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NICE Publish Guidance on Mifamurtide for the treatment of Osteosarcoma

Mifamurtide in combination with postoperative multi-agent chemotherapy is recommended within its licensed indication as an option for the treatment of high-grade resectable nonmetastatic osteosarcoma after macroscopically complete surgical resection in children, adolescents and young adults and when mifamurtide is made available at a reduced cost to the NHS under the patient access scheme.

Mifamurtide (Mepact, Takeda) is an immune macrophage stimulant. It has a marketing authorisation for use in ‘children, adolescents and young adults for the treatment of high-grade resectable non-metastatic osteosarcoma after macroscopically complete surgical resection’. The
marketing authorisation further states that mifamurtide is used in combination with postoperative multi-agent chemotherapy, and that safety and efficacy have been assessed in studies of patients 2 to 30 years of age at initial diagnosis. It is not recommended for use in children below the age of 2 years.

NICE Publish Guidance on Hyperglycaemia in Acute Coronary Syndromes

This guideline covers the role of intensive insulin therapy in managing hyperglycaemia within the first 48 hours in people admitted to hospital for acute coronary syndromes (ACS). Intensive insulin therapy is defined as an intravenous infusion of insulin and glucose with or without
potassium. For the purposes of this guideline, hyperglycaemia is defined as a blood glucose level above 11 mmol/litre. This definition was based on the expert opinion of the Guideline Development Group (GDG) and was agreed by consensus.

ACS encompass a spectrum of unstable coronary artery disease, ranging from unstable angina to transmural myocardial infarction. All forms of ACS begin with an inflamed and complicated fatty deposit (known as an atheromatous plaque) in a blood vessel, followed by blood clots
forming on the plaque. The principles behind the presentation, investigation and management of these syndromes are similar, but there are important distinctions depending on the category of ACS.
Hyperglycaemia is common in people admitted to hospital with ACS. Recent studies found that approximately 65% of patients with acute myocardial infarction who were not known to have diabetes had impaired glucose regulation when given a glucose tolerance test.
Hyperglycaemia at the time of admission with ACS is a powerful predictor of poorer survival and increased risk of complications while in hospital, regardless of whether or not the patient has diabetes. Despite this, hyperglycaemia remains underappreciated as a risk factor in ACS and is frequently untreated.
Persistently elevated blood glucose levels during acute myocardial infarction have been shown to be associated with increased in-hospital mortality, and to be a better predictor of outcome than admission blood glucose. Management of hyperglycaemia after ACS is therefore an important clinical issue.
A wide range of national guidance is available for the care of people with diabetes in hospital with relevance to ACS patients. For example the NHS Institute for Innovation and Improvement

NICE Publish Guidance on EOS 2D/3D Imaging Systems

The EOS 2D/3D imaging system is an emerging technology with potentially important clinical benefits. Current evidence shows there are some patient benefits for people with spinal deformities in terms of radiation dose reduction and increased throughput. However, those
benefits alone are insufficient to justify the cost of the system. No clinical evidence was available to quantify the extent of patient benefits from the EOS system’s imaging features including 3D reconstruction, weight-bearing whole-body imaging, and simultaneous posteroanterior (PA) and lateral imaging. Therefore, the EOS 2D/3D imaging system is not currently recommended for routine use in the NHS.

NICE encourages use of the EOS 2D/3D imaging system in specialist research settings to
collect evidence about potentially important clinical benefits associated with 3D reconstruction,
single image weight-bearing whole-body imaging and simultaneous PA and lateral imaging.

NICE Publish Guidance on Ticagrelor in acute coronary syndromes

Ticagrelor in combination with low-dose aspirin is recommended for up to 12 months as a treatment option in adults with acute coronary syndromes (ACS) that is, people:

  • With ST-segment-elevation myocardial infarction (STEMI) – defined as ST elevation or new left bundle branch block on electrocardiogram – that cardiologists intend to treat with primary percutaneous coronary intervention (PCI) or
  • with non-ST-segment-elevation myocardial infarction (NSTEMI) or
  • admitted to hospital with unstable angina – defined as ST or T wave changes on electrocardiogram suggestive of ischaemia plus one of the characteristics defined in section 1.2. Before ticagrelor is continued beyond the initial treatment, the diagnosis of unstable angina should first be confirmed, ideally by a cardiologist.

