natgillin/translations-raw huggingface dataset:
The CHMP therefore adopted the following List of Outstanding Issues to be addressed by the Applicant: “Following discussion and considering the differences in the composition and the demonstrated PK differences, the CHMP was of the opinion that it was not sufficiently demonstrated that Teicoplanin Hospira is a generic of Targocid. 
CHMP je zato pripravil naslednji seznam nerešenih vprašanj, na katera naj bi odgovoril predlagatelj: „CHMP je po razpravi in upoštevanju razlik v sestavi ter dokazanih razlik v farmakokinetiki menil, da ni dovolj dokazov, da je zdravilo Teicoplanin Hospira generično zdravilo zdravila Targocid.
The Applicant did not further discuss the outcomes of the partially completed bioequivalence studies evaluating AUC and Cmax, as the CHMP considered that due to the nature of this drug, the whole drug (total) AUC is not appropriate to demonstrate bioequivalence. 
Predlagatelj ni dodatno razpravljal o izidih delno opravljenih študij biološke enakovrednosti, v katerih so vrednotili AUC in Cmax, saj je CHMP menil, da za dokazovanje biološke enakovrednosti AUC za celotno (skupno) zdravilo ni primerna zaradi narave zdravila.
The Applicant also provided a briefing document stating that other endpoints, including pharmacodynamics, protein binding and analysis of the PK and PD of the principal sub-components, were measured in the study as it is believed that only free drug (non-protein bound teicoplanin) contributes to pharmacodynamic activity. 
Predlagatelj je predložil tudi navodila, ki kažejo, da so v študiji merili druge končne točke, vključno s farmakodinamiko, vezavo na beljakovine in analizo farmakokinetike in farmakodinamike glavnih podkomponent, saj so menili, da le prosto zdravilo (na beljakovine nevezani teikoplanin) prispeva k farmakodinamični aktivnosti.
Safety data obtained from clinical study and non-clinical toxicity study The Applicant stated that the dosing regimen of teicoplanin is predictable, therefore dose-dependent toxicity is not of concern under standard clinical use. 
Podatki o varnosti, pridobljeni iz klinične študije in neklinične študije toksičnosti Predlagatelj je navedel, da je režim odmerjanja napovedljiv, zato od odmerka odvisna toksičnost ni zadržek pri standardni klinični rabi.
The CHMP considered that similarity with regards to the free drug is important and that with regards to free AUC, the sum of all free TA2 subcomponents is 13% higher for Teicoplanin Hospira. 
CHMP je menil, da je podobnost v smislu prostega zdravila pomembna in da je pri AUC prostega zdravila vsota vseh prostih podkomponent TA2 13 % večja pri zdravilu Teicoplanin Hospira.
All subcomponents are well characterised and readily identifiable and there is no doubt that each individual subcomponent in Teicoplanin Hospira has the same characteristics as in Targocid. 
Vse podkomponente so dobro opisane in enostavno določljive, zato ni dvoma, da ima vsaka posamezna podkomponenta zdravila Teicoplanin Hospira enake značilnosti kot v zdravilu Targocid.
As the CHMP considered that free AUC is the most important PK parameter and that the dominant pharmacodynamic driver of microbiological and clinical outcome is AUC/MIC, the Applicant concluded that the most important PK/PD parameter for assessing microbiological and clinical outcome is the free AUC/MIC. 
Ker je CHMP štel AUC prostega zdravila kot najpomembnejši parameter farmakokinetike in AUC/MIK kot poglavitno farmadinamično gonilo mikrobiološkega in kliničnega izida, je predlagatelj menil, da je najpomembnejši parameter farmakokinetike in farmadinamike za oceno mikrobiološkega in kliničnega izida AUC/MIK.
The CHMP also noted that the PK parameters of the subcomponents are unknown in children and that composition differences may lead to more pronounced PK differences in children, as literature data indicates differences in PK properties in adults and children. 
CHMP je upošteval tudi, da so parametri farmakokinetike podkomponent neznani pri otrocih in da lahko razlike v sestavi povzročijo bolj izrazite razlike farmakokinetike pri otrocih, saj podatki iz literature kažejo razlike v farmakokinetičnih značilnostih pri odraslih in otrocih.
