include an updated contraindication in patients with established congestive heart failure (NYHA II-IV), ischemic heart disease, peripheral arterial disease and/or cerebrovascular disease.
PRAC je zato priporočil spremembo informacij o zdravilu za diklofenak, tako da bo v informacije vključena posodobljena kontraindikacija pri bolnikih z ugotovljenim kongestivnim srčnim popuščanjem (NYHA II-IV), ishemično boleznijo srca, periferno arterijsko boleznijo in/ali cerebrovaskularnim obolenjem.
Considering that an increased cardiovascular risk with diclofenac is observed, and this appears similar to that of selective Cox-2 inhibitors, it therefore follows that any risk minimisation in place for Cox-2 inhibitors with respect to cardiovascular risk should also apply to diclofenac.
Glede na to, da so zabeležili povečano srčno-žilno tveganje z diklofenakom, ki se zdi podobno tveganju selektivnih zaviralcev Cox-2, je treba vsak ukrep za zmanjšanje tveganja, sprejet za zaviralce Cox-2 glede srčno-žilnega tveganja, vpeljati tudi za diklofenak.
Meta-analyses of observational data and individual observational studies also consistently indicated that diclofenac is associated with a similar level of risk as Cox-2 inhibitors.
Metaanalize opazovalnih podatkov in posameznih opazovalnih študij prav tako dosledno kažejo, da je diklofenak povezan s podobno stopnjo tveganja kot zaviralci Cox2.
The CMDh, having considered the PRAC recommendation dated 13 June 2013 pursuant to Article 107k(1) and (2) of Directive 2001/83/EC, reached a position on the variation of the marketing authorisations of diclofenac containing medicinal products for which the amendments to the product information are set out in annex III.
Skupina CMDh je po obravnavi priporočila odbora PRAC z dne 13. junija 2013 v skladu s členom 107k(1) in (2) Direktive 2001/83/ES sprejela stališče glede spremembe dovoljenj za promet z zdravili, ki vsebujejo diklofenak, za katera so spremembe informacij o zdravilu navedene v Prilogi III.
• The PRAC considered the totality of the data available in relation to the cardiovascular safety of diclofenac containing medicinal products, acknowledging the conclusions from previous reviews by the CHMP, the submissions by marketing authorisation holders in writing and at an oral explanation, and emerging data from independent researchers.
• PRAC je obravnaval vse razpoložljive podatke v zvezi s srčno-žilno varnostjo zdravil, ki vsebujejo diklofenak, in potrdil sklepe odbora CHMP iz predhodnih pregledov, vloge imetnikov dovoljenja za promet z zdravilom v pisni obliki in njihove ustne obrazložitve ter nove podatke, ki so jih priskrbeli neodvisni raziskovalci;
The study, which looked at more than 600 randomised clinical trials, concluded that the vascular risks of high dose diclofenac are comparable to Cox-2 inhibitors.
V študiji, v kateri so obravnavali več kot 600 randomiziranih kliničnih preskušanj, so zaključili, da so vaskularna tveganja visokega odmerka diklofenaka primerljiva s tveganji zaviralcev Cox-2.
An increased risk with diclofenac was also observed in the SOS nested-cases control studies across all databases and for both myocardial infarction and ischaemic stroke.
Povečano tveganje z diklofenakom so zabeležili tudi pri ugnezdenih študijah „primer-kontrola‟ SOS v vseh zbirkah podatkov, in sicer tako za miokardni infarkt kot za ishemično kap.
NSAIDs, such as diclofenac, are indicated in the relief of all grades of pain and inflammation associated with a wide range of conditions, including arthritic conditions, acute musculo-skeletal disorders and other painful conditions resulting from trauma.
Nesteroidna protivnetna zdravila, kakršno je tudi diklofenak, so indicirana za lajšanje vseh stopenj bolečine in vnetja pri različnih bolezenskih stanjih, vključno z artritičnimi obolenji, akutnimi mišično-skeletnimi okvarami in drugimi bolečimi stanji, ki so posledica poškodb.
Diclofenac containing medicinal products (systemic formulations) are available as tablets, capsules for oral administration, suppositories for rectal administration and solutions for intravenous or intramuscular injection.
Zdravila, ki vsebujejo diklofenak (sistemske formulacije), so na voljo v obliki tablet, kapsul za peroralno uporabo, svečk za rektalno uporabo in raztopin za intravensko ali intramuskularno injiciranje.