For the purposes of this guidance, characteristics to be used in defining treatment with ticagrelor for unstable angina are: age 60 years or older; previous myocardial infarction or previous coronary artery bypass grafting (CABG); coronary artery disease with stenosis of 50% or more in at least two vessels; previous ischaemic stroke; previous transient ischaemic attack, carotid stenosis of at least 50%, or cerebral revascularisation; diabetes mellitus; peripheral arterial disease; or chronic renal dysfunction, defined as a creatinine clearance of less than 60 ml per minute per 1.73 m2 of body-surface area.

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EMA publishes a reflection paper on methodological issues associated with pharmacgenomic biomarkers

As the number of available techniques to facilitate the study of human genomics has led to an exponential increase in investigation into genomic bio markersthe diagnosis of specific diseases. The AMA has decided that a guidance would be required to assist companies in implementing these technologies into clinical drug development.

These techniques are frequently used patient selection stratification or treatment strategies of patient groups, and the EMA is concerned the appropriate steps are not been taken hence the publication of this guidance.

excerpt from guidance

full text here

The availability of techniques that facilitate study of the human genome has led to an exponential increase in investigation into genomic biomarkers (GBMs) for diagnosis of specific diseases, as a marker of response to treatment or of prognosis. Theoretically genomic BMs should offer the advantage of improved specificity and reduction of heterogeneity that is an integral part of phenotypic population grouping. This is very attractive in drug development because of their potential ability to reduce drug attrition and to reduce overall developmental costs, that are achieved through improved understanding of the mechanism of drug action, predict adverse events to individual drugs or as a group effect (e.g. CYP poor metabolisers), and use of novel development strategies in pre-clinical and clinical phases.
In clinical drug development, GBMs may aid and influence a wide range of areas: patient selection, stratification of treatment strategies or patient groups, early evaluation of treatment effect including adverse reactions, and prognosis. There is opportunity for the GBMs to be used for pre-defined subgroup analysis or to enable novel trial designs that might not be possible otherwise due to heterogeneity of clinical characteristics.1,2 GBMs could also play a valuable role in the risk management strategies including risk minimisation by aiding a priori identification of patients susceptible to develop severe adverse effects (e.g. HLA B*- 5701 and use of Abacavir).
While a number of these aspects are discussed in many publications in the recent years, specific aspects relating to drug development and discussion on regulatory considerations have lagged behind. The intention of this paper is therefore to provide an evidence based consideration of GBM related issues from a regulatory viewpoint. Mention is also made of co-development of a GBM diagnostic test for use with a medicinal product.
The principles established in the reflection paper are based on the experiences gained from the evaluation of dossiers within the EU regulatory processes —including marketing authorisation applications reviewed by CHMP, the scientific advice documents and additionally, the voluntary genomic data submission meetings (briefing meetings) at the Pharmacogenomic Working party (PGWP) over the last several years. It is expected that these principles guide both industry and the assessors in the evaluation of such biomarkers in relation to the qualification process in the context of clinical development (BM qualification in EU) and the assessment of benefit: risk balance of medicinal products or selection of the relevant target population. The paper should also be read in conjunction with other relevant guidelines listed at the end of the documents under section “Other aspects”.
Development of GBMs and diagnostic tests may involve additional development of tests (companion diagnostics) or specific kits (platforms) to detect for the presence or absence of the GBM. Issues relating to these are outside the scope of this paper but a short discussion is included. The readers are referred to appropriate guidelines/ papers for details (see section on other aspects).

EMA publishes guideline on bioanalytical method validation

EMA has publishes guidelines to assist companies understand key elements required for validation of a bioanalytical method. It focuses on the validation geared towards quantitative concentration data used for pharmacokinetic and toxicokinetic parameter definitions. Guidance on criteria of application of these validated methods in the routine analysis of study samples from animals and humans.

excerpts from guidance

full text here

This guideline defines key elements necessary for the validation of bioanalytical methods. The guideline focuses on the validation of the bioanalytical methods generating quantitative concentration data used for pharmacokinetic and toxicokinetic parameter determinations. Guidance and criteria are given on the application of these validated methods in the routine analysis of study samples from animal and human studies.

Measurement of drug concentrations in biological matrices (such as serum, plasma, blood, urine, and saliva) is an important aspect of medicinal product development. Such data may be required to support applications for new actives substances and generics as well as variations to authorised drug products. The results of animal toxicokinetic studies and of clinical trials, including bioequivalence studies are used to make critical decisions supporting the safety and efficacy of a medicinal drug substance or product. It is therefore paramount that the applied bioanalytical methods used are well characterised, fully validated and documented to a satisfactory standard in order to yield reliable results.
Acceptance criteria wider than those defined in this guideline may be used in special situations. This should be prospectively defined based on the intended use of the method.