The Applicant discussed the variation in subcomponent levels and stated that bioequivalence or essential similarity for Teicoplanin is best assessed by comparing the sum of free AUC/MIC for the subcomponents. 
Predlagatelj je razpravljal o razlikah v ravneh podkomponent in navedel, da biološko enakovrednost ali osnovno podobnost teikoplanina najbolje vrednotimo s primerjavo vsote AUC/MIK prostih podkomponent.
The Applicant considered the AUC/MIC ratio individually for all 5 subcomponents, for the free drug, as teicoplanin is extensively protein bound, and the biological activity of the preparation mainly results from the free drug component. 
Predlagatelj je upošteval posamezno razmerje AUC/MIK za vseh 5 podkomponent prostega zdravila, saj se teikoplanin močno veže na beljakovine, in biološko aktivnost pripravka predvsem iz rezultatov za prosto zdravilo.
Accordingly, the Applicant argued that the sum of free AUC/MIC of the subcomponents is substantiating comparable activity between the generic and the innovator. 
Skladno s tem je predlagatelj argumentiral, da vsota AUC/MIK prostih podkomponent utemeljuje primerljivo aktivnost med generičnim zdravilom in inovatorskim zdravilom.
In addition, the use of MIC values from 1984 published data is not supported and correlating PK/PD with clinical outcome and the probability of achieving certain targets is not accepted for abridged products. 
Poleg tega uporaba vrednosti MIK iz podatkov, objavljenih leta 1984, ni podprta, korelacija farmakokinetike in farmadinamike s kliničnim izidom ter verjetnostjo doseganja določenih ciljev pa ni sprejemljiva za zdravila s skrajšanim postopkom.
The Applicant examined both available active drug (free AUC) and whole drug and free AUC/MIC, concluding that Teicoplanin Hospira is at least as efficacious as Targocid. 
Predlagatelj je pregledal razpoložljivo aktivno zdravilo (AUC prostega zdravila) in skupno zdravilo ter AUC/MIK prostega zdravila ter zaključil, da je zdravilo Teicoplanin Hospira vsaj tako učinkovito kot zdravilo Targocid.
The CHMP noted the neutropenic mouse study demonstrating efficacy in reducing bacterial count and demonstrating biological equivalence. 
CHMP je upošteval, da študija na nevtropeničnih miškah dokazuje učinkovitost pri zmanjšanju bakterijskega števila in dokazuje biološko enakovrednost.
The CHMP accepted the Applicant response, as the provided guidance documents supporting teicoplanin monitoring were considered relevant. 
CHMP je sprejel odgovor predlagatelja, saj je menil, da so predložene smernice, ki podpirajo spremljanje teikoplanina, pomembne.
The Applicant discussed the results of a post hoc analysis on the free AUC, rather than on total AUC. 
Predlagatelj je razpravljal o rezultatih post hoc analize AUC prostega zdravila namesto AUC skupnega zdravila.
Therefore a bioequivalence study is not required, in line with the Note for Guidance on The Investigation of Bioavailability and Bioequivalence (CPMP/EWP/QWP/1401/98). 
Zato v skladu z Obvestilom o smernici o raziskavah biološke razpoložljivosti in enakovrednosti (CPMP/EWP/QWP/1401/98) študija biološke enakovrednosti ni potrebna.
The issue was considered unresolved and needs further discussion. 
CHMP je menil, da je zadržek nerešen in da zahteva dodatno razpravo.
The CHMP noted that for Teicoplanin Hospira to be considered as a generic product, the difference in the amounts of glycopeptides subcomponents must be acceptable and that this difference must not lead to a difference in safety and/or efficacy. 
CHMP je opozoril, da se zdravilo Teicoplanin Hospira lahko šteje za generično zdravilo, če so razlike v količinah glikopeptidnih podkomponent sprejemljive in če ta razlika ne povzroči razlike v varnosti in/ali učinkovitosti.