1 For more details on the MEDAL programme, including its components, please refer to the assessment report for the review conducted in 2006 at http://www.ema.europa.eu/docs/en_GB/document_library/Report/2010/01/WC500054344.pdf.
2 Za več informacij o pregledu, ki ga je odbor izvedel leta 2012, glejte poročilo o oceni postopka na spletni strani http://www.ema.europa.eu/docs/en_GB/document_library/Report/2012/11/WC500134717.pdf.
• The PRAC considered that with regards to the arterial thrombotic risks of diclofenac, the data available to date from randomised clinical trials, observational studies and individual epidemiological studies, including meta-analysis thereof, allow the conclusion that diclofenac is associated with increased cardiovascular risks.
• PRAC je menil, da je na podlagi dotedanjih razpoložljivih podatkov iz randomiziranih kliničnih preskušanj, opazovalnih študij in posameznih epidemioloških študij, vključno z metaanalizo teh študij, v zvezi z arterijskimi trombotičnimi tveganji diklofenaka mogoče zaključiti, da je diklofenak povezan s povečanimi srčno-žilnimi tveganji.
The study by Krum et al 2012, a post hoc analysis of the MEDAL trial, showed that there was no significant differential effect between etoricoxib and diclofenac in relation to cardiovascular events, except for confirmed congestive heart failure.
in je bila post hoc analiza preskušanja MEDAL, je pokazala, da ni pomembno drugačnega učinka med etorikoksibom in diklofenakom v povezavi s srčno-žilnimi dogodki, razen za potrjeno kongestivno srčno popuščanje.
In addition, patients with certain cardiovascular risk factors (such as hypertension, hyperlipidaemia, diabetes mellitus or smoking) should only use diclofenac after careful consideration and therefore the warnings should also be updated to reflect this.
Poleg tega lahko bolniki z nekaterimi srčno-žilnimi dejavniki tveganja (kot so hipertenzija, hiperlipidemija, diabetes in kajenje) diklofenak uporabljajo le po temeljitem premisleku, kar je treba vključiti tudi v opozorila.
With regards to cardiovascular risks, the PRAC noted that the initial signal from the MEDAL programme was confirmed by the meta-analyses of randomised clinical trials conducted by Trelle et al (2011) and Chen and Ashcroft (2007).
V zvezi s srčno-žilnimi tveganji je PRAC zabeležil, da je bilo začetno sporočilo programa MEDAL potrjeno z metaanalizami randomiziranih kliničnih preskušanj, ki so jih izvedli Trelle in sod.
In addition, patients with certain cardiovascular risk factors (hypertension, hyperlipidaemia, diabetes mellitus, and smoking) should only use diclofenac after careful consideration and therefore the warnings should be updated to reflect this.
Poleg tega lahko bolniki z določenimi srčno-žilnimi dejavniki tveganja (hipertenzija, hiperlipidemija, diabetes in kajenje) diklofenak uporabljajo le po temeljitem premisleku, kar je treba vključiti tudi v opozorila.
The PRAC concluded that the benefit-risk balance for diclofenac containing medicinal products (systemic formulations) remains favourable subject to the agreed restrictions, warnings, other changes to the product information and additional risk minimisation measures, in the form of a communication letter.
je PRAC zaključil, da razmerje med koristmi in tveganji za zdravila, ki vsebujejo diklofenak (sistemske formulacije), ostaja ugodno, če se spoštujejo dogovorjene omejitve, opozorila, druge spremembe informacij o zdravilu in dodatni ukrepi za zmanjšanje tveganja v obliki sporočila.
Schjerning Olsen et al (2011) provided data on risks in relation to duration of exposure and found that the risks associated with diclofenac were very similar to those of coxibs at all time points.
(2011) so zagotovili podatke o tveganjih v povezavi s trajanjem izpostavljenosti in zabeležili, da so bila tveganja, povezana z diklofenakom, pri vseh časovnih točkah zelo podobna tveganjem koksibov.
• The PRAC concluded that in view of the currently available safety data in order to maintain a favourable benefit/risk, diclofenac containing medicinal products should be contraindicated in patients with established congestive heart failure (NYHA II-IV), ischemic heart disease, peripheral arterial disease and/or cerebrovascular disease.
