natgillin/translations-raw huggingface dataset:
Nimesulide is a non-steroidal anti-inflammatory drug (NSAID), available only on prescription and authorised in Europe since 1985.
Nimesulid je nesteroidno protivnetno zdravilo (NSAID), ki se dobi samo na recept in je v Evropi dovoljeno za uporabo od leta 1985.
Having reviewed all available data on hepatotoxicity, the CHMP concluded the following.
Po pregledu vseh razpoložljivih podatkov o jetrni toksičnosti je CHMP zaključil naslednje:
The CHMP agreed, that the risk minimisation measures adopted at the end of the first referral have been able to contain the incidence of the most serious liver injuries.
CHMP se je strinjal, da so ukrepi za zmanjševanje tveganj, sprejeti ob zaključku prvega napotitvenega postopka, uspeli zajeziti pojavnost večine resnih jetrnih poškodb.
The use of nimesulide in strict accordance with the Product Information recommendations has been shown to be equally effective in reducing hepatic toxicity.
Pokazalo se je tudi, da je uporaba nimesulida ob strogem upoštevanju priporočil v informacijah o zdravilu enako učinkovit način za zmanjšanje jetrne toksičnosti.
The CHMP reviewed the data presented, including answers provided by the Marketing Authorisations Holders (MAHs), pharmacovigilance data provided by the Member States, data provided by the EMEA and literature review.
CHMP je pregledal predstavljene podatke, vključno z odgovori, ki so jih predložili imetniki dovoljenja za promet z zdravilom, podatki o farmakovigilanci, ki so jih predložile države članice, ter podatki, ki jih je zagotovila EMEA, in podatki, zbranimi s pregledom objavljene literature.
- The limitation of treatment with nimesulide not longer than 15 days may limit the risk of acute liver injury.
- Omejitev trajanja zdravljenja z nimesulidom na največ 15 dni utegne omejiti tveganje za akutno poškodbo jeter.
This simulation showed a notable reduction of hospitalisation due to liver injuries whilst hospitalisation due to gastroinstestinal toxicity might increase.
Simulacija je pokazala opazno zmanjšanje obsega hospitalizacije zaradi poškodb jeter, medtem ko se je izkazalo, da utegne obseg hospitalizacije zaradi gastrointestinalne toksičnosti narasti.
Finally, according to the data submitted by the Marketing Authorisation Holder the majority of hepatic disorders (56%), occurred after two weeks of treatment, therefore a treatment period of not longer than 15 days may limit the risk of acute liver injury.
Glede na podatke, ki jih je predložil imetnik dovoljenja za promet z zdravilom, je do večine jetrnih obolenj (56 %) prišlo po dveh tednih zdravljenja, zato lahko s skrajšanjem obdobja zdravljenja na največ 15 dni omejimo tveganje za akutno poškodbo jeter.
The review concluded that a small increase in the absolute risk for hepatotoxic reactions associated with nimesulide cannot be excluded although the overall risk benefit/balance remains positive.
Pregled je bil zaključen z ugotovitvijo, da ni mogoče izključiti majhnega porasta absolutnega tveganja za hepatotoksične reakcije, povezane z nimesulidom, vendar pa skupno razmerje med tveganji in koristmi še dalje ostaja pozitivno.
The additional Product Information restrictions together with a limitation of duration of treatment and withdrawal of the pack sizes above 30 units aim at further minimising such risk, together with the conditions (see Annex IV) and the effort of national competent authorities in education and information activities on both prescribers and patients.
Cilj dodatnih omejitev v informacijah o zdravilu skupaj z omejitvijo trajanja zdravljenja in umikom iz prometa vseh pakiranj, ki vsebujejo več kot 30 enot, je, da poleg pogojev (glejte Dodatek IV) in prizadevanj nacionalnih pristojnih organov za izobraževanje in informiranje zdravnikov in bolnikov, še dodatno zmanjšajo omenjeno tveganje.
This referral concluded, with divergent positions submitted by Finland, Spain and Ireland, that the benefit/risk profile of nimesulide for systemic use remained positive, subject to revision of the product information, including a restriction of the maximum oral dose to 100 mg twice daily.
