natgillin/translations-raw huggingface dataset:
The results of the pivotal phase III clinical study are considered robust and consistent with respect to primary and secondary efficacy parameters (addressing severity and impact of the disease and quality of life) as well as with respect to responder rates and various subgroup analyses.
Rezultati ključne klinične študije 3. faze so bili ocenjeni kot prepričljivi in dosledni pri primarnih in sekundarnih parametrih učinkovitosti (ki so se nanašali na stopnjo resnosti in vpliv bolezni ter kakovost življenja) ter tudi pri stopnjah odziva in različnih analizah podskupin.
A detailed review of safety data from both the double-blind phase and extension phase (OXN3502/S) was conducted.
Opravljen je bil podroben pregled podatkov o varnosti iz dvojno slepe faze in podaljšane faze (OXN3502/S).
Based on clinical experience and clinical guidance, the potential abuse and misuse of opioid analgesics in the controlled pain therapy is considered low.
Na podlagi kliničnih izkušenj in kliničnih smernic se ocenjuje, da je možnost za zlorabo in napačno uporabo opioidnih analgetikov pri nadzorovanem protibolečinskem zdravljenju majhna.
The maintenance of treatment effect was investigated in the open extension phase of the pivotal study.
Ohranjanje učinka zdravljenja so proučili v odprti podaljšani fazi ključne študije.
In addition, clear instructions have been proposed for section 4.2 of the SmPC to re-evaluate the benefits and risks in individual RLS patients regularly every 3 months and to consider a discharge regimen by gradual tapering before treatment is continued beyond 1 year.
Poleg tega so bila za poglavje 4.2 povzetka glavnih značilnosti zdravila predlagana jasna navodila, da je treba redno vsake 3 mesece ponovno oceniti koristi in tveganja pri posameznih bolnikih s SNN in ob odpustu razmisliti o režimu, ki vključuje postopno zmanjševanje odmerka pred nadaljevanjem zdravljenja po enem letu.
In addition, in order to further increase safety and appropriate use of OXN PR in the IRLS indication, the maximum daily dose has been limited to 60 mg/day.
Poleg tega so za dodatno povečanje varnosti in ustrezne uporabe zdravila OXN PR pri indikaciji iSNN največji dnevni odmerek omejili na 60 mg/dan.
The available clinical data of only one single, short term, pivotal trial are considered insufficient considering the risks.
2. razpoložljivi klinični podatki iz enega samega kratkotrajnega ključnega preskušanja glede na tveganja niso zadostni.
Therefore, further justification that the different criteria for approval on the basis of one pivotal trial should be provided by the applicant.
Imetnik dovoljenja za promet z zdravilom mora zato dodatno utemeljiti, da so izpolnjena različna merila za odobritev na podlagi enega ključnega preskušanja.
The review of ‘opioid dependence' revealed that during the extension phase two reports of withdrawal symptoms were obtained as part of the standard adverse event reporting procedures.
Pregled „odvisnosti od opioidov“ je razkril, da so med podaljšano fazo v okviru standardnih postopkov poročanja o neželenih dogodkih zabeležili dve poročili o odtegnitvenih simptomih.
Overall, the CHMP considered that benefits of Oxynal and Targin and associated names in the sought indication outweigh the risks, taking into account the additional risk minimisations measures which had already been agreed at CMD(h) and the changes recommended to the product information.
Na splošno je odbor CHMP menil, da so koristi zdravil Oxynal in Targin ter povezanih imen pri predlagani indikaciji večje od tveganj, če se upoštevajo dodatni ukrepi za zmanjšanje tveganja, ki so bili že dogovorjeni na ravni skupine CMD(h), in predlagane spremembe informacij o zdravilu.
Therefore, the Committee recommended the granting of the variation to the terms of the marketing authorisations for the medicinal products referred to in Annex I, for which the valid summary of product characteristics, labelling and package leaflets remain as per the final versions achieved during the Coordination group procedure with amendments as mentioned in Annex III.
zato je Odbor priporočil odobritev spremembe pogojev dovoljenj za promet z zdravili, navedenimi v Prilogi I, katerih povzetek glavnih značilnosti zdravila, označevanje in navodila za uporabo ostanejo enaki kot končne različice, dogovorjene med postopkom Usklajevalne skupine, z dopolnili, ki so navedena v Prilogi III.
