natgillin/translations-raw huggingface dataset:
The benefits of mipomersen-induced reductions in LDL-C in this population, which is at great risk of premature death, are anticipated to be large (potentially greater than 50% risk reduction of CHD, based on meta-analysis of multiple clinical trials), in contrast to the known and hypothetical risks of treatment with mipomersen.
Koristi mipomersena pri zniževanju holesterola LDL pri zadevni populaciji z velikim tveganjem za prezgodnjo smrt bi lahko bile velike (glede na metaanalizo več kliničnih preskušanj obstaja verjetnost za več kot 50-odstotno zmanjšanje tveganja za koronarno bolezen srca) v primerjavi z znanimi in možnimi tveganji, povezanimi z mipomersenom.
With regard to ALT and AST elevations, results from the pooled phase 3 studies (mipomersen n=261, placebo n=129, including patients with HoFH and HeFH) are summarized.
Za prikaz povišanja encimov ALT in AST so povzeti rezultati iz združenih študij 3. faze (mipomersen n=261, placebo n=129, vključeni so bolniki s homozigotno družinsko hiperholesterolemijo in s hudo heterozigotno družinsko hiperholesterolemijo).
Mipomersen reduces LDL level in a relevant manner, but in long term use might induce other changes in CV risk factors that could counteract such effect.
Mipomersen pomembno zniža raven holesterola LDL, vendar ima lahko dolgotrajna uporaba zdravila tudi druge vplive na kardiovaskularne dejavnike tveganja, ki bi lahko odtehtali koristi zdravila.
In absolute terms, it corresponds to a placebo-corrected reduction with mipomersen by -100 and -114 mg/dl in LDL-C at PET versus baseline, which may be considered of clinical relevance.
V absolutnih vrednostih je mipomersen ob upoštevanju prilagoditve glede na rezultate pri placebu znižal ravni holesterola LDL za -100 oziroma -114 mg/dl od izhodišča do PET, kar se lahko šteje za klinično pomembno.
Potential negative effects, in particular inflammatory effects, immunological reactivity, increase in blood pressure and renal toxicity (as shown by proteinuria) on other cardiovascular risk factors may counteract the potential beneficial effect on CV outcome due to reduction in LDL-C;
Možni neželeni učinki, zlasti vnetne reakcije, imunske reakcije, povišanje krvnega tlaka in toksični učinki na ledvica (ki se kažejo s proteinurijo), na druge kardiovaskularne dejavnike tveganja bi lahko odtehtali morebitne koristne učinke na kardiovaskularni sistem zaradi znižanja holesterola LDL.
Uncertainties remain regarding effects of mipomersen on long-term cardiovascular outcome.
Odprta ostajajo vprašanja glede dolgoročnega učinka mipomersena na kardiovaskularni izid.
Treatment with mipomersen results in a statistically significant decline of 24.7% and 35.9% in LDL-C levels at Primary Efficacy Time point (PET) versus baseline in patients with homozygous familial hypercholesterolaemia (HoFH) and severe heterozygous familial hypercholesterolaemia (HeFH) on top of statins, respectively.
Pri zdravljenju z mipomersenom kot dodatkom k statinom so na primarni časovni točki učinkovitosti (PET) opazili statistično pomembno znižanje ravni holesterola LDL za 24,7 % oziroma 35,9 % glede na izhodišče pri bolnikih s homozigotno družinsko hiperholesterolemijo (HoFH) oziroma hudo heterozigotno družinsko hiperholesterolemijo (HeFH).
In the clinical development programme increases in hepatic transaminases (ALT, AST) and liver fat were observed frequently in patients who received mipomersen therapy.
V kliničnem razvojnem programu so pri bolnikih, ki so prejemali mipomersen, pogosto opazili porast jetrnih transaminaz (ALT, AST) in maščob v jetrih.
• CHMP ground 2: Uncertainties remain regarding effects of mipomersen on longterm cardiovascular outcome.
• Razlog 2: Odprta ostajajo tudi vprašanja glede dolgoročnega vpliva mipomersena na kardiovaskularni izid.
Approximately 70% of patients in the mipomersen groups of pivotal trials had at least a 15% decrease in LDL-C levels from baseline to PET in comparison with approximately 20% of patients in the placebo groups.