Napotitveni postopek se je vpričo razhajajočih se stališč, ki so jih predložile Finska, Španija in Irska, končal z ugotovitvijo, da ostaja razmerje med koristmi in tveganji pri sistemski uporabi nimesulida pozitivno, vendar pa je treba informacije o zdravilu revidirati tako, da bodo vključevale omejitev največjega peroralnega odmerka na 100 mg dvakrat dnevno.
- Nimesulide showed a higher frequency of severe adverse hepatic reactions but the overall safety profile of nimesulide is not modified.
- Nimesulid je pokazal višjo pogostost hudih neželenih jetrnih reakcij, toda celokupni varnostni profil nimesulida ostaja nespremenjen.
On 15th May 2007, following new safety information regarding cases of fulminant hepatic failure associated with nimesulide, the Irish Medicines Board suspended the national marketing authorisations for all systemic medicinal products containing nimesulide available in Ireland.
Ko so se 15. maja 2007 pojavile nove informacije o varnosti glede primerov fulminantnega hepatitisa, povezanega z nimesulidom, je irski odbor za zdravila umaknil nacionalna dovoljenja za promet za vsa zdravila za sistemsko uporabo, ki vsebujejo nimesulid, ki so na voljo na Irskem.
The assessment of overall post-marketing spontaneous reporting data, clinical studies, and epidemiological data, show a higher frequency of severe adverse hepatic reactions with nimesulide compared with other NSAIDs.
Ocena celokupnih postmarketinških podatkov, ki temeljijo na spontanem poročanju, ter kliničnih študij in epidemioloških podatkov, kaže, da je pri nimesulidu pogostost hudih neželenih jetrnih reakcij višja kot pri ostalih nesteroidnih protivnetnih zdravilih.
Furthermore the maintenance of the Marketing Authorisations is linked to the conditions, below: - Submission of 6-monthly PSURs - Implementation of a retrospective study, followed by a prospective study in transplant centres - Update of Risk Management Plan - Information of healthcare professional via a ‘Direct Healthcare Professional Communication'
Poleg tega so bili za ohranitev dovoljenj za promet z zdravilom postavljeni naslednji pogoji: - predložitev 6-mesečnih rednih poročil o varnosti zdravila (PSUR), - izvedba retrospektivne študije, ki ji sledi prospektivna študija v centrih za presajanje organov, - posodobitev načrta za obvladovanje tveganj, - neposredno obveščanje zdravstvenih delavcev z dopisom ‘Spoštovani zdravnik'
However, with the exception of the signal of serious hepatic adverse reactions raised by Ireland, the review of the overall data submitted do not modify the safety profile of nimesulide as established after the previous CHMP opinion.
Vendar pa pregled vseh predloženih podatkov ne glede na signal o resnih jetrnih neželenih reakcijah, ki ga je prijavila Irska, ne spreminja varnostnega profila nimesulida, ki je bil ugotovljen po izdaji prejšnjega mnenja CHMP.
During its plenary meeting in May 2007, the CHMP considered the emerging safety data from Ireland on the risk of fulminant hepatic failure associated with nimesulide, as well as data available from published literature, and concluded that hepatotoxicity data on nimesulide should be reviewed in accordance with Article 107(2) of Directive 2001/83/EC, as amended.
Med svojim plenarnim zasedanjem maja 2007 je CHMP preučil nove podatke o varnosti, ki so bili zbrani na Irskem in se nanašajo na tveganje za pojav fulminantne jetrne odpovedi, povezane z nimesulidom, preučil pa je tudi podatke iz objavljene literature, na podlagi česar je zaključil, da je potrebno podatke o jetrni toksičnosti nimesulida pregledati v skladu s členom 107(2) Direktive 2001/83/ES, kakor je bila spremenjena.
Some of the cases reported were however confounded by concommittant disease/hepatotoxic medication and a clear causal relationship with nimesulide could not be concluded.
Vendar pa je pri nekaterih od teh evidentiranih primerov prišlo do zamenjave s sočasno boleznijo/hepatotoksičnimi zdravili, zato ni bilo mogoče ugotoviti jasne vzročne povezave z nimesulidom.