The CHMP assessed the studies and concluded that the MIC results were similar between Teicoplanin Hospira and the originator and that no difference in antibacterial activity or in effectiveness was observed. 
CHMP je ovrednotil študije in zaključil, da so rezultati MIK podobni pri zdravilu Teicoplanin Hospira in originatorskem zdravilu ter da ni opažene razlike v protibakterijski aktivnosti ali učinkovitosti.
As the ratios observed for Teicoplanin Hospira fall outside these ranges, equivalence cannot be assumed, based on the in vitro data alone. 
Ker so razmerja v zdravilu Teicoplanin Hospira izven teh razponov, enakovrednosti ne moremo predpostavljati zgolj na in vitro podatkih.
It was considered that Teicoplanin Hospira and Targocid are comparable in terms of overall active drug content, but differ in the composition of the TA-2 subcomponents, resulting in major objections. 
Štelo se je, da sta zdravili Teicoplanin Hospira in Targocid primerljivi v smislu skupne vsebnosti aktivnega zdravila, vendar se razlikujeta v sestavi podkomponent TA2, kar je povzročilo velike zadržke.
The effect of variability in PK on the expected outcome (AUC/MIC) was assessed and even with differences in distributions for the subcomponents, the overall AUC/MIC values are similar for the two products. 
Ocenjevali so učinke variabilnosti farmakokinetike na pričakovani izid (AUC/MIK) in kljub razlikam v porazdelitvah podkomponent so skupne vrednosti AUC/MIK med zdraviloma podobne.
It is agreed that bound drug is not available to exert its therapeutic effect and that for antimicrobial agents, only free drug treats infections. 
Dogovorjeno je, da vezano zdravilo ni zmožno izražati terapevtskega učinka ter da pri protimikrobnih snoveh okužbe zdravi le prosto zdravilo.
The Applicant submitted a request for a re-examination of the CHMP opinion, responding to the grounds supporting the decision that Teicoplanin Hospira cannot be considered to be a generic of the innovator Targocid and addressed one by one the three grounds for refusal of the granting of the Marketing Authorisations. 
Predlagatelj je predložil zahtevek za ponovni pregled mnenja CHMP kot odziv na utemeljitev odločitve, da se zdravilo Teicoplanin Hospira ne more šteti za generično zdravilo inovatorskega zdravila Targocid, ter obravnaval vse tri podlage za zavrnitev odobritve dovoljenja za promet z zdravilom.
The Applicant discussed the compliance of Teicoplanin Hospira to the monographs, stating that the tighter controls over the individual components proposed signify that the active pharmaceutical ingredient used in Teicoplanin Hospira meets the requirements of both monographs and that the individual components are controlled to a far greater extent. 
Predlagatelj je razpravljal o skladnosti zdravila Teicoplanin Hospira z monografijami, pri čemer navaja, da predlagani strožji nadzor nad posameznimi komponentami kaže, da zdravilna učinkovina v zdravilu Teicoplanin Hospira ustreza zahtevam obeh monografij ter da so posamezne komponente nadzorovane veliko bolje.
The results show that free drug for each teicoplanin subcomponent was similar. 
Rezultati kažejo, da je prosto zdravilo za vsako podkomponento teikoplanina podobno.
The Applicant concluded that there are many recent references recommending that the dose of teicoplanin is adjusted based on the monitoring of blood levels and that the guidance in the proposed SPC provides a solid baseline for managing patients requiring teicoplanin. 
Predlagatelj je zaključil, da obstaja več novejših virov, ki priporočajo prilagajanje odmerka teikoplanina na osnovi spremljanja ravni v krvi ter da so smernice v predlogu povzetka glavnih značilnosti zdravila dobro izhodišče za obravnavo bolnikov, ki potrebujejo teikoplanin.
Ground 3: Furthermore the submitted additional non-clinical and serum bactericidal data are not considered sufficient to adequately demonstrate that Teicoplanin Hospira is a generic of the innovator Targocid 
Podlaga 3: Poleg tega se predloženi dodatni nekliničnih podatki in podatki o baktericidnosti seruma ne štejejo za zadostne za ustrezen dokaz, da je zdravilo Teicoplanin Hospira generično zdravilo inovatorskega zdravila Targocid.