The results at the end of the extension phase at week 52 showed a further slight improvement of the IRLS sum score compared to the results towards the end of 12-week double-blind phase.
Rezultati ob zaključku podaljšane faze po 52. tednih so pokazali nadaljnje rahlo izboljšanje skupnega rezultata po mednarodni lestvici za oceno SNN v primerjavi z rezultati proti koncu 12-tedenske dvojno slepe faze.
The safety profile was also considered to be in-line with the experience of OXN PR used for the treatment of pain where adverse events are also more frequently reported at the beginning of therapy.
Tudi za varnostni profil je bilo ocenjeno, da je skladen z izkušnjami pri uporabi zdravila OXN PR za zdravljenje bolečine, pri kateri o neželenih dogodkih prav tako pogosteje poročajo na začetku zdravljenja.
In addition, further improvements in the patient's condition by the end of the extension phase compared to the end of the double-blind phase was observed in the secondary efficacy parameters, including reduction in the severity of illness, improvements in sleep, RLS related pain and quality of life, respectively.
Poleg tega so ob zaključku podaljšane faze opazili dodatno izboljšanje stanja bolnikov v primerjavi z zaključkom dvojno slepe faze pri sekundarnih parametrih učinkovitosti, vključno z zmanjšanjem resnosti bolezni in izboljšanjem spanja, bolečine, povezane s SNN, oziroma kakovosti življenja.
These findings are in line with the results of the post-marketing surveillance with OXN PR in the treatment of pain where addiction and related abuse are carefully monitored.
Te ugotovitve so skladne z rezultati spremljanja v obdobju trženja, ki se izvaja za zdravilo OXN PR za zdravljenje bolečine in v okviru katerega skrbno spremljajo odvisnost in z njo povezane zlorabe.
Compared to other opioids, a lower potential for psychological dependence and abuse is further expected with OXN PR, as it is a prolonged release formulation whereas it is currently accepted knowledge that the risk of psychological dependence increases with faster drug release.
V primerjavi z drugimi opioidi naj bi bila pri uporabi zdravila OXN PR možnost za psihološko odvisnost in zlorabo še manjša, saj gre za formulacijo s podaljšanim sproščanjem, medtem ko je trenutno sprejeto spoznanje, da je tveganje za psihološko odvisnost večje pri oblikah s hitrejšim sproščanjem.
Annex II Scientific conclusions and grounds for the variation to the terms of the marketing authorisation
Znanstveni zaključki in podlaga za spremembo pogojev dovoljenja za promet z zdravilom
As requested during the CMDh procedure, the applicant has further made a commitment to perform a drug utilisation study (DUS) and to update the risk management plan (RMP) subsequently to approval of the DUS in order to address concerns based on uncertainties that data of the clinical study including the long-term extension might not fully characterise a possible risk of tolerance, dependence and drug abuse in long-term use in IRLS.
Kot je bilo zahtevano med postopkom skupine CMDh, se je predlagatelj tudi obvezal, da bo izvedel študijo o uporabi zdravila in da bo po odobritvi študije posodobil načrt obvladovanja tveganj (RMP), da bi odpravil zadržke zaradi negotovosti glede tega, ali podatki iz klinične študije, vključno s tistimi iz dolgotrajne podaljšane faze, dovolj celovito opredeljujejo možno tveganje za toleranco, odvisnost in zlorabo zdravila pri dolgotrajni uporabi za zdravljenje iSNN.
A drug utilisation study will also be conducted to further characterise a possible risk of tolerance, dependence and drug abuse in long-term use in idiopathic restless leg syndrome.
Izvedena bo tudi študija o uporabi zdravila, namenjena nadaljnji opredelitvi možnega tveganja za toleranco, odvisnost in zlorabo zdravila pri dolgotrajni uporabi za zdravljenje idiopatskega sindroma nemirnih nog;
Therefore, the CHMP endorsed that the use OXN PR as a prolonged-release formulation of oxycodone and naloxone reduces the risk of abuse or misuse.