Overall, the benefit-risk profile of nimesulide-containing medicinal products for systemic use remains favourable and the Marketing Authorisations for products containing nimesulide for systemic use should be maintained with the following restrictions: - The decision to prescribe nimesulide should be based on an assessment of the individual patient's overall risks.
V celoti gledano, ostaja razmerje med koristmi in tveganji zdravil, ki vsebujejo nimesulid, še dalje ugodno, zato se dovoljenja za promet z zdravili za sistemsko uporabo, ki vsebujejo nimesulid, lahko ohranijo pod pogojem, da se uvedejo naslednje omejitve: - Odločitev, da se bolniku predpiše nimesulid, mora biti sprejeta na podlagi ocene celotnih tveganj za vsakega posameznega bolnika posebej.
The CHMP has recommended the maintenance of the Marketing Authorisations for all medicinal products referred to in Annex I of the Opinion and to amend the relevant sections of the Summary of Product Characteristics and Package Leaflet of systemic formulations of nimesulide, as set out in Annex III of the Opinion in accordance with Article 107(2) of Directive 2001/83/EC, as amended.
CHMP je priporočil ohranitev dovoljenj za promet za vsa zdravila, našteta v Dodatku I Odločbe, in spremembo vseh ustreznih poglavij Povzetka glavnih značilnosti zdravila in Navodila za uporabo za zdravila za sistemsko uporabo, ki vsebujejo nimesulid, kot je bilo opredeljeno v Dodatku III Odločbe v skladu s členom 107(2) Direktive 2001/83/ES, kakor je bila spremenjena.
This decision was endorsed by the European Commission in April 2004 and the product information was subsequently amended to contraindicate its use in patients with hepatic impairment, and to include warnings about the risk of hepatitis, fulminant hepatitis (including fatal cases), jaundice and cholestasis.
Informacije o zdravilu so bile zato spremenjene tako, da vsebujejo navedbo, da je uporaba te učinkovine pri bolnikih z jetrno okvaro kontraindicirana, pa tudi opozorilo glede tveganja za pojav hepatitisa, fulminantnega hepatitisa (vključno s smrtnimi primeri), zlatenice in holestaze.
ANNEX II SCIENTIFIC CONCLUSIONS AND GROUNDS FOR THE MAINTENANCE OF THE MARKETING AUTHORISATIONS AND AMENDMENTS OF THE SUMMARY OF PRODUCT CHARACTERISTICS AND PACKAGE LEAFLET PRESENTED BY THE EMEA
DODATEK II ZNANSTVENI ZAKLJUČKI IN PODLAGA ZA OHRANITEV DOVOLJENJ ZA PROMET Z ZDRAVILOM IN SPREMEMBO POVZETKA GLAVNIH ZNAČILNOSTI ZDRAVILA TER NAVODILA ZA UPORABO, KI JIH JE PREDSTAVILA EMEA
The Irish Medicines Board informed the EMEA, other Member States and the Marketing Authorisation Holders in accordance with Article 107(2) of Directive 2001/83/EC, as amended.
Irski odbor za zdravila je v skladu s členom 107(2) Direktive 2001/83/ES, kakor je bila spremenjena, o tem obvestil agencijo EMEA, druge države članice in imetnike dovoljenj za promet z zdravilom.
- The CHMP considered the gastrointestinal toxicity profile of nimesulide and the possible consequences of switching to other NSAIDs.
- CHMP je preučil profil nimesulida glede njegove gastrointestinalne toksičnosti in možne posledice prehoda na druga nesteroidna protivnetna zdravila.
The hepatotoxic signal seen in Ireland showed that nimesulide was associated with more cases of nonA non-B non-paracetamol-related fulminant hepatic failure requiring liver transplantation in Ireland than any other medicinal product.
Hepatotoksični signal, opažen na Irskem, je pokazal, da je v tej državi nimesulid bolj kot katerokoli drugo zdravilo povezan z višjim številom primerov fulminatne jetrne odpovedi, ki ni povezana s hepatitisom A ali B ali paracetamolom in zaradi katere je bila potrebna presaditev jeter.
