natgillin/translations-raw huggingface dataset:
• A variety of studies are available on the distribution of florfenicol in bronchial secretions in man and various animal species (pigs and calves).
• Na voljo so različne študije o porazdelitvi florfenikola v izločkih bronhijev pri ljudeh in različnih živalskih vrstah (prašiči in teleta).
Furthermore, the treatment failure rates in the clinical field study submitted by the applicant were considered too high.
Nadalje je menila, da je delež neuspešnega zdravljenja v klinični terenski študiji, ki jo je predložil predlagatelj, previsok.
Risk management or mitigation measures
Obvladovanje tveganj ali ukrepi za njihovo zmanjšanje
The valid Summary of Product Characteristics, Labelling and Package Leaflet are the final versions achieved during the Coordination Group procedure with the following amendments:
Veljaven povzetek glavnih značilnosti zdravila, označevanja in navodil za uporabo je končna verzija, ki je bila sprejeta v teku postopka koordinacijske skupine z naslednjimi dopolnili:
In order to address the concerns raised by the referral, the applicant presented all available efficacy data for sheep.
V odziv na pomisleke, izražene v napotitvi, je predlagatelj predložil vse razpoložljive podatke o učinkovitosti pri ovcah.
Field study
Študija na terenu
In terms of design, the field study followed EMA/CVMP guideline recommendations.
V zasnovi študije so bila upoštevana priporočila smernic EMA/CVMP.
Having considered all data submitted in writing and in the oral explanation the CVMP concluded that:
Ob upoštevanju vseh pisno predloženih podatkov in ustnih razlag je odbor CVMP sklenil:
The concern relating to the high failure rate and assumed lack of efficacy has been addressed under benefit assessment.
Skrbi, povezane z visoko stopnjo neučinkovitosti zdravljenja in domnevno neučinkovitostjo, so bile obravnavane v okviru ocene koristi.
The applicant provided detailed pharmacodynamic and pharmacokinetic data to justify the proposed dose for the claimed indication.
Predlagatelj je predložil podrobne farmakodinamične in farmakokinetične podatke, v katerih utemeljuje predlagani odmerek za navedeno indikacijo.
Based on the data presented in relation to the concerns notified for this referral procedure, the Committee for Medicinal Products for Veterinary Use (CVMP) concluded that the benefit-risk balance was favourable.
Na podlagi podatkov, predloženih v zvezi s pomisleki, sporočenimi v tem napotitvenem postopku, je Odbor za zdravila za uporabo v veterinarski medicini (CVMP) zaključil, da je razmerje med tveganji in koristmi za zdravilo pozitivno.
Thus, florfenicol behaves essentially like a bactericidal time dependant antibiotic.
Zato se florfenikol v bistvu vede kot antibiotik, odvisen od baktericidnega časa.
For the objecting Member State, this gave rise to concerns that there was the potential for underdosing and that there may be an increase in risk for development of florfenicol resistance.
Ugovarjajoča država članica je zaradi tega izrazila skrb, da obstaja možnost za premajhno odmerjanje in posledično povečanje razvoja odpornosti proti florfenikolu.
Add the following text in the relevant sections of the product information:
Dodaj naslednje besedilo v ustrezno poglavje o značilnostih zdravila:
Based on the available pharmacodynamic data, it is accepted that a dose selected on the basis of this study should also be predictive of likely efficacy against P. multocida.
Na podlagi razpoložljivih podatkov o farmakodinamiki se sprejme, da odmerek, določen na podlagi te študije, napoveduje verjetno učinkovitost proti P. multocida.
Repeat administration of 20 mg/kg once daily for three days (proposed posology) resulted in some accumulation (accumulation factor of 1.48).
Ponavljajoče se dajanje 20 mg/kg enkrat dnevno, ki je trajalo tri dni (predlagano odmerjanje), je povzročilo nekaj akumulacije (akumulacijski faktor 1,48).
List of the names, pharmaceutical form, strength of the veterinary medicinal product, animal species, routes of administration, applicant in the Member States
Seznam imen, farmacevtska oblika, jakost zdravila za uporabo v veterinarski medicini, ciljna živalska vrsta, način uporabe , predlagatelj v državi članici
Quality, User safety, Environmental risk and Residues were not assessed in this referral procedure.