Therefore, PK/PD relationships for antimicrobials are based on free drug. 
Zato zveze v okviru farmakokinetike in farmakodinamike temeljijo na prostem zdravilu.
The CHMP endorsed the answer of the Applicant, from a pharmacodynamic point of view, free AUC is the most important PK parameter. 
CHMP je potrdil odgovor predlagatelja, da je z vidika farmakodinamike AUC prostega zdravila najpomembnejši parameter farmakokinetike.
The Applicant conducted a bioequivalence study to provide further information on the PK/PD and to demonstrate similar safety and efficacy. 
Predlagatelj je opravil študijo biološke enakovrednosti, s katero je želel pridobiti dodatne informacije o farmakokinetiki in farmakodinamiki ter dokazati podobno varnost in učinkovitost.
Both products include the same subcomponents and despite differences in the subcomponent ratios, both comply with the European Pharmacopoeia (Ph.Eur.) 
Zdravili vsebujeta iste podkomponente in kljub razlikam v razmerju podkomponent ustrezata monografiji Evropske farmakopeje (Ph.
The half- lives of the TA2 components correlates to their lipophilicity, and because Teicoplanin Hospira has a lower proportional content of subcomponents with a longer half-life and a higher proportion with a shorter half-life, the overall elimination of total teicoplanin is faster, and the resulting AUC is lower. 
Ker zdravilo Teicoplanin Hospira vsebuje manjši delež podkomponent z daljšo razpolovno dobo in višji delež komponent s krajšo razpolovno dobo, je končna eliminacija skupnega teikoplanina hitrejša, nastala AUC pa nižja.
The Applicant concluded that taking into account the teicoplanin subcomponents and their relative amounts, lipophilicity and MIC's, numerous experts believe that in a clinical setting, teicoplanin should be treated as a whole, regardless of the relative levels of subcomponents, due to the differences in PK characteristics being small. 
Predlagatelj je menil, da številni strokovnjaki ob upoštevanju podkomponent teikoplanina in njihovih relativnih količin, lipofilnosti in vrednosti MIC menijo, da bi bilo treba v kliničnem okolju teikoplanin šteti kot celoto ne glede na relativne ravni podkomponent, ker so razlike v značilnostih farmakokinetike majhne.
As the additional non-clinical and serum bactericidal data submitted are not sufficient to adequately demonstrate that Teicoplanin Hospira is a generic of Targocid, the CHMP therefore maintained its previous opinion that the current application for this product is not approvable. 
Ker predloženi dodatni nekliničnih podatki in podatki o baktericidnosti seruma niso zadostni za dokaz, da je zdravilo Teicoplanin Hospira generično zdravilo zdravila Targocid, je CHMP ohranil svoje prejšnje mnenje, da trenutne vloge za pridobitev dovoljenja za to zdravilo ni mogoče odobriti.
The CHMP considers that with respect to pharmacodynamics, the study demonstrated that serum bactericidal activity was similar for both the Teicoplanin Hospira and Targocid and that the free drug proportion for each sub-component was similar for the two products. 
CHMP meni, da je študija v smislu farmakodinamike dokazala, da je bila serumska baktericidna aktivnost enaka pri zdravilu Teicoplanin Hospira in zdravilu Targocid ter da je delež prostega zdravila za vsako podkomponento podoben pri obeh zdravilih.
The CHMP noted that the proposed specifications result in a considerably greater control of the individual subcomponents than if they had simply been in line with the monographs; however this does not establish that Teicoplanin Hospira is a generic of Targocid. 
CHMP je upošteval, da predlagane specifikacije omogočajo bistveno večji nadzor posameznih podkomponent, kot če bi bile skladne z monografijami, vendar to ne dokazuje, da je zdravilo Teicoplanin Hospira generično zdravilo zdravila Targocid.
EUCAST reported values for the whole (total) teicoplanin should be used instead. 