EMA publishes guidelines on clinical investigation of recumbent humanplasma derived factor IX products

This guideline developed by the EMA is to assist companies in providing the documentation that is required for when making and marketing authorisation application for recombinant human plasma derived factor 9 product. Specifically the product being used to treat patients the prevention of bleeding in haemophilia B. The guidance covers the clinical investigations to be conducted the prick and post marketing authorisation, this guide is also provides information when there is a significant change in the manufacturing process.

excerpt from guidance

full text here

This guideline describes the information to be documented when an application for a marketing authorisation for recombinant or human plasma-derived factor IX products is made for use in treatment and prevention of bleeding in patients with haemophilia B. The guideline covers clinical investigations to be conducted pre- and post-marketing authorisation. Guidance is also provided for authorised products where a significant change in the manufacturing process has been made.
Timeline history of guideline: The original Note for Guidance on Clinical Investigation of Human Plasma Derived FVIII and FIX Products (CPMP/BPWG/198/95) came into operation on 14 February 1996. The first revision (CPMP/BPWG/198/95 Rev. 1) came into operation in April 2001. The original Note for Guidance on Clinical Investigation on Recombinant FVIII and FIX Products (CPMP/BPWG/1561/99) came into operation in April 2001. Draft revisions of CPMP/BPWG/1561/99 and CPMP/BPWG/198/95 were released for public consultation in July 2007. Following this consultation, it was decided to reorganise the guidance to have separate documents: The Guideline on clinical investigation of recombinant and plasma derived factor VIII products (EMA/CHMP/BPWP/144533/2009) and the Guideline on clinical investigation of recombinant and plasma derived factor IX products (EMA/CHMP/BPWP/144552/2009).

 

EMA Publush Guidance on the Treatment of Premenstrual Dysphotic Disorder (PMDD)

EMA considers that there is sufficient research data available to support premenstrual dysphoric disorder (PMDD) at a diagnostic entity.

It is considered to have considerable public health impact in a small subpopulation of menstruating women. This guideline is to provide guidance on the clinical evaluation of products to treat this patient group.

excerpt from guidance

full text here

There are substantial research data available to support premenstrual dysphoric disorder (PMDD) as a diagnostic entity of a severe form of premenstrual disorder, which causes clinically relevant functional impairment and requires treatment. It is considered a disorder with substantial clinical and public health impact in a [small] subpopulation of menstruating women. The aim of this guideline is to provide guidance for the evaluation of medicinal products in the treatment of PMDD.
The present document should be conceived as general guidance, and should be read in conjunction with other applicable EU and ICH guidelines (see Section 3)..

Up to 70-90 % of women of reproductive age have one or more signs of physical discomfort or emotional symptoms in the premenstrual, i.e. luteal phase of their menstrual cycle. About 20-40 % of menstruating women have premenstrual syndrome (PMS) and experience luteal phase symptoms that are bothersome. A smaller number, up to 8 %, experience more severe symptoms, which lead to substantial distress or functional impairment and are referred to as premenstrual dysphoric disorder (PMDD) (10, 11, 13, 14, 23, 38, 39, 42). Although PMDD, like PMS includes physical symptoms, it always involves a worsening of mood that interferes significantly with the woman’s quality of life. The burden of illness of PMDD results from the severity of luteal phase symptoms, the chronicity of the disorder and the impairment in work, relationships and activities.
In the last decades a very broad diagnostic concept of the premenstrual disorders PMS and PMDD has been used in clinical research, which produced different diagnostic criteria and highly heterogeneous study populations.
Recent advances and research data improved the knowledge on diagnosis, frequency, pathophysiologic mechanisms, and treatment options in PMDD. This led to treatment recommendations by learned societies for PMDD.

EMA publishes guidance on quality aspects on the isolation of candidate influenza viruses in cell culture

This EMA guideline lays down the quality recommendations the cells used to isolate candidate influenza vaccine viruses, the conditions in which to which the viruses are isolated and the subsequent purification and development of master seed batches and GMP conditions.

This guidance considers the different technologies available and that are in wide use and makes a series of recommendations. Manufactures still need to consider which are most appropriate for their products.

excerpt from guidance

full text here

This Guideline lays down the quality recommendations for cells used to isolate candidate influenza vaccine viruses, the conditions under which the viruses are isolated and the subsequent passage of the
viruses until the manufacturer’s Master Seed is prepared under GMP conditions.