V ključnih preskušanjih so znižanje ravni holesterola LDL za najmanj 15 % od izhodišča do PET opazili pri približno 70 % bolnikov v skupini z mipomersenom, v skupini s placebom pa pri približno 20 % bolnikov.
In the HoFH, the retention rate was only 8% at 3 years, with 63% withdrawing due to adverse events.
V skupini s homozigotno družinsko hiperholesterolemijo je po treh letih zdravilo uporabljalo samo še 8 % bolnikov, medtem ko jih je 63 % zdravljenje prekinilo zaradi neželenih dogodkov.
Concern remains about the potential progression of fatty liver disease to steatohepatitis and fibrosis, for which monitoring of patients at risk of developing inflammatory and fibrotic changes includes repeated liver biopsy.
Še vedno je zaskrbljujoče možno napredovanje zamaščenosti jeter v steatohepatitis in fibrozo, zaradi česar bi bila potrebna redna biopsija jeter za spremljanje bolnikov, pri katerih obstaja tveganje za pojav vnetnih in fibroznih sprememb.
The CHMP felt that this assumption would imply that the benefits of mipomersen treatment in HoFH patients would outweigh an unknown detrimental effect of this new substance.
CHMP je menil, da bi to pomenilo, da koristi mipomersena za zdravljenje bolnikov s homozigotno družinsko hiperholesterolemijo odtehtajo z njim povezane neznane neželene učinke.
The withdrawal rate - even if “similar to that observed with statins and other lipidlowering therapies and with other approved SC injectable therapies studied in similar long-term studies” as claimed by the applicant - must be seen in the context of the identified safety concerns and the limited population studied.
Stopnjo prekinitve zdravljenja je kljub trditvam predlagatelja, da je „podobna stopnji, opaženi v podobnih dolgoročnih študijah zdravljenja s statini in drugimi zdravili za zniževanje ravni lipidov ter drugimi odobrenimi zdravili za injiciranje pod kožo‟, treba obravnavati v okviru obstoječih pomislekov glede varnosti in omejene preučevane populacije.
Furthermore, in the placebo arm of the pooled phase 2 and 3 trial population including patients at somewhat lower CVS risk (as compared with the very high CV risk in HoFH patients), a higher number of MACE was noted, again potentially indicating that the absence of MACE in the placebo arms of the pivotal studies of overall small size might be a chance finding.
Poleg tega so v združenih študijah 2. in 3. faze, v katere je bila vključena populacija bolnikov z nekoliko manjšim kardiovaskularnim tveganjem (v primerjavi z zelo visokim kardiovaskularnim tveganjem pri bolnikih s homozigotno družinsko hiperholesterolemijo), v skupini s placebom zabeležili večje število resnih neželenih srčnih dogodkov, kar ponovno kaže na to, da bi lahko bila odsotnost resnih neželenih srčnih dogodkov v skupini s placebom v ključnih študijah z majhnim skupnim številom bolnikov naključna.
However, while it is agreed that the LDL reduction is predictive of a long-term CVS risk reduction, the implied magnitude of reduction of CHD risk of 50% is speculative.
Medtem ko se je strinjal, da je mogoče predvideti, da bi znižanje holesterola LDL dolgoročno zmanjšalo kardiovaskularno tveganje, je menil, da je napovedano 50-odstotno zmanjšanje tveganja za koronarno bolezen srca špekulativno.
CHMP position on ground 3
Mnenje odbora CHMP o razlogu 3
The applicant presented an updated proposed SmPC and RMP, and the postauthorisation safety study (PASS) and believes that mipomersen would serve as an important therapeutic option to help address the significant unmet medical need of patients with HoFH.
Predlagatelj je predložil posodobljen povzetek glavnih značilnosti zdravila in načrt za obvladovanje tveganja ter študijo o varnosti zdravila po pridobitvi dovoljenja za promet (PASS) in meni, da mipomersen predstavlja pomembno možnost zdravljenja za bolnike s homozigotno družinsko hiperholesterolemijo, katerih zdravstvene potrebe večinoma niso zadovoljene.