V tem napotitvenem postopku kakovost, varnost za uporabnika, tveganje za okolje in ostanki zdravila niso bili ocenjeni.
(Clinical breakpoint is a MIC value used by clinicians to classify bacteria as susceptible or resistant to a certain antimicrobial and is therefore a measure of clinical efficacy.)
(Klinična mejna vrednost je vrednost MIK, ki jo zdravniki uporabljajo za razvrstitev bakterije med občutljive ali odporne proti določenemu antimikrobnemu zdravilu, zato je merilo klinične učinkovitosti).
It is noted that, currently, for ovine respiratory disease pathogens there is no internationally agreed breakpoint for florfenicol sensitivity.
Pri tem se upošteva, da za povzročitelje bolezni dihal pri ovcah trenutno ni mednarodno dogovorjene mejne vrednosti za občutljivost na florfenikol.
The concerns raised for this referral procedure related to the efficacy of the product.
Pomisleki, izraženi v tem napotitvenem postopku, se nanašajo na učinkovitost zdravila.
While similar data have not been generated for sheep, it is reasonable to assume that that florfenicol concentrations achieved in plasma reflect what will be achieved in the lung.
Čeprav podobnih podatkov za ovce ni, je razumno sklepati, da koncentracije florfenikola, dosežene v plazmi, izražajo koncentracije, ki bi bile dosežene v pljučih.
The available data suggest, therefore, that for this antibiotic the most relevant parameter for prediction of efficacy is time above MIC.
Razpoložljivi podatki zato kažejo, da je za ta antibiotik najpomembnejši parameter pri napovedovanju učinkovitosti čas, ko je njegova koncentracija višja od MIK.
There appears to be no advantage to increasing the dose to 30 mg/kg.
Kaže, da povečanje odmerka na 30 mg/kg ne prinese dodatnih koristi.
The active substance is included in veterinary medicinal products currently licensed in several countries in the European Union for use in cattle and pigs for the treatment of respiratory disease.
Zdravilna učinkovina je vsebovana v zdravilih za uporabo v veterinarski medicini, ki so trenutno odobrena v več državah Evropske unije za uporabo pri govedu in prašičih za zdravljenje bolezni dihal.
While there were some reservations about the use of oxytetracycline as the positive control, it is accepted that the chosen comparator product has a claim for ovine respiratory disease and is commonly used as a first-line therapy that will most likely be administered without any information on the sensitivity of causal organisms.
Čeprav obstajajo glede uporabe oksitetraciklina kot pozitivne kontrole nekateri zadržki, se sprejme, da je izbrano primerjano zdravilo odobreno za zdravljenje bolezni dihal pri ovcah in da se pogosto uporablja kot zdravljenje prve izbire, ki se običajno uporabi brez vsakršnih informacij o občutljivosti povzročiteljev.
There was a concern that a dose of 20 mg florfenicol/kg administered intramuscularly every 24 hours would not maintain an active/effective concentration of florfenicol at the infection site for the between treatment interval (that is, 24 hours).
Izražen je bil pomislek, da odmerek florfenikola 20 mg/kg, dan intramuskularno vsakih 24 ur, ne ohranja aktivne oziroma učinkovite koncentracije florfenikola na mestu okužbe v intervalu med odmerki (to je 24 ur).
The selected dose and between treatment interval was in line with the PK/PD conclusions.
Izbrani odmerek in interval med odmerki sta bila skladna z zaključki o farmakokinetiki/farmakodinamiki.
• The MIC90 values of florfenicol are in the range 0.5 - 1 μg/ml for target pathogens M. haemolytica and P. multocida.
• Vrednosti MIK90 za florfenikol so v razponu 0,5-1 μg/ml za ciljna povzročitelja bolezni M. haemolytica in P. multocida.
From the M. haemolytica data, it can be seen that time to achieve a 3-Log reduction decreased with increasing florfenicol concentration; and, after only two hours exposure, florfenicol exhibits a post-antibiotic effect (ranging from 1 - 3 hours at concentrations >1 μg/ml).
