Commission. Product. Notification. Decision. Issued 2 / affected 3 amended on. 08/05/2018 n/a

Transcription

1 Procedural steps taken and scientific information after the authorisation Application Scope Opinion/ Commission Product Summary number Notification Decision Information 1 issued on Issued 2 / affected 3 amended on IG/0921 B.III.2.b - Change to comply with Ph. Eur. or with a national pharmacopoeia of a Member State - Change to comply with an update of the relevant monograph of the Ph. Eur. or national pharmacopoeia of a Member State 08/05/2018 n/a II/0235 Update of section 4.5 of the SmPC in order to update the interactions section with additional data on the co-administration with Meningococcal serogroup B 12/04/2018 SmPC can be given concomitantly with meningococcal serogroup B vaccine (MenB). When Infanrix hexa was co-administered with MenB and pneumococcal 1 Notifications are issued for type I variations and Article 61(3) notifications (unless part of a group including a type II variation or extension application or a worksharing application). Opinions are issued for all other procedures. 2 A Commission decision (CD) is issued for procedures that affect the terms of the marketing authorisation (e.g. summary of product characteristics, annex II, labelling, package leaflet). The CD is issued within two months of the opinion for variations falling under the scope of Article 23.1a(a) of Regulation (EU) No. 712/2012, or within one year for other procedures. 3 SmPC (Summary of Product Characteristics), Annex II, Labelling, PL (Package Leaflet). 30 Churchill Place Canary Wharf London E14 5EU United Kingdom Telephone +