Given that withdrawals are mainly due to intolerance, it is unlikely that retention rates may be improved in a less selected population in standard practice;
Ker je glavni razlog za prekinitev nezmožnost prenašanja zdravljenja, ni verjetno, da bi bila stopnja v standardni praksi pri manj omejeni populaciji bolnikov drugačna.
In addition, it must also be considered that the estimates result from a small HoFH patient set, and though a treatment effect on LDL reduction is shown, the magnitude of this estimate is still prone to some variability.
Prav tako je treba upoštevati, da ocene temeljijo na rezultatih študije z majhnim številom bolnikov s homozigotno družinsko hiperholesterolemijo, zato kljub dokazanemu učinku mipomersena na znižanje holesterola LDL takšne ocene ne morejo biti povsem natančne.
Potential negative effects, in particular inflammatory effects, immunological and renal toxicity (as shown by proteinuria) on other cardiovascular risk factors may counteract the potential beneficial effect on CVS outcome due to reduction in LDL-C.
Možni neželeni učinki, zlasti vnetne reakcije, imunske reakcije in toksični učinki na ledvica (ki se kažejo s proteinurijo), na druge kardiovaskularne dejavnike tveganja bi lahko odtehtali morebitne koristne učinke na kardiovaskularni sistem zaradi znižanja ravni holesterola LDL.
The indication originally proposed in the mipomersen MAA included both HoFH and severe HeFH.
Indikacija, ki je bila prvotno predlagana v vlogi za pridobitev dovoljenja za promet z mipomersenom, je vključevala homozigotno družinsko hiperholesterolemijo in hudo heterozigotno družinsko hiperholesterolemijo.
Given that withdrawals are mainly due to intolerance, it is unlikely that retention rates may be improved in clinical practice.
Ker je glavni razlog za prekinitev nezmožnost prenašanja zdravila, ni verjetno, da bi bila stopnja v klinični praksi drugačna;
Statistically significant percent reductions with mipomersen compared to placebo were also observed for apo B, TC, and non HDL-C from baseline to PET.
V skupini z mipomersenom so v primerjavi s placebom opazili tudi statistično pomemben odstotek znižanja ravni apolipoproteina B, skupnega holesterola in ne-HDL-holesterola od izhodišča do PET.
Furthermore, although the relevant risks (apart from the off label use) are identified within the RMP, the PRAC considers the RMP insufficient to adequately identify CVS risk.
Poleg tega PRAC meni, da načrt za obvladovanje tveganja sicer obravnava pomembna tveganja (razen uporabe, ki ni v skladu z indikacijami), vendar ne zadostuje za ustrezno opredelitev kardiovaskularnih tveganj.
The high overall withdrawal rate with mipomersen after 2-3 years, even in the restricted HoFH population, remains a concern, thus severely limiting the number of patients that may obtain a potential benefit from its lipid-lowering effect.
Visoka stopnja prekinitve zdravljenja z mipomersenom, opažena po 2-3 letih, tudi pri omejeni populaciji bolnikov s homozigotno družinsko hiperholesterolemijo, je še naprej zaskrbljujoča, saj to pomeni znatno zmanjšanje števila bolnikov, pri katerih bi zdravilo lahko izkazalo koristi v smislu znižanja ravni lipidov.
While some patients might discontinue, patients remaining long-term are anticipated to receive benefit from substantial reductions in LDL-C.
Čeprav nekateri bolniki prekinejo zdravljenje, bi lahko zdravilo pri tistih, ki ga uporabljajo dlje časa, znatno znižalo holesterol LDL.
• CHMP ground 3: The high overall withdrawal rate with mipomersen after 2-3 years, even in the restricted HoFH population, remains a major concern, thus severely limiting the number of patients that may obtain a potential benefit from its lipid-lowering effect.
• Razlog 3: Visoka skupna stopnja prekinitve zdravljenja z mipomersenom, tudi med omejeno populacijo s homozigotno družinsko hiperholesterolemijo, ki so jo zabeležili po 2-3 letih, je še naprej zelo zaskrbljujoča, saj pomeni znatno zmanjšanje števila bolnikov, pri katerih bi lahko zdravilo izkazalo koristi v smislu znižanja ravni lipidov.