Iz podatkov za M. haemolytica je mogoče videti, da se je čas do doseženega zmanjšanja 3-log krajšal z naraščanjem koncentracije florfenikola; in po samo dveh urah izpostavljenosti kaže florfenikol poantibiotični učinek (v razponu od 13 ur pri koncentracijah ≥ 1 μg/ml).
• Although some concentration dependency trends were observed for M. haemolytica strains, the killing effect/kinetic does not increase dramatically with the concentration of the antibiotic over the MIC or twice the MIC.
• Čeprav so za seve M. haemolytica opazili nekatere trende, odvisne od koncentracije, se učinek uničevanja oziroma kinetika ne poveča dramatično, če so koncentracije antibiotika višje od MIK ali dvakratnik MIK-a.
Pharmacokinetics/pharmacodynamics data (PK/PD)
Farmakokinetični/farmakodinamični podatki
• The following can be concluded from the pharmacodynamic data presented: florfenicol has a pronounced bactericidal effect with Minimum Bactericidal Concentration (MBC) values the same, or one dilution higher, than the MIC of the tested strains.
• Iz predloženih farmakodinamičnih podatkov je mogoče sklepati naslednje: florfenikol ima izrazit baktericidni učinek z vrednostmi minimalne baktericidne koncentracije (MBK), ki so enake, po razredčitvi pa višje, od MIK testiranih sevov.
Based on available data, it would appear that florfenicol concentrations achieved in lung tissue/bronchial secretions are at least as high as those detected in serum.
Iz razpoložljivih podatkov je videti, da so koncentracije florfenikola, dosežene v pljučnem tkivu/izločkih bronhijev, vsaj tako visoke kot tiste, ki so jih izmerili v serumu.
Based on dossier data concerning Minimum Inhibitory Concentrations (MICs) for florfenicol (MIC90= 1 µg/ml) and considering its pharmacokinetic/pharmacodynamic (PK/PD) plasma profile, the period of exposure to the MIC90 strength was believed by the objecting Member State to be too short.
Na podlagi podatkov iz dokumentacije v zvezi z minimalnimi inhibitornimi koncentracijami (MIK) za florfenikol (MIK90 = 1 µg/ml) in ob upoštevanju njegovega farmakokinetičnega/farmakodinamičnega profila v plazmi ugovarjajoča država članica meni, da je obdobje izpostavljenosti jakosti MIK90 prekratko.
In support of the proposed recommended treatment dose, the applicant conducted a comprehensive dose finding study using an experimental model of respiratory disease where test animals were challenged with M. haemolytica.
V podporo predlaganemu terapevtskemu odmerku je predlagatelj izvedel obsežno študijo za določitev odmerka z uporabo poskusnega modela bolezni dihal, kjer so bile testirane živali okužene z M. haemolytica.
The applicant Intervet International BV submitted an application for a decentralised procedure (DCP) for an extension (Article 19 of Regulation (EC) 1234/2008) of the existing marketing authorisation of Nuflor 300 mg/ml solution for injection for cattle to add sheep as a target species.
Predlagatelj, Intervet International BV, je predložil vlogo za decentralizirani postopek (DCP) za podaljšanje (člen 19 Uredbe Komisije (ES) 1234/2008) obstoječega dovoljenja za promet z zdravilom Nuflor 300 mg/ml raztopina za injiciranje za govedo in ovce kot ciljni živalski vrsti.
The preclinical data provided support the recommended treatment interval (24 hours) for target pathogens with MIC up to 1 μg/ml.
Predklinični podatki potrjujejo priporočen interval zdravljenja (24 ur) za ciljne bakterije za katere je MIC do 1 μg/ml.
The benefit of florfenicol is that ovine respiratory disease associated with susceptible M. haemolytica and P. multocida can effectively be treated.
Korist florfenikola je učinkovito zdravljenje bolezni dihal pri ovcah, ki jih povzročata občutljivi M. haemolytica in P. multocida.