GROUNDS FOR THE MAINTENANCE OF THE MARKETING AUTHORISATIONS AND THE AMENDMENTS OF THE SUMMARY OF PRODUCT CHARACTERISTICS AND PACKAGE LEAFLET
PODLAGA ZA OHRANITEV DOVOLJENJ ZA PROMET IN SPREMEMBO POVZETKA GLAVNIH ZNAČILNOSTI ZDRAVILA TER NAVODILA ZA UPORABO
This review focused on the hepatic safety of nimesulide in light of the significant concern arising from the Irish data and within the defined scope of the Article 107.
Pregled vseh omenjenih podatkov je bil osredotočen na vprašanje varnosti nimesulida za jetra, zastavljeno na podlagi irskih podatkov, in se je izvajal znotraj obsega, predpisanega s členom 107.
Therefore pack sizes above 30 units should be withdrawn and not authorised - New contraindications and strengthened warnings have been added to the Summary of Product characteristics and Package Leaflet in order to limit exposure of nimesulide to those patients without risk factors for hepatic reactions.
- V Povzetek glavnih značilnosti zdravila in Navodilo za uporabo so bile vključene nove kontraindikacije in okrepljena opozorila z namenom omejiti izpostavljanje nimesulidu zgolj na tiste bolnike, pri katerih ne obstajajo dejavniki tveganja za jetrne reakcije.
Nimesulide was the subject of an Article 31 referral to the CHMP in 2002, following national suspension of its licence in Finland, and subsequently Spain, due to concerns regarding hepatotoxicity.
Ko sta Finska in nato še Španija umaknili dovoljenje za promet z nimesulidom, je bil ta leta 2002 v skladu s členom 31 napoten na Odbor za zdravila za uporabo v humani medicini (CHMP) zaradi zadržkov glede jetrne toksičnosti.
NSAIDs, and the possible consequences of switching to other NSAIDs with a higher gastrointestinal risk.
CHMP je preučil profil nimesulida glede njegove gastrointestinalne toksičnosti v primerjavi z ostalimi nesteroidnimi protivnetnimi zdravili in možne posledice prehoda na druga nesteroidna protivnetna zdravila z višjim gastrointestinalnim tveganjem.
Annex II Conditions to the marketing authorisation(s)
Priloga II Pogoji dovoljenja (dovoljenj) za promet z zdravilom
For N-nitrosodimethylamine (NDMA) and N nitrosodiethylamine (NDEA) the MAH must introduce the following specifications for the drug substance: 1) Limits for NDMA and NDEA outlined below should be implemented for a transitional period of 2 years:
Imetnik dovoljenja za promet z zdravilom mora za N-nitrozodimetilamin (NDMA) in N-nitrozodietilamin (NDEA) uvesti naslednje specifikacije za učinkovino:
1 pre-filled pen + 7 NovoTwist needles
1 napolnjen injekcijski peresnik + 7 igel NovoTwist
1 pre-filled pen + 7 NovoFine needles
1 napolnjen injekcijski peresnik + 7 igel NovoFine
EU Number
Številka EU Lastniško ime
Urokinase is considered to have a well-established use in the above indications within the European Union and on 29 September 2006, Syner-Kinase was granted a marketing authorisation in the UK according to Article 10(a) of Directive 2001/83/EC.
Za urokinazo se šteje, da ima dobro uveljavljeno uporabo pri zgoraj navedenih indikacijah v Evropski uniji, 29. septembra 2006 pa je bilo izdano dovoljenje za promet z zdravilom Syner-Kinase v Združenem kraljestvu v skladu s členom 10(a) Direktive 2001/83/ES.
• The Committee considered the referral under Article 29(4) of Directive 2001/83/EC,
• Odbor je obravnaval napotitev v skladu s členom 29(4) Direktive 2001/83/ES.
In January 2018, Syner-Medica Ltd sumitted a mutual recognition application for Syner-Kinase 10,000 IU, 25,000 IU, 100,000 IU, 250,000 IU and 500,000 IU powder for solution for injection or infusion in France, Germany, Spain and the Netherlands with the United Kingdom as the reference Member State (RMS).