26, week 52 and week 72 is too small to draw firm conclusions regarding long-term effects on liver fat accumulation with mipomersen treatment.
V odprti podaljšani študiji je bilo premalo bolnikov z razpoložljivimi podatki od začetka študije ter iz 26., 52. in 72. tedna, da bi lahko podali dokončne zaključke glede dolgoročnega vpliva zdravljenja z mipomersenom na kopičenje maščob v jetrih.
In the pooled phase 3 studies, thirty six (13.8%) mipomersen-treated patients experienced increases in ALT and AST that met protocol-defined monitoring/safety rules for liver chemistry.
V združenih študijah 3. faze so povišanje ravni ALT in AST, ki so izpolnile po protokolu določene kriterije spremljanja/varnosti kemičnih snovi v jetrih, opazili pri šestintridesetih bolnikih (13,8 % bolnikov), zdravljenih z mipomersenom.
In particular, the numerical imbalance in overall CV events, MACE and CV hospitalisations is of concern.
Še zlasti je zaskrbljujoče številčno neravnovesje skupnih kardiovaskularnih dogodkov, resnih neželenih srčnih dogodkov in primerov bolnišničnega zdravljenja zaradi kardiovaskularnih zapletov.
This corresponds to a reduction by 21% and 48% with mipomersen when corrected with placebo (for HoFH and HeFH, respectively).
Ob upoštevanju prilagoditve glede na rezultate pri placebu je mipomersen ravni znižal za 21 % oziroma 48 % (pri homozigotni družinski hiperholesterolemiji oziroma hudi heterozigotni družinski hiperholesterolemiji).
It will also provide a final analysis from the main study on how long patients who have been treated with the medicine survive.
Prav tako bo pripravila končno analizo glavne študije glede trajanja preživetja bolnikov, zdravljenih s tem zdravilom.
The CHMP therefore decided that Farydak's benefits are greater than its risks in this group and recommended that it be approved for use in the EU.
Odbor CHMP je zato zaključil, da so koristi zdravila Farydak večje od z njim povezanih tveganj pri tej skupini, in priporočil, da se odobri za uporabo v EU.
In addition, panobinostat works in a different way to existing treatments.
Poleg tega panobinostat deluje na drugačen način kot obstoječe oblike zdravljenja.
The recommended starting dose of Farydak is 20 mg, taken on days 1, 3, 5, 8, 10 and 12 of the cycle.
Priporočeni začetni odmerek zdravila Farydak je 20 mg, ki se vzame 1., 3., 5., 8., 10. in 12. dan cikla.
This is a summary of the European public assessment report (EPAR) for Farydak.
To je povzetek evropskega javnega poročila o oceni zdravila (EPAR) za zdravilo Farydak.
This is expected to stop the cancer cells from multiplying and to activate processes that kill the cell, thereby slowing down the growth of the cancer.
Pričakovano je, da bo to zaustavilo razmnoževanje rakavih celic in aktiviralo procese, ki ubijajo te celice, s tem pa upočasnilo rast raka.
What measures are being taken to ensure the safe and effective use of Farydak?
Kateri ukrepi se izvajajo za zagotovitev varne in učinkovite uporabe zdravila Farydak?
Although the side effects were of concern and could not be justified in patients who could be given less toxic treatments, the CHMP considered that they were acceptable in this previously treated subgroup in view of the lack of alternatives, and could be managed.
Čeprav so neželeni učinki zaskrbljujoči in jih ni mogoče upravičiti pri bolnikih, ki jim je mogoče dati manj toksične oblike zdravljenja, je odbor CHMP menil, da so sprejemljivi pri tej predhodno zdravljeni podskupini, saj ni drugih možnosti, neželene učinke pa je mogoče obvladovati.
For further information, see the summary of product characteristics (part of the product information).
Za več informacij glejte povzetek glavnih značilnosti zdravila (ki je del informacij o zdravilu).
Other information about Farydak
Druge informacije o zdravilu Farydak
The Agency's Committee for Medicinal Products for Human Use (CHMP) considered the increase in progression free survival to be clinically significant although it noted that a benefit in overall survival had not yet been shown.