Summary of Product Characteristics
Povzetek glavnih značilnosti
• Based on data generated in the pivotal pharmacokinetic study, intramuscular administration of the proposed recommended treatment dose resulted in mean peak serum concentrations of ~9 - 10 μg/ml by approximately 1 hour after treatment.
• Na podlagi podatkov, pridobljenih v osrednji farmakokinetični študiji, je intramuskularno dajanje predlaganega priporočenega terapevtskega odmerka povzročilo najvišje koncentracije v serumu ~9-10 μg/ml približno 1 uro po zdravljenju.
A florfenicol concentration of 4 x MIC (2 μg/ml) resulted in a decrease of bacterial count by 99.9% (3-Log drop) in 4 - 8 hours for the M. haemolytica isolates.
Koncentracija florfenikola 4 x MIK (2 μg/ml) je v 4-8 urah povzročila zmanjšanje števila bakterij za 99,9 % (upad 3-log) za izolate M. haemolytica.
Grounds for amendment of the summary of product characteristics
Razlogi za spremembo povzetka glavnih značilnosti zdravila
The results of this study demonstrated that florfenicol administered once daily at a dose of either 10, 20 or 30 mg/kg was effective for the treatment of pneumonia in sheep induced by M. haemolytica.
Rezultati te študije so pokazali, da je bil florfenikol, uporabljen enkrat dnevno v odmerku 10, 20 ali 30 mg/kg, učinkovit za zdravljenje pljučnice pri ovcah, ki jo je povzročila M. haemolytica.
These issues remained unsolved and therefore a referral under Article 33(1) of Directive 2001/82/EC to the CMD(v) was started.
Zadeva je ostala nerešena, zato je bila v skladu s členom 33(1) Direktive 2001/82/ES napotena k Usklajevalni skupini za postopek z medsebojnim priznavanjem in decentralizirani postopek - zdravila za uporabo v veterinarski medicine (CMD(v)).
Similarly, a florfenicol concentration of 2 x MIC (0.5-1 μg/ml) resulted in a 3-Log drop of bacterial count in 10 - 24 hours for the P. multocida isolates.
Podobno so koncentracije florfenikola 2 x MIK (0,5-1 μg/ml) v 10-24 urah povzročile upad 3-log števila bakterij za izolate P. multocida.
Overall summary of the scientific evaluation of Nuflor 300 mg/ml solution for injection for cattle and sheep
Splošni povzetek znanstvenega vrednotenja zdravila Nuflor 300 mg/ml raztopina za injiciranje za govedo in ovce
• The proposed dosing schedule is supported by a dose finding study using an experimental model of respiratory disease where test animals were challenged with Mannheimia haemolytica, and
• da predlagani režim odmerjanja podpirajo izsledki študije za določitev odmerka z uporabo poskusnega modela bolezni dihal, v katerem so testne živali okužili z Mannheimia haemolytica in
Therefore, the CVMP concluded that the objections raised by Denmark should not prevent the granting of the marketing authorisation for Nuflor 300 mg/ml solution for injection for cattle and sheep as the overall benefit-risk balance of the product is positive, subject to the recommended changes in the product information set out in annex III.
Zato je odbor CVMP zaključil, da ugovori Danske ne preprečijo izdaje dovoljenja za promet z zdravilom Nuflor 300 mg/ml raztopina za injiciranje za govedo in ovce, saj je splošno razmerje med tveganji in koristmi za to zdravilo pozitivno pod pogojem, da se v informacije o zdravilu navedene v Prilogi III, vnesejo priporočene spremembe.
Based on the findings of the field study, the applicant concluded that based on the primary efficacy parameter - treatment failure rates, Nuflor can be considered superior (at Day 4) or non-inferior (at Day 11) to the positive control product containing 100 mg/ml oxytetracycline, when used for the treatment of respiratory disease in sheep associated with either M. haemolytica or P. multocida.
Na podlagi izsledkov iz študije na terenu je predlagatelj sklenil, da se lahko na podlagi primarnega parametra učinkovitosti - deleža neuspešnosti zdravljenja - zdravilo Nuflor obravnava kot bolj (na 4. dan) ali enako učinkovito (na 11. dan) kot zdravilo s pozitivno kontrolo, ki vsebuje 100 mg/ml oksitetraciklina, če se uporablja za zdravljenje bolezni dihal pri ovcah, povezanih z M. haemolytica ali P. multocida.