Januarja 2018 je družba Syner Medical Ltd. vložila vlogo za medsebojno priznavanje praška za raztopino za injiciranje ali infundiranje Syner-Kinase 10.000 IU, 25.000 IU, 100.000 IU, 250.000 IU in 500.000 IU v Franciji, Nemčiji, Španiji in na Nizozemskem, z Združenim kraljestvom kot referenčno državo članico.
The UK therefore triggered a referral under Article 29(4) of Directive 2001/83/EC.
Združeno kraljestvo je sprožilo napotitev v skladu s členom 29(4) Direktive 2001/83/ES.
A referral was thus triggered at the CMD(h) but at D60 of the procedure, the PSRPH issues remained unresolved.
Zato je bila sprožena napotitev pri CMD(h), vendar so pri D60 postopka vprašanja v zvezi z morebitnim resnim tveganjem za javno zdravje ostala nerešena.
The Committee, as a consequence, considers that the benefit-risk balance of Syner-Kinase and associated names is favourable and therefore recommends the granting of the marketing authorisation(s) for the medicinal products referred to in Annex I of the CHMP opinion.
Odbor zato ocenjuje, da je razmerje med tveganji in koristmi zdravila Syner-Kinase in povezanih imen ugodno, in priporoča izdajo dovoljenja (dovoljenj) za promet z zdravili, navedenimi v Prilogi I k mnenju odbora CHMP.
The MAH/applicant has successfully demonstrated that the virus removal/inactivation steps are appropriately controlled and will provide the final reports of the virus and TSE removal studies and the updated risk assessment analysis by 31 May 2019 to the relevant national competent authorities.
Imetnik dovoljenja za promet/predlagatelj je uspešno dokazal, da je korak odstranjevanja/inaktivacije virusov ustrezno nadzorovan ter bo do 31. maja 2019 ustreznim nacionalnim pristojnim organom predložil končno poročilo o študijah o odstranjevanju virusov in TSE ter posodobljeno analizo ocen tveganja.
• The Committee concluded that the purification process of the active substance is suitable for the removal of possible viral and prion impurities.
• Odbor je sklenil, da je postopek čiščenja aktivne učinkovine ustrezen za odstranjevanje morebitnih nečistot v obliki virusov ali prionov ustrezen.
• The Committee considered the totality of the data submitted by the MAH/applicant in relation to the objections raised as potential serious risk to public health.
• Odbor je proučil podatke, ki jih je predložil imetnik dovoljenja za promet/predlagatelj v odziv na zadržke glede morebitnih resnih tveganj za javno zdravje.
Urokinase is used for the lysis of blood clots in the following conditions: thrombosed intravascular catheters and cannulae; extensive acute proximal deep vein thrombosis; acute massive pulmonary embolism and acute occlusive peripheral arterial disease with limb threatening ischemia.
Urokinaza se uporablja za lizo krvnih strdkov v naslednjih primerih: pri tromboziranih žilnih katetrih in kanilah, obsežni akutni proksimalni globoki venski trombozi, akutni masivni pljučni emboliji in akutni okluzivni periferni arterijski bolezni z ishemijo, ki ogroža ud.
The CHMP considered, as a consequence, that the benefit-risk balance of Syner-Kinase is favourable.
Zato je odbor CHMP menil, da je razmerje med koristmi in tveganji zdravila Syner-Kinase ugodno.
Finally, evidence has been provided that the manufacture of semi-purified urokinase is adequately validated and controlled and in compliance with good manufacturing practices and all concerns raised over the quality and manufacturing of Syner-Kinase are considered solved.
Zagotovljeni so bili tudi dokazi, da je proizvodnja polprečiščene urokinaze ustrezno potrjena in nadzorovana ter skladna z dobro proizvodno prakso, vsi pomisleki v zvezi s kakovostjo in proizvodnjo zdravila Syner-Kinase pa se štejejo za odpravljene.
• The Committee concluded that manufacture of the semi-purified urokinase is adequately validated and controlled, and that reassurance has been provided that this intermediate is manufactured at a site that complies with the principles and guidelines of Good Manufacturing Practice (GMP).
• Odbor je sklenil, da je proizvodnja polprečiščene urokinaze ustrezno potrjena in nadzorovana ter da je bilo dodatno zagotovljeno, da se ta vmesni proizvod proizvaja v obratu, ki je skladen z načeli in smernicami dobre proizvodne prakse.