Odbor CHMP se je zato strinjal, da uporaba zdravila OXN PR v obliki formulacije s podaljšanim sproščanjem, ki vsebuje oksikodon in nalokson, zmanjša tveganje za zlorabo ali napačno uporabo.
There is a lack of confirmatory evidence regarding the maintenance of efficacy and the long-term safety, which has not been provided by the open-label extension study phase, due to its methodological limitations.
1. potrditvenih dokazov o ohranjanju učinkovitosti in dolgoročni varnosti je premalo, saj jih zaradi metodoloških pomanjkljivosti v odprti podaljšani fazi študije niso uspeli pridobiti.
Even using a very conservative statistical approach, the magnitude of effect (decrease in mean IRLS of 5.9 points compared to placebo) was in line with or even slightly better than the results found in the placebo-controlled studies with dopamine agonists approved as first line treatment.
Celo pri uporabi zelo konservativnega statističnega pristopa je bil obseg učinka (znižanje povprečnega rezultata po mednarodni lestvici za oceno SNN za 5,9 točke v primerjavi s placebom) skladen z rezultati s placebom kontroliranih študij z agonisti dopamina, odobrenimi za zdravljenje prve izbire, ali celo nekoliko večji.
The CHMP agreed that the risk of physical dependence and associated withdrawal reaction can be mitigated and adequately managed by the strengthened tapering advice proposed.
Odbor CHMP se je strinjal, da je tveganje za telesno odvisnost in povezane odtegnitvene reakcije mogoče zmanjšati in zadovoljivo obvladati s predlaganim okrepljenim priporočilom o postopnem zmanjševanju odmerka.
The CHMP noted that there is evidence from the literature that the endogenous opioid system is involved in the pathogenesis of RLS on a spinal and supraspinal level and therefore there is a plausible rationale to justify the use of opioids for treatment of RLS 1,2.
Odbor CHMP je izpostavil, da dokazi iz literature kažejo, da ima endogeni opioidni sistem vlogo pri patogenezi SNN na spinalni in supraspinalni ravni, kar pomeni, da obstaja utemeljen razlog, ki upravičuje uporabo opioidov za zdravljenje SNN 1,2.
The treatment effect during the extension phase was independent from treatment during the pivotal study.
Učinek zdravljenja med podaljšano fazo ni bil odvisen od zdravljenja med ključno študijo.
The CHMP acknowledged the methodological limitations of the open label study however the CHMP considered that reasonable justifications for maintenance of effect up to 52 weeks of treatment were provided by the MAH.
Odbor CHMP se je strinjal, da je imela odprta študija metodološke omejitve, vendar je menil, da je imetnik dovoljenja za promet z zdravilom podal sprejemljivo utemeljitev glede ohranitve učinka do 52 tednov zdravljenja.
In addition, the CHMP highlighted the unmet medical need in the treatment of severe to very severe RLS.
Poleg tega je odbor CHMP izpostavil neizpolnjeno potrebo po zdravilu za zdravljenje hude do zelo hude oblike SNN.
The CHMP noted that the mean daily dose of OXN PR used in the extension phase was almost identical (and even slightly lower) compared to the mean daily dose used in the double-blind phase (18.12 mg vs. 22.62 mg), with no difference in mean doses in the extension phase between the subgroups previously treated with OXN PR or placebo.
Odbor CHMP je upošteval, da je bil povprečni dnevni odmerek zdravila OXN PR, ki so ga uporabili v podaljšani fazi, skoraj enak (in celo nekoliko manjši) kot povprečni dnevni odmerek, ki so ga uporabili v dvojno slepi fazi (18,12 mg v primerjavi z 22,62 mg), pri čemer se povprečna odmerka v podaljšani fazi med skupinama, predhodno zdravljenima z zdravilom OXN PR oziroma placebom, nista razlikovala.
97% of patients completing the double-blind controlled study entered the extension phase.
V podaljšani fazi je sodelovalo 97 % bolnikov, ki so zaključili dvojno slepo kontrolirano študijo.