Nuflor 300 mg/ml solution for injection for cattle and sheep contains florfenicol as active substance.
Zdravilo Nuflor 300 mg/ml raztopina za injiciranje za govedo in ovce vsebuje zdravilno učinkovino florfenikol.
• A field study conducted in line with EMA/CVMP guideline recommendations showed that Nuflor, administered in accordance with the proposed dosing schedule, was non-inferior to the authorised reference product, Terramycin 100 mg/ml, when used for the treatment of respiratory disease in sheep associated with either Mannheimia haemolytica or Pasteurella multocida.
• da je študija na terenu, opravljena po priporočilih smernice EMA/CVMP, pokazala, da zdravilo Nuflor, če se uporablja v skladu s predlaganim režimom odmerjanja, ni slabše kot odobreno referenčno zdravilo, Terramycin 100 mg/ml, kar zadeva zdravljenje bolezni dihal pri ovcah, povezanih z Mannheimia haemolytica ali Pasteurella multocida.
However, the CVMP agreed that section 4.9 of the Summary of Product Characteristics should be amended to clarify that the recommended treatment dose and treatment interval for sheep is based on the time mean florfenicol concentrations are maintained above MIC90 (see Annex III).
Vendar pa se je odbor CVMP strinjal, da je treba poglavje 4.9 povzetka glavnih značilnosti zdravila ustrezno spremeniti z vključitvijo pojasnila, da priporočeni terapevtski odmerek in interval zdravljenja za ovce temeljita na času, med katerim se srednje koncentracije florfenikola obdržijo nad MIK90 (glejte Prilogo III).
The applicant conducted a single field study to determine the efficacy and safety of the test product administered at 20 mg florfenicol/kg bodyweight intramuscularly once daily for three days to sheep with naturally acquired respiratory infections.
Predlagatelj je izvedel eno samo študijo na terenu, s katero je ugotavljal učinkovitost in varnost preskušanega zdravila v odmerku 20 mg florfenikola/kg telesne mase, ki so ga tri dni enkrat dnevno intramuskularno dajali ovcam z naravno pridobljeno okužbo dihal.
However, the CVMP agreed that section 4.9 of the Summary of Product Characteristics should be amended to clarify that the recommended treatment dose and treatment interval for sheep is based on the time mean florfenicol concentrations are maintained above MIC90.
Vendar pa se je odbor CVMP strinjal, da je treba poglavje 4.9 povzetka glavnih značilnosti zdravila dopolniti z vključitvijo pojasnila, da priporočeni odmerek in interval zdravljenja za ovce temeljita na času, med katerim se srednje koncentracije florfenikola ohranijo nad MIK90.
The application in question, submitted via the decentralised procedure, is an extension of the existing marketing authorisation of Nuflor 300 mg/ml solution for injection for cattle to add sheep as a target species.
Zadevna vloga za promet z zdravilom, predložena v okviru decentraliziranega postopka, je razširitev obstoječega dovoljenja za promet z zdravilom Nuflor 300 mg/ml raztopina za injiciranje za govedo, ki se mu doda ciljna živalska vrsta ovce.
The overall conclusion is that the efficacy dataset as a whole is adequate to support the efficacy of Nuflor 300 mg/ml solution for injection for cattle and sheep at the dose of 20 mg/kg daily via the intramuscular route of administration for three consecutive days in the treatment of Ovine Respiratory Disease associated with M. haemolytica and P. multocida.
Splošni zaključek je, da nabor podatkov kot celota ustrezno podpira učinkovitost zdravila Nuflor 300 mg/ml raztopina za injiciranje za govedo in ovce v odmerku 20 mg/kg dnevno, kadar se uporablja po intramuskularni poti tri zaporedne dni za zdravljenje bolezni dihal pri ovcah, povezanih z M. haemolytica in P. multocida.