Odbor za zdravila za uporabo v humani medicini (CHMP) pri agenciji je zaključil, da je podaljšanje preživetja brez napredovanja bolezni klinično pomembno, čeprav korist pri skupnem preživetju še ni bila dokazana.
In addition, the company that markets Farydak will provide educational materials for patients, including a patient card, to help them take the medicine correctly.
Poleg tega bo družba, ki trži zdravilo Farydak, pripravila izobraževalno gradivo za bolnike, vključno s kartico za bolnike, ki jim bo pomagala pri pravilnem jemanju zdravila.
The benefits of Farydak have been shown in one main study involving 768 patients with multiple myeloma that had come back after previous treatments.
Koristi zdravila Farydak so pokazali v eni glavni študiji, ki je vključila 768 bolnikov z multiplim mielomom, pri katerih se je bolezen po predhodnih zdravljenjih ponovila.
The summary of the opinion of the Committee for Orphan Medicinal Products for Farydak can be found on the Agency's website: ema.europa.eu/Find medicine/Human medicines/Rare disease designation.
Povzetek mnenja Odbora za zdravila sirote o zdravilu Farydak je na voljo na spletni strani agencije: ema.europa.eu/Find medicine/Human medicines/Rare disease designation.
Because the number of patients with multiple myeloma is low, the disease is considered ‘rare', and Farydak was designated an ‘orphan medicine' (a medicine used in rare diseases) on 8 November 2012.
Ker je bolnikov z multiplim mielomom malo, velja ta bolezen za redko, zato je bilo zdravilo Farydak 8. novembra 2012 določeno kot „zdravilo sirota“« (zdravilo za zdravljenje redkih bolezni).
A risk management plan has been developed to ensure that Farydak is used as safely as possible.
Za zagotovitev čim varnejše uporabe zdravila Farydak je bil pripravljen načrt obvladovanja tveganj.
What benefits of Farydak have been shown in studies?
Kakšne koristi je zdravilo Farydak izkazalo v študijah?
What are the risks associated with Farydak?
Kakšna tveganja so povezana z zdravilom Farydak?
What is Farydak and what is it used for?
Kaj je zdravilo Farydak in za kaj se uporablja?
It blocks the activity of enzymes called histone deacetylases (HDACs), which are involved in switching the activity of genes on and off within cells.
Zavira dejavnost encimov, imenovanih histonske deacetilaze (HDAC), ki so vključeni v preklapljanje med vklopom in izklopom dejavnosti genov v celicah.
The main measure of effectiveness was the average length of time before the patient's disease got worse again (progression-free survival), which was 12 months in patients given Farydak, compared with around 8 months in those given placebo.
Glavno merilo učinkovitosti je bil povprečen čas do ponovnega poslabšanja bolezni (preživetje brez napredovanja), ki je bil 12 mesecev pri bolnikih, ki so prejemali zdravilo Farydak, in približno 8 mesecev pri bolnikih, ki so prejemali placebo.
Why is Farydak approved?
Zakaj je bilo zdravilo Farydak odobreno?
For more information about treatment with Farydak, read the package leaflet (also part of the EPAR) or contact your doctor or pharmacist.
Za več informacij o zdravljenju z zdravilom Farydak preberite navodilo za uporabo (ki je prav tako del EPAR) ali se posvetujte z zdravnikom ali farmacevtom.
The full EPAR and risk management plan summary for Farydak can be found on the Agency's website: ema.europa.eu/Find medicine/Human medicines/European public assessment reports.
Celotno evropsko javno poročilo o oceni zdravila (EPAR) in povzetek načrta obvladovanja tveganj za zdravilo Farydak sta na voljo na spletni strani agencije: ema.europa.eu/Find medicine/Human medicines/European public assessment reports.
Effects on the heart occurred in between 1 and 2 patients in 10 and included tachycardia (increased heart rate), palpitations, and irregular heart rhythms (atrial fibrillation, sinus tachycardia); more rarely patients had changes in electrical conduction in the heart (prolonged QTc interval).