No convincing scientific evidence has been provided in the perspective of public health that the benefit of the fixed dose combination of oxycodone/naloxone in the treatment of idiopathic restless leg syndrome (IRLS) outweighs the expected adverse effects that are associated with the use of strongopioids in doses equipotent to doses up to 90 mg of oral morphine; dependence, withdrawal, augmentation, misuse and abuse.
Predloženi niso bili nobeni prepričljivi znanstveni dokazi, pomembni z vidika javnega zdravja, da koristi fiksne kombinacije oksikodona in naloksona pri zdravljenju idiopatskega sindroma nemirnih nog (iSNN) odtehtajo pričakovane neželene učinke, povezane z uporabo močnih opioidov v odmerkih, katerih jakost je enaka odmerkom do 90 mg peroralnega morfina - to so odvisnost, odtegnitveni simptomi, poslabšanje simptomov, napačna uporaba in zloraba;
There were no notable differences in the frequency of adverse events, severe adverse events and serious adverse events (overall and treatment-related) for young vs. elderly subjects as well as for females vs. males.
Ugotovili niso nobenih opaznih razlik v pogostnosti neželenih dogodkov, hudih neželenih dogodkov in resnih neželenih dogodkov (vseh in povezanih z zdravljenjem) med mlajšimi in starejšimi preiskovanci ter med ženskami in moškimi.
Grounds for the variation to the terms of the marketing authorisation with amendments to the relevant sections of the summary of product characteristics
Podlaga za spremembo pogojev dovoljenja za promet z zdravilom z dopolnili zadevnih poglavij povzetka glavnih značilnosti zdravila
The CHMP also took note of the risks of iatrogenic drug dependence, drug abuse or misuse, augmentation, tolerance, and psychological dependence associated with Oxynal and Targin and associated names.
Odbor CHMP je upošteval tudi tveganja za iatrogeno odvisnost od zdravila, zlorabo ali napačno uporabo zdravila, poslabšanje simptomov, toleranco in psihološko odvisnost, povezana z zdraviloma Oxynal in Targin ter povezanimi imeni.
Warning regarding somnolence/sleep attacks and ability to drive/operating machinery has been added to the product information in accordance with the information given in the respective product information of dopaminergic substances approved in the RLS indication.
V informacije o zdravilu so bila dodana opozorila v zvezi s somnolenco/napadi spanja in sposobnostjo vožnje/upravljanja strojev, ki so skladna z informacijami v zadevnih informacijah o zdravilu za dopaminergike, odobrene za indikacijo, povezano s SNN.
In order to demonstrate the efficacy and safety of OXN PR in the symptomatic treatment of patients with moderate to severe idiopathic restless legs syndrome insufficiently treated with dopaminergic therapy, the application dossier was based on a pivotal phase III clinical study (No OXN 3502) and open label extension study phase (No OXN 3502S).
Da bi dokazali učinkovitost in varnost zdravila OXN PR pri simptomatskem zdravljenju bolnikov z zmerno do hudo obliko idiopatskega sindroma nemirnih nog, ki ga ni bilo mogoče učinkovito zdraviti z dopaminergiki, je vloga za pridobitev dovoljenja temeljila na ključni klinični študiji 3. faze (št. OXN 3502) in odprti podaljšani fazi študije (št. OXN 3502S).
Therefore, short term efficacy of OXN PR as second line treatment of severe to very severe RLS after failure of dopaminergic treatment has convincingly been shown in the pivotal study OXN3502.
Kratkoročna učinkovitost zdravila OXN PR kot zdravila druge izbire za zdravljenje hude do zelo hude oblike SNN po neuspešnem zdravljenju z dopaminergiki je bila torej v ključni študiji OXN3502 prepričljivo dokazana.
The frequency of adverse events and related adverse events was mostly comparable for both study phases (OXN3502/S) and points to a better tolerability of OXN PR in the extension phase.
Pogostnost neželenih dogodkov in z zdravljenjem povezanih neželenih dogodkov je bila v obeh fazah študije (OXN3502/S) v glavnem primerljiva in kaže na to, da so bolniki v podaljšani fazi zdravilo OXN PR bolje prenašali.
Further caution is included in the section 4.4 of the SmPC when OXN PR is administered to elderly irrespective of the indication.