Uporabiti bi bilo treba vrednosti za celotni (skupni) teikoplanin, o katerih je poročal EUCAST.
In conclusion, the CHMP noted that although complying with the European Pharmacopoeia monograph, the quality of Teicoplanin Hospira is different from the innovator subcomponents as Teicoplanin Hospira does not meet the originator specifications with respect to the individual glycopeptides subcomponents. 
CHMP je na koncu izpostavil, da je kakovost zdravila Teicoplanin Hospira kljub skladnosti z monografijo Evropske farmakopeje drugačna od podkomponent inovatorskega zdravila, saj zdravilo Teicoplanin Hospira z vidika posameznih glikopeptidnih podkomponent ne izpolnjuje specifikacij originatorskega zdravila.
The CHMP was of the opinion that compliance with the specifications of the European Pharmacopoeia does not automatically imply that Teicoplanin Hospira is a generic of Targocid and maintained that demonstrating this is crucial for approval. 
CHMP je menil, da skladnost s specifikacijami Evropske farmakopeje samodejno ne pomeni, da je zdravilo Teicoplanin Hospira generično zdravilo zdravila Targocid, in da je dokaz slednjega ključen za odobritev zdravila.
The CHMP was also of the opinion that the study conducted by the Applicant did not demonstrate bioequivalence between Teicoplanin Hospira and Targocid and that the MIC studies are not sensitive enough to detect differences between the two products in the case of teicoplanin, since in vitro anti-bacterial activity is independent of lipophilicity, tissue distribution and clearance of the subcomponents, i.e. differences in systemic exposure. 
CHMP je menil tudi, da študija, ki jo je opravil predlagatelj, ni dokazala biološke enakovrednosti med zdraviloma Teicoplanin Hospira in Targocid, in da študije MIK niso bile dovolj občutljive, da bi zaznale razliko med zdraviloma, saj je protibakterijska aktivnost in vitro neodvisna od lipofilnosti, porazdelitve v tkivih ali očistka podkomponent, tj. razlik v sistemski izpostavljenosti.
Regarding the available literature concluding that Teicoplanin should be treated as a whole regardless of the relative levels of subcomponents, the CHMP is of the opinion that this would have been considered during the development of the Ph.Eur. 
CHMP glede na razpoložljivo literaturo z zaključki, da je treba teikoplanin šteti kot celoto ne glede na relativne ravni podkomponent, meni, da bi bilo to treba upoštevati med razvojem monografije Ph. Eur.
Although the EMEA guideline for bioequivalence states that a bioequivalence study is not required for IV products, this study provided useful additional information. 
Čeprav smernice EMEA za biološko enakovrednosti določajo, da se študija biološke enakovrednosti ne zahteva za i.v.
Finally, the in vitro MIC studies performed by the Applicant are not sensitive enough to detect any differences between the two products since in vitro anti-bacterial activity is independent of lipophilicity, tissue distribution and clearance of the subcomponents. 
Poleg tega študije MIC in vitro, ki jih je opravil predlagatelj, niso dovolj občutljive, da bi zaznale razliko med zdraviloma, saj je protibakterijska aktivnost in vitro neodvisna od lipofilnosti, porazdelitve v tkivih ali očistka podkomponent.
In conclusion, the CHMP considers that the difference in concentration of the glycopeptide subcomponents precludes Teicoplanin Hospira being a considered a generic of Targocid, despite the composition being in line with the JP monograph and the draft Ph.Eur monograph. 
CHMP torej meni, da zaradi razlik v koncentraciji podkomponent glikopeptida zdravila Teicoplanin Hospira ne moremo šteti za generično zdravilo zdravila Targocid, čeprav je sestava skladna z monografijo JP in osnutkom monografije Ph. Eur.
The results of the phase I study failed to demonstrate PK equivalence for total drug exposure. 
Rezultati študije faze I niso dokazali farmakokinetične enakovrednosti skupne izpostavljenosti zdravilu.
Protein binding was assessed, showing that the unbound fraction for each sub-component was essentially similar for Targocid and Teicoplanin Hospira and confirming that the individual protein binding values for the subcomponents did not vary with the different component composition. 