• na podlagi trenutno razpoložljivih podatkov o varnosti je PRAC zaključil, da je treba zdravila, ki vsebujejo diklofenak, kontraindicirati pri bolnikih z ugotovljenim kongestivnim srčnim popuščanjem (NYHA II-IV), ishemično boleznijo srca, periferno arterijsko boleznijo in/ali cerebrovaskularnim obolenjem, da se ohrani ugodno razmerje med koristmi in tveganji.
The new evidence provided by marketing authorisation holders including evidence from new casecontrol studies and retrospective studies add to the evidence of an increased risk with diclofenac
Novi dokazi, ki so jih predložili imetniki dovoljenja za promet z zdravilom, vključno z dokazi iz novih študij „primer-kontrola‟ in retrospektivnih študij, potrjujejo dokaze o povečanem tveganju z diklofenakom v primerjavi z drugimi nesteroidnimi protivnetnimi zdravili in da je tveganje z diklofenakom podobno tveganju s koksibi.
Moreover, the general rule that NSAIDs should be used at the lowest dose for the shortest duration possible should be consistently implemented in the posology section of the product information.
Nadalje je treba v poglavje o odmerjanju v informacijah o zdravilu dosledno dodati splošno pravilo, da se naj nesteroidna protivnetna sredstva uporabljajo pri nizkih odmerkih za čim krajši čas;
The CMDh, having considered the PRAC recommendation dated 13 June 2013 with regards to diclofenac containing medicinal products (systemic formulations), agrees with the recommendation therein as stated below:
Skupina za usklajevanje za postopek z medsebojnim priznavanjem in decentralizirani postopek za zdravila za uporabo v humani medicini (CMDh) se je po preučitvi priporočila, ki ga je za zdravila, ki vsebujejo diklofenak (sistemske formulacije), dne 13. junija 2013 izdal Odbor za oceno tveganja na področju farmakovigilance (PRAC), strinjala s priporočilom, ki je navedeno v nadaljevanju:
Having noted all of the above, the PRAC concluded that the benefit-risk balance for diclofenac containing medicinal products (systemic formulations) remains favourable subject to the agreed restrictions, warnings, other changes to the product information and additional risk minimisation measures, in the form of a DHPC letter.
V skladu z zgoraj navedenim je odbor PRAC v obliki pisma DHPC (neposrednega sporočila za zdravstvene delavce) zaključil, da razmerje med koristmi in tveganji za zdravila, ki vsebujejo diklofenak (sistemske formulacije), ostaja ugodno, če se spoštujejo dogovorjene omejitve, opozorila, druge spremembe informacij o zdravilu in dodatni ukrepi za zmanjšanje tveganja.
Epidemiological and clinical trial data on the cardiovascular risks of NSAIDs, including diclofenac, were previously reviewed by the Committee for Medicinal Products for Human Use (CHMP).
Odbor za zdravila za uporabo v humani medicini (CHMP) je predhodno pregledal epidemiološke podatke in podatke iz kliničnih preskušanj o srčno-žilnih tveganjih nesteroidnih protivnetnih zdravil.
The case resolved within three days.
Težava je bila odpravljena v treh dneh.
This is very rare.
Do tega pride zelo redko.
Children and adolescents This medicine should not be given to children and adolescents less than 18 years of age.
Otroci in mladostniki To zdravilo se ne sme dajati otrokom in mladostnikom, mlajšim od 18 let.
These infections are usually easily treated.
Te okužbe so običajno zlahka ozdravljive.
The condition gets better on its own or with treatment of the infection.
Stanje se izboljša samo od sebe ali pa z zdravljenjem okužbe.
The following terms represent a group of related events that describes a medical condition rather than a single event.
Naslednji izrazi predstavljajo skupino povezanih dogodkov, ki bolje opisujejo zdravstveno stanje kot pa en sam dogodek.
All these changes were considered to be incidental and probably related to the intravenous administration procedure.
Vse te spremembe so bile ocenjene kot naključne in verjetno povezane s postopkom intravenskega dajanja.
Submission of final study results:
Predložitev končnih rezultatov študije:
If your partner becomes pregnant within three months of your treatment, you must immediately tell your doctor.
Če vaša partnerka v obdobju treh mesecev med vašim zdravljenjem zanosi, morate to takoj sporočiti vašemu zdravniku.
Phase III Study (PCM301)
Študija III. faze (PCM301)