• The Committee concluded that Syner-Kinase is comparable to the urokinase products mentioned in the published literature, and that the data available are adequate to support its proposed use.
• Odbor je sklenil, da je zdravilo Syner-Kinase primerljivo z zdravili, ki vsebujejo urokinazo, iz objavljene literature, in da razpoložljivi podatki ustrezno podpirajo njegovo predlagano uporabo.
The mutual recognition procedure was closed on day 90, with the four concerned Member States raising potential serious risk to public health (PSRPH) in relation to the lack of bridging data between the product applied for and the product(s) described in literature that was used to demonstrate the benefit/risk of Syner-Kinase, the adventitious agent safety with respect to viral and prion clearance and the lack of adequate quality of the process validation of the semi-purified urokinase and lifetime of columns used for urokinase purification.
Postopek medsebojnega priznavanja se je zaključil 90. dan, pri čemer so zadevne štiri države članice opozorile na morebitno resno tveganje za javno zdravje v zvezi s pomanjkljivimi povezovalnimi podatki med zdravilom, za katero je bila vložena vloga, in zdravili, opisanimi v literaturi, ki je bila uporabljena za dokazovanje koristi/tveganj zdravila Syner-Kinase, varnosti naključno prisotnih snovi, kar zadeva odsotnost virusov in prionov, pomanjkanja ustrezne kakovosti postopka potrjevanja polprečiščene urokinaze in življenjske dobe stolpcev, ki se uporabljajo za čiščenje urokinaze.
Urokinase is a serine protease that catalyses conversion of plasminogen to plasmin with resultant fibrinolytic and thrombolytic properties.
Urokinaza je serinska proteaza, ki katalizira reakcijo pretvorbe plazminogena v plazmin, ki pridobi fibrinolitične in trombolitične lastnosti.
Based on the data provided, it is considered that the comparability of Syner-Kinase and urokinase products used in the literature studies cited in the submission has been sufficiently demonstrated.
Na podlagi zagotovljenih podatkov se šteje, da je primerljivost zdravila Syner-Kinase in zdravil, ki vsebujejo urokinazo, iz študij literature, navedene v predložitvi, zadostno dokazana.
The CHMP also requested the MAH/applicant to provide further information to support the viral and prion clearance capacity of the process and justify the adequacy of the procedures to support the suitability of viral and prion removal, including transmissible spongiform encephalopathies (TSE) infectivity reduction.
Odbor CHMP je tudi zahteval, naj imetnik dovoljenja za promet z zdravilom/predlagatelj zagotovi dodatne informacije, ki dokazujejo sposobnost odstranjevanja virusov in prionov v okviru postopka in ustreznost postopkov za dokazovanje primernosti odstranjevanja virusov in prionov, vključno z zmanjšanjem infektivnosti transmisivnih spongiformnih encefalopatij (TSE).
As part of this procedure, the CHMP requested the applicant to justify that the available data on SynerKinase, including its comparison to the urokinase products mentioned in the literature, are adequate to support its positive benefit/risk balance in the proposed indications.
V okviru tega postopka je odbor CHMP zahteval, naj predlagatelj dokaže, da so razpoložljivi podatki o zdravilu Syner-Kinase, vključno z njegovo primerjavo z zdravili, ki vsebujejo urokinazo, iz literature, primerni za potrditev njegovega pozitivnega razmerja med tveganji in koristmi pri predlaganih indikacijah.
Finally, the CHMP requested the MAH/applicant to provide further information to demonstrate that the manufacturing steps for semi-purified urokinase have been satisfactorily validated, and also that the control strategy for column lifetime during the manufacture of the active pharmaceutical ingredient is suitable.
Na koncu je odbor CHMP zahteval, naj imetnik dovoljenja za promet z zdravilom/predlagatelj zagotovi dodatne informacije, ki dokazujejo, da so bili proizvodni koraki za polprečiščeno urokinazo zadovoljivo potrjeni, in tudi, da je strategija nadzora za življenjsko dobo stolpcev med proizvodnjo aktivne farmacevtske učinkovine ustrezna.