Pri oceni vezave na beljakovine so ugotovili, da je nevezana frakcija vsake podkomponente v osnovi podobna med zdraviloma Targocid in Teicoplanin Hospira, in potrdili, da se posamezne vrednosti vezave na beljakovine za podkomponente ne razlikujejo med različnimi sestavami komponent.
The Applicant undertook an extensive testing program to characterise the activity of Teicoplanin Hospira versus Targocid against a series of clinically relevant species and demonstrated essential similarity between Teicoplanin Hospira and Targocid for all individual strains and species. 
Predlagatelj je izvedel obsežen program preskušanja, s katerim je želel opredeliti aktivnost zdravila Teicoplanin Hospira v primerjavi z zdravilom Targocid proti številnim klinično pomembnim vrstam bakterij, ter dokazati osnovno podobnost med zdraviloma Teicoplanin Hospira in Targocid za vse bakterijske seve in vrste.
The Applicant is therefore requested to further justify that Teicoplanin Hospira is a generic of Targocid in writing and/or at an Oral Explanation in light of the CHMP opinion.“ The Applicant decided to address the List of Outstanding Issues during an oral explanation. 
Predlagatelja zato prosimo, da glede na mnenje CHMP dodatno utemelji trditev, da je zdravilo Teicoplanin Hospira generično zdravilo zdravila Targocid, pisno in/ali ustno.“ Predlagatelj se je odločil obravnavati seznam nerešenih vprašanj ustno.
The CHMP requested the Applicant to further discuss their claim that Teicoplanin Hospira is a generic of Targocid. 
CHMP je zahteval, da predlagatelj znova premisli o trditvi, da je zdravilo Teicoplanin Hospira generično zdravilo zdravila Targocid.
The Applicant also discussed the data from the neutropenic mouse thigh infection study, arguing that the results clearly show that Teicoplanin Hospira and Targocid were equally effective in reducing bacterial count, confirming that the differences in relative composition of individual components do not affect the biological activity of the product. 
Predlagatelj je razpravljal tudi o podatkih iz študije okužbe stegna pri nevtropeničnih miškah z argumenti, da rezultati jasno kažejo enako učinkovitosti zdravil Teicoplanin Hospira in Targocid pri zmanjševanju števila bakterij, s čimer je potrjeno, da razlike v relativni sestavi posameznih komponent ne vplivajo na biološko aktivnost zdravila.
- Teicoplanin Hospira does not meet the originator specifications with respect to the individual glycopeptides subcomponents and has shown to be bio-inequivalent to the originator 
- zdravilo Teicoplanin Hospira z vidika posameznih glikopeptidnih podkomponent ne izpolnjuje specifikacij originatorskega zdravila in zanj je bila dokazana biološka neenakovrednost z originatorskim zdravilom,
The Applicant considers that the achieved product is in line with the published EDQM teicoplanin monograph, but stated that only the originator MAH was invited to comment on this monograph, and that comments submitted by Hospira were not accepted. 
Predlagatelj meni, da je doseženo zdravilo skladno z objavljeno monografijo EDQM za teikoplanin, vendar navaja, da je bil k razpravi o tej monografiji povabljen le imetnik dovoljenja za promet z originatorskim zdravilom ter da predlogi družbe Hospira niso bili sprejeti.
The Applicant stated that the antimicrobial potency of the drug is a sum of the component parts and that In vitro antibacterial potency is established by MIC testing. 
Predlagatelj je navedel, da je protimikrobna jakost zdravila vsota vseh komponent in da je protimikrobna jakost in vitro dokazana z določanjem vrednosti MIK.
Teicoplanin Hospira has a different sub-component mix to the originator; however the Applicant considers that it is not reasonable to use total teicoplanin MICs to assess the impact of differing proportions of subcomponents. 
Zdravilo Teicoplanin Hospira ima drugačno zmes podkomponent kot originatorsko zdravilo, vendar predlagatelj meni, da pri ugotavljanju učinka različnih deležev podkomponent ni utemeljeno uporabljati MIK za skupni teikoplanin.