Učinki na srce so se pojavili pri od 1 do 2 bolnikih od 10 in so vključevali tahikardijo (pospešen srčni utrip), palpitacije in nereden srčni ritem (atrijsko fibrilacijo, sinusno tahikardijo); redkeje so se pri bolnikih pojavile spremembe električnega prevajanja v srcu (podaljšan interval QTc).
The most significant effects that led to patients having to stop treatment (which happened in about 4 patients in 10) were diarrhoea, weakness and tiredness, and pneumonia (lung infection).
Najpomembnejši učinki, ki so povzročili prekinitev zdravljenja (kar se je pojavilo pri 4 bolnikih od 10), so bili driska, šibkost, utrujenost in pljučnica (okužba pljuč).
It is given to adults whose disease has come back or got worse after at least two previous treatments, including bortezomib and an immunomodulatory medicine (a medicine that acts on the immune system).
Daje se odraslim, pri katerih se je bolezen ponovila ali poslabšala po vsaj dveh predhodnih zdravljenjih, skupaj z bortezomibom in imunomodulacijskim zdravilom (zdravilom, ki deluje na imunski sistem).
When results were analysed just for the group of patients who had previously received at least two previous treatments, including bortezomib and an immunomodulatory medicine (thalidomide, lenalidomide or pomalidomide), the average time until the myeloma got worse was 12.5 months with Farydak, versus 4.7 months with placebo.
Pri analizi rezultatov, ki je vključila samo bolnike, ki so predhodno že prejeli vsaj dve zdravljenji, vključno z bortezomibom in imunomodulacijskim zdravilom (talidomidom, lenalidomidom ali pomalidomidom), je bil povprečni čas do poslabšanja mieloma 12,5 meseca pri zdravilu Farydak in 4,7 meseca pri placebu.
Patients are given the medicine for 8 cycles, and further 8 cycles of treatment are recommended in those that benefit.
Če bolnikom zdravljenje koristi, je priporočljivo izvesti dodatnih 8 ciklov.
The active substance in Farydak, panobinostat, is a type of medicine called a histone deacetylase (HDAC) inhibitor.
Zdravilna učinkovina v zdravilu Farydak, panobinostat, je vrsta zdravila, ki se imenuje zaviralec histonske deacetilaze (HDAC).
The most common side effects with Farydak (which may affect more than 1 in 10 people) are diarrhoea, tiredness, nausea (feeling sick) and vomiting, and effects on the blood such as thrombocytopenia (low levels of blood platelets which are important for blood clotting), anaemia and neutropenia and lymphopenia (low levels of certain white blood cells).
Najpogostejši neželeni učinki zdravila Farydak (ki lahko prizadenejo več kot 1 osebo od 10) so driska, utrujenost, navzeja (slabost), bruhanje in učinki na kri, kot so trombocitopenija (nizka raven trombocitov v krvi, ki so pomembni za strjevanje krvi), anemija ter nevtropenija in limfopenija (nizke ravni nekaterih belih krvničk).
Farydak is available as capsules (10, 15 and 20 mg) and it is given in 21-day treatment cycles, together with bortezomib and dexamethasone.
Zdravilo Farydak je na voljo v obliki kapsul (10, 15 in 20 mg) in se daje v 21-dnevnih ciklih zdravljenja skupaj z bortezomibom in deksametazonom.
For practical information about using Farydak, patients should read the package leaflet or contact their doctor or pharmacist.
Za praktične informacije o uporabi zdravila Farydak naj bolniki preberejo navodilo za uporabo ali se posvetujejo z zdravnikom ali farmacevtom.
Farydak must not be used in women who are breast-feeding.
Zdravila Farydak ne smejo uporabljati doječe matere.
For the full list of all side effects reported with Farydak, see the package leaflet.
Za celoten seznam neželenih učinkov, o katerih so poročali pri uporabi zdravila Farydak, glejte navodilo za uporabo.
Based on this plan, safety information has been included in the summary of product characteristics and the package leaflet for Farydak, including the appropriate precautions to be followed by healthcare professionals and patients.
V skladu s tem načrtom so bile v povzetek glavnih značilnosti zdravila in navodilo za njegovo uporabo vključene informacije o varnosti, vključno s previdnostnimi ukrepi, ki jih morajo upoštevati zdravstveni delavci in bolniki.