Many influenza vaccine manufacturers are developing cell culture processes for the production of inactivated vaccine using a variety of cell types and several such vaccines have been licensed within the EU. Manufacturers of cell-derived vaccine typically use the recommended egg-derived candidate vaccine virus to derive their seed virus; this may be the wild type egg isolate or a high growth reassortant (hgr), especially for influenza A viruses. There is currently no published evidence that the use of an egg-derived hgr provides a growth advantage in cells compared with the wild type eggderived recommended strain – it is simply the vaccine virus that is available from WHO collaborative laboratories that supply such viruses.
Manufacturers of cell-derived influenza vaccine may prefer to use a cell-only passaged virus instead of one that has been egg-adapted. This is because research indicates that when a human influenza virus is adapted to grow in eggs, it undergoes phenotypic changes that might include changes to its antigenicity/immunogenicity [1]. Virus isolated on mammalian cell cultures do not, attheleast initially, undergo the type of selection that occurs during initial passage in eggs and typically the haemagglutinin (HA) of a cell isolated virus is structurally more related to the virus found in clinical specimens in contrast to egg-adapted variants in which specific HA amino acid substitutions have been identified [1]. Thus a cell-isolated virus might be more clinically relevant for vaccine than an egg isolate although to date this has not been fully demonstrated scientifically. For the reasons mentioned above, manufacturers are now keen to use non-egg adapted viruses, which are antigenically closer to the wild type virus. However, cells in general use by National Influenza Centres and WHO Collaborating Centres for virus isolation are not qualified/validated for use in deriving a candidate vaccine virus and so currently only egg-isolated viruses are taken forward as vaccine candidates.

The major concern in isolating vaccine viruses in cells is the possibility of adventitious agent contamination that might derive from the cells, the environment or materials used during isolation and propagation of the viruses. Thus, the purpose of this document is to provide regulatory guidance on the quality of the cells used to isolate the virus, the conditions under which viruses are isolated and the subsequent passage of these viruses until the manufacturer’s master seed is prepared according to GMP. Normally, regulatory guidance is directed towards the vaccine manufacturers as it is they who have the responsibility for ensuring that their vaccine seed is suitable for the production of a human influenza vaccine. However, it is appreciated that the isolation of influenza candidate vaccine viruses will take place in WHO Collaborating Centres and as such, from a practical point of view, these laboratories should be familiar with the EU recommendations presented in this document. The quality aspects of the establishment of a manufacturer’s Master Seed lot and subsequent use in a cell vaccine manufacturing process have been described previously in the guideline ‘Cell Culture Inactivated Influenza Vaccines, Annex to note for guidance on harmonisation of requirements for influenza vaccines’ [2] and will not be further addressed in this document.

EMA publish revision to guidance on impurities in veterinary medical products

This guidance is being published with the objective to recommend acceptable amount of residual solvents in pharmaceuticals forthe safety of target animals as well of the safety of residuals in products derived from treated food producing animals.

There are no therapeutic benefits from residual solvents, all residual solvent should be removed to the extent possible to meet product specifications. The list of solvents and their acceptable levels is not exhaustive and other solvent will be added to this list as it develops.

excerpt from guideline

full text here

The objective of this guideline is to recommend acceptable amounts for residual solvents in pharmaceuticals for the safety of the target animal as well as for the safety of residues in products derived from treated food producing animals. The guideline recommends use of less toxic solvents and describes levels considered to be toxicologically acceptable for some residual solvents.
Residual solvents in pharmaceuticals are defined here as organic volatile chemicals that are used or produced in the manufacture of active substances or excipients, or in the preparation of veterinary medicinal products. The solvents are not completely removed by practical manufacturing techniques. Appropriate selection of the solvent for the synthesis of active substance may enhance the yield, or determine characteristics such as crystal form, purity, and solubility. Therefore, the solvent may sometimes be a critical parameter in the synthetic process. This guideline does not address solvents deliberately used as excipients nor does it address solvates. However, the content of solvents in such products should be evaluated and justified.
Since there is no therapeutic benefit from residual solvents, all residual solvents should be removed to the extent possible to meet product specifications, good manufacturing practices, or other quality-based requirements. Veterinary medicinal products should contain no higher levels of residual solvents than can be supported by safety data. Some solvents that are known to cause unacceptable toxicities (Class 1, Table 1) should be avoided in the production of active substances, excipients, or veterinary medicinal products unless their use can be strongly justified in a risk-benefit assessment. Some solvents associated with less severe toxicity (Class 2, Table 2) should be limited in order to protect target animals and human consumers from potential adverse effects. Ideally, less toxic solvents (Class 3, Table 3) should be used where practical. The complete list of solvents included in this guideline is given in Appendix 1.
The lists are not exhaustive and other solvents can be used and later added to the lists. Recommended limits of Class 1 and 2 solvents or classification of solvents may change, as new safety data becomes available. Supporting safety data in a marketing application for a new veterinary medicinal product containing a new solvent may be based on concepts in this guideline or the concept of qualification of impurities as expressed in the guideline for active substance (VICH GL 10, Impurities in New Veterinary Drug Substances) or veterinary medicinal product (VICH GL 11, Impurities in New Veterinary Medicinal Products), or all three guidelines.