V poglavje 4.4 povzetka glavnih značilnosti zdravila so bila vključena dodatna opozorila o previdnosti, kadar se zdravilo OXN PR daje starejšim, ne glede na indikacijo.
• The Committee considered that the amendments to the product information are appropriate to mitigate the risks of iatrogenic drug dependence, drug abuse or misuse, augmentation, tolerance and psychological dependence.
• odbor je menil, da so dopolnila informacij o zdravilu primerna za zmanjšanje tveganj za iatrogeno odvisnost od zdravila, zlorabo ali napačno uporabo zdravila, poslabšanje simptomov, toleranco in psihološko odvisnost.
The CHMP is of the opinion that the mean daily dose of 20mg/10mg oxycodone hydrochloride/naloxone used in the pivotal trial and being considerably lower than the doses needed in the pain indication should be mentioned in the SmPC to guide dosing.
Odbor CHMP je menil, da je treba povprečni dnevni odmerek 20 mg/10 mg oksikodonijevega klorida/naloksona, ki so ga uporabili v ključnem preskušanju in ki je znatno manjši od odmerkov, potrebnih za indikacijo, povezano z bolečino, navesti v povzetku glavnih značilnosti zdravila za pomoč pri odmerjanju.
The mean ILRS score at the end of the open extension study was 9.72 and corresponds to a mild symptom severity.
Povprečno število točk po mednarodni lestvici za oceno SNN ob koncu odprte podaljšane študije je bilo 9,72, kar označuje blage simptome.
Furthermore, the risk of parenteral or intranasal misuse of OXN PR by individuals dependent on opioid agonists is expected to be low as marked withdrawal symptoms are expected due to the opioid receptor antagonist characteristics of naloxone.
Poleg tega naj bi bilo tveganje, da bi posamezniki, odvisni od opioidnih agonistov, napačno uporabljali zdravilo OXN PR po parenteralni ali intranazalni poti, majhno, saj naj bi se zaradi naloksona, ki ima značilnosti antagonista opioidnih receptorjev, pojavili izraziti odtegnitveni simptomi.
Treatment with OXN PR in RLS has been contraindicated in patients with a history of opioid abuse.
Zdravljenje SNN z zdravilom OXN PR je kontraindicirano pri bolnikih, ki so že kdaj zlorabljali opioide.
The RLS treatment with OXN PR should be supervised by a clinician with experience in the management of IRLS.
Zdravljenje SNN z zdravilom OXN PR mora nadzorovati zdravnik, ki ima izkušnje z zdravljenjem iSNN.
During the CMD(h) referral procedure, the proposed restless legs syndrome indication was restricted to “second line symptomatic treatment of patients with severe to very severe idiopathic restless legs syndrome after failure of dopaminergic therapy".
Med napotitvenim postopkom skupine CMD(h) so predlagano indikacijo v zvezi s sindromom nemirnih nog omejili na „simptomatsko zdravljenje druge izbire bolnikov s hudo do zelo hudo obliko idiopatskega sindroma nemirnih nog po neuspešnem zdravljenju z dopaminergiki“.
On 31 August 2012, the MAH submitted a type II variation via the mutual recognition procedure (MRP) for Oxynal and Targin and associated names, to request the inclusion of “symptomatic treatment of patients with moderate to severe idiopathic restless legs syndrome insufficiently treated with dopaminergic therapy”.
Imetnik dovoljenja za promet z zdravilom je 31. avgusta 2012 predložil vlogo za spremembo tipa II po postopku z medsebojnim priznavanjem za zdravili Oxynal in Targin ter povezana imena, da bi zaprosil za vključitev indikacije „simptomatsko zdravljenje bolnikov z zmerno do hudo obliko idiopatskega sindroma nemirnih nog, ki ga ni bilo mogoče učinkovito zdraviti z dopaminergiki“.
• The Committee considered that the data of the pivotal phase III study and extension phase part are supportive of short term and long term efficacy of Oxynal and Targin and associated names in the second line symptomatic treatment of patients with severe to very severe idiopathic restless legs syndrome after failure of dopaminergic therapy.