• The MIC and pharmacokinetic data, taken together with what is known about florfenicol kill kinetics and post-antibiotic effect, support the recommended treatment interval (24 hours) for target respiratory tract pathogens with MIC up to 1 μg/ml when the product is administered to sheep at the proposed dose of 20 mg florfenicol/kg bodyweight,
• da podatki o MIK in farmakokinetični podatki, obravnavani skupaj z znanimi dejstvi o florfenikolovi kinetiki uničevanja in poantibiotičnem učinku, podpirajo priporočeni interval zdravljenja (24 ur) za ciljne povzročitelje bolezni dihal z MIK do 1 μg/ml, če se zdravilo daje ovcam v predlaganem odmerku 20 mg florfenikola/kg telesne mase;
The CVMP accepted that the MIC and pharmacokinetic data, taken together with what is known about florfenicol kill kinetics and post-antibiotic effect (PAE), support the recommended treatment interval (24 hours) for target pathogens with MIC up to 1 μg/ml and suggest that the proposed dose of 20 mg florfenicol/kg and the proposed between treatment interval of 24 hours should be appropriate for testing in the clinical setting for the treatment of respiratory infection associated with M. haemolytica and P. multocida.
Odbor CVMP je sprejel mnenje, da MIK in farmakokinetični podatki, obravnavani skupaj z znanimi dejstvi o florfenikolovi kinetiki uničevanja in poantibiotičnem učinku, podpirajo priporočeni interval zdravljenja (24 ur) za ciljne povzročitelje bolezni z MIK do 1 μg/ml in kažejo, da sta predlagani odmerek 20 mg florfenikola/kg in predlagani 24-urni interval med zdravljenjem ustrezna za testiranje zdravljenja okužb dihal z M. haemolytica in P. multocida v kliničnem okolju.
For sheep, the proposed indication is for treatment of respiratory tract infections due to Mannheimia haemolytica (M. haemolytica) and Pasteurella multocida (P. multocida) susceptible to florfenicol at a dose of 20 mg florfenicol/kg bodyweight intramuscular daily for three consecutive days.
Za ovce je predlagana indikacija zdravljenje okužb dihalnih poti, ki jih povzročata Mannheimia haemolytica (M. haemolytica) in Pasteurella multocida (P. multocida), občutljivi na florfenikol, z odmerkom 20 mg florfenikola/kg telesne mase, intramuskularno enkrat dnevno, ki traja tri zaporedne dni.
The concern related to the efficacy of the product - in particular to the high failure rate - have been assessed and it is confirmed that the product is proved to be efficacious in the treatment of ovine respiratory disease associated with M. Haemolytica and P. multocida when administered at a dose of 20 mg/kg bodyweight once daily via the intramuscular route of administration for three days.
Skrb, povezana z učinkovitostjo zdravila, zlasti z visoko stopnjo neučinkovitosti zdravljenja, je bila ocenjena in dokazano je bilo, da je zdravilo učinkovito pri zdravljenju bolezni dihal pri ovcah, povezanih z M. Haemolytica in P. multocida, če se uporablja v odmerku 20 mg/kg telesne mase enkrat dnevno po intramuskularni poti, s trajanjem zdravljenja tri dni.
Pharmacokinetic studies showed that mean plasma concentrations remain above MIC90 (1 μg/ml) for up to 18 hours after administration of the product at the recommended treatment dose.
Farmakokinetične študije kažejo da srednja koncentracija v serumu ostane nad MIC90 (1 μg/ml) do 18 ur po dajanju zdravila v priporočenem odmerku.
Dose finding study
Študija za določitev odmerka
Overall, the benefit-risk balance is considered positive for Nuflor 300 mg/ml solution for injection for cattle and sheep.
Na splošno je bilo razmerje med tveganji in koristmi za zdravilo Nuflor 300 mg/ml raztopina za injiciranje za govedo in ovce ocenjeno kot pozitivno.
Amendments in the relevant sections of the summary of product characteristics, labelling and package leaflet
Dopolnila k ustreznemu poglavju v povzetku glavnih značilnosti zdravila,označevanju in navodilu za uporabo
Pharmaceutical form Strength Animal species Route of administration
Farmacevtska oblika Jakost