EMA published draft guideline on SMPC for plasma-derived Fibrin sealant

This guideline describes information should be included in the summary of product characteristics (SMPC) for plasma-derived fibrin sealant or haemostatic products. this guidance is being put together so that all products within this group are harmonised guidance on what to include. General guidance has been found in several areas but the DMA felt a single guidance brought it all together would be of value. Specifically sections 4.4 4.8 concerning transmissible agents should be of concern. Also revisions for products recommended for use with gas pressurised fibrin sprayers have been included.

excerpt from draft guidance

full text here

This guideline describes the information to be included in the Summary of Product Characteristics (SmPC) for plasma-derived fibrin sealant / haemostatic products.

The purpose of this core SmPC is to provide applicants and regulators with harmonised guidance on the information to be included in the Summary of product characteristics (SmPC) for plasma-derived fibrin sealant / haemostatic products.
The QRD product information template with explanatory notes (′QRD annotated template’)1 and the convention to be followed for QRD templates2 provide general guidance on format and text and should be read in conjunction with the core SmPC and the Guideline on summary of product characteristics3. It is very useful to provide information for health professionals on posology and method of administration at the end of the package leaflet since the SmPC is not always readily available. See the QRD annotated template for further guidance on how to present such information.
In addition, for the content of sections 4.4 and 4.8 concerning transmissible agents, refer to the current version of the Note for guidance on the warning on transmissible agents in SmPCs and package leaflets for plasma-derived medicinal products (CPMP/BPWG/BWP/561/03)4.
Timeline history of core SmPC: The original core SmPC (CPMP/BPWP/153/00) came into operation in January 2005. This revision concerns new statements in 4.4 and 6.6 for products recommended for use with gas pressurised fibrin sprayers.

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EMA Publish Guidelines on Interactive Response Technologies in Clinical Trials

EMA Publish Guidelines on Interactive Response Technologies in Clinical Trials

Full Text Here

Over the last 15 years there has been an increasing utilisation of interactive voice response systems (IVRS) utilising telephones. Such systems have been developed further into interactive web based systems (IWRS) utilising the internet. These systems were developed initially to optimise drug availability at sites. However, this has expanded into other areas such as dose titration, unblinding and expiry date updating. This of course may, if not handled appropriately, pose an increased risk to the patient and so IVRS/IWRS is of increasing interest to National Competent Authorities (NCAs).
One specific example is the potential use of IVRS/IWRS to justify the removal of expiry dates from IMP labels. This paper seeks to provide guidance to Member States on what our expectations are of these systems and in particular their use in expiry updating. These positions will form guidance for sponsors and IVRS/IWRS providers.

Sponsors have previously contacted the regulatory agencies with requests to omit the use-by date on study medication in case of IVRS/IWRS use. An advantage of this approach would be avoiding issues related to relabelling of the use-by date on site, which can often cause issues in themselves with poor control of the expiry update labels. However, the request of the sponsors raises concerns for Regulatory Authorities; based on experience, for example GCP inspection findings around IVRS validation and the possibility of dispensing expired study medication to patients.
A White Paper by the ISPE/PDA Expiry Date Task Force produced in 2009, raises an important issue in that many sponsors, due to lack of knowledge, may not be able to use the IVRS/IWRS appropriately (p. 8, 3rd paragraph).
Currently, the information on the use of IVR/IWR systems is limited to the completion of a tick box in the clinical trial authorisation application filled in by the sponsor. Also, the protocol may only provide limited detail on the use of the IVR/IWR.
As IVR/IWR systems are developed to facilitate overall drug management and expanded to assist with dose titration, unblinding and expiry date update, the intent of the paper is to provide guidance to the sponsors and to the IVR/IWR providers in the use of the systems within clinical trials and detail the expectations of the NCA on such systems.
The potential for the revision of Annex 13, when it is next reviewed is also considered.