• odbor je menil, da podatki iz ključne študije 3. faze in podaljšane faze študije podpirajo kratkoročno in dolgoročno učinkovitost zdravil Oxynal in Targin ter povezanih imen pri simptomatskem zdravljenju druge izbire bolnikov s hudo do zelo hudo obliko idiopatskega sindroma nemirnih nog po neuspešnem zdravljenju z dopaminergiki;
• The Committee reviewed all available data in support of the safety and efficacy of Oxynal and Targin and associated names in “second line symptomatic treatment of patients with severe to very severe idiopathic restless legs syndrome after failure of dopaminergic therapy”.
• odbor je pregledal vse razpoložljive podatke v podporo varnosti in učinkovitosti zdravil Oxynal in Targin ter povezanih imen pri indikaciji „simptomatsko zdravljenje druge izbire bolnikov s hudo do zelo hudo obliko idiopatskega sindroma nemirnih nog po neuspešnem zdravljenju z dopaminergiki“;
• The Committee concluded, in view of available data, that the benefit risk of Oxynal and Targin and associated names for “second line symptomatic treatment of patients with severe to very severe idiopathic restless legs syndrome after failure of dopaminergic therapy” is positive.
• odbor je na podlagi razpoložljivih podatkov zaključil, da je razmerje med tveganji in koristmi zdravil Oxynal in Targin ter povezanih imen pri indikaciji „simptomatsko zdravljenje druge izbire bolnikov s hudo do zelo hudo obliko idiopatskega sindroma nemirnih nog po neuspešnem zdravljenju z dopaminergiki“ pozitivno;
The CHMP considered that the data provided by the MAH are sufficient to support the use of Oxynal and Targin and associated names in the second line symptomatic treatment of patients with severe to very severe idiopathic restless legs syndrome after failure of dopaminergic therapy.
Odbor CHMP je menil, da so podatki, ki jih je predložil imetnik dovoljenja za promet z zdravilom, zadostni, da se lahko podpre uporaba zdravil Oxynal in Targin ter povezanih imen za simptomatsko zdravljenje druge izbire bolnikov s hudo do zelo hudo obliko idiopatskega sindroma nemirnih nog po neuspešnem zdravljenju z dopaminergiki.
No case of augmentation, tolerance, psychological dependence (addiction), abuse or misuse was reported in the studies OXN3502/S.
V študijah OXN3502/S niso poročali o nobenem primeru poslabšanja simptomov, tolerance, psihološke odvisnosti (zasvojenosti), zlorabe ali napačne uporabe.
Keep container tightly closed.
Shranjujte vsebnik dobro zaprt.
In such situations, appropriate monitoring of INR is desirable.
V takih primerih je zaželeno spremljanje INR.
The absolute bioavailability is approximately 20%.
Absolutna biološka uporabnost je približno 20 %.
Such factors include:
Taki dejavniki so:
LU1 3LU England UK
LU1 3LU England
Luomanportti 3 FIN-02200 Espoo Finland
Luomanportti 3 FIN-02200 Espoo Finska
The clinical relevance of this interaction has not been studied.
Kliničen pomen te interakcije ni bil raziskan.
Blisters of aluminium laminate/aluminium foil of 7, 14, 15, 20, 28, 30, 42, 50, 56, 60, 84, 98 and 100 tablets and HDPE bottles of 30 and 100 tablets.
Blistri iz aluminijevega laminata/aluminijeve folije po 7, 14, 15, 20, 28, 30, 42, 50, 60, 84, 98 in 100 tablet in plastenke DHPE po 30 in 100 tablet.
This is reflected in available treatment guidelines from learned societies.
To se odraža v dostopnih smernicah za zdravljenje, ki so jih izdala znanstvena združenja.
Crestor is contraindicated:
Crestor je kontraindiciran:
Crestor may be given at any time of day, with or without food.
Bolniki lahko Crestor zaužijejo kadar koli, bodisi s hrano bodisi brez nje.
{Name and address}
{Ime in naslov}
The contribution of environmental and genetic factors to these observed differences has not been determined.
Vpliva okolja in genetskih dejavnikov na te razlike niso ugotovili.
Rosuvastatin is excreted in the milk of rats.
Rosuvastatin se pri podganah izloča v mleko.