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Damien Bové is THE Drug Development and Regulatory Consultant (pharmaceutical or biotechnology), I work with my clients to define a drug development target, define a drug development strategy, define a regulatory strategy or define a commercial strategy. Our clients are generally raising funds or looking to license out their technology and we help them achieve it. If you want to know more don’t hesitate to get in touch.

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EMA Publishes Public Statement on Allium Cepa L., bulbus

EMA Publishes Public Statement on Allium Cepa L., bulbus

Full Text Here

The HMPC/MLWP decided to prepare a Community herbal monograph on Allium cepa L., bulbus as announced in the meeting report from the January 2010 HMPC meeting.
After reviewing information on the products containing Allium cepa L., bulbus and preparations thereof marketed in the Community, it appears that very few products (single-ingredient and combination) are available.
A comprehensive literature search was conducted and available data, including information on products on the market in the Community, are assessed vis-à-vis the requirements laid down in Directive 2001/83/EC and its Annex I, in particular Article 1, Article 10a and Chapter 2a.
The HMPC/MLWP concluded that the following requirements for the establishment of a Community herbal monograph on traditional and well-established herbal medicinal products containing Allium cepa L., bulbus are not fulfilled:
- the requirement laid down in Article 10a of Directive 2001/83/EC that the active substance has a recognised efficacy and an acceptable level of safety and that the period of well-established medicinal use has elapsed
- the requirement laid down in Article 16a(1)(d) of Directive 2001/83/EC that “the period of traditional use as laid down on Article 16c(1)(c) has elapsed”

Based on the above-mentioned information, the HMPC is of the opinion that a Community herbal monograph on Allium cepa L., bulbus cannot be established.
To read more about the assessment carried out, a link is provided to the page where to access the draft assessment report on Allium cepa L., bulbus and its list of references.



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Damien Bové is THE Drug Development and Regulatory Consultant (pharmaceutical or biotechnology), I work with my clients to define a drug development target, define a drug development strategy, define a regulatory strategy or define a commercial strategy. Our clients are generally raising funds or looking to license out their technology and we help them achieve it. If you want to know more don’t hesitate to get in touch.

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EMA Publishes Herbal Monograph for Glycyrrhiza glabra L.,

EMA Publishes Herbal Monograph for Glycyrrhiza glabra L.,

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With regard to the registration application of Article 16d(1) of Directive 2001/83/EC as amended
Glycyrrhiza glabra L. and/or Glycyrrhiza inflata Bat. and/or Glycyrrhiza uralensis Fisch, radix (liquorice root)
i) Herbal substance Not applicable.
ii) Herbal preparations

a) Comminuted herbal substance

b) Soft extract (DER 1:0.4-0.5), extraction solvent water

c) Soft extract (DER 3:1), extraction solvent water

Comminuted herbal substance as a herbal tea for oral use.
Herbal preparations in liquid dosage forms for oral use.
The pharmaceutical form should be described by the European Pharmacopoeia full standard term.


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EMA Publishes Comments Received on Herbal Monograph, Symphytum Officinale L., radix

EMA Publishes Comments Received on Herbal Monograph, Symphytum Officinale L., radix

Full Text Here

With regard to the registration application of Article 16d(1) of Directive 2001/83/EC as amended
Symphytum officinale L., radix (comfrey root)
i) Herbal substance Not applicable.
ii) Herbal preparations Liquid extract (DER 2:1), extraction solvent ethanol 65% V/V.

Herbal preparations in semi-solid dosage forms for cutaneous use.
The pharmaceutical form should be described by the European Pharmacopoeia full standard term.

Traditional herbal medicinal product used for the symptomatic treatment of minor sprains and bruises.
The product is a traditional herbal medicinal product for use in the specified indication



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Damien Bové is THE Drug Development and Regulatory Consultant (pharmaceutical or biotechnology), I work with my clients to define a drug development target, define a drug development strategy, define a regulatory strategy or define a commercial strategy. Our clients are generally raising funds or looking to license out their technology and we help them achieve it. If you want to know more don’t hesitate to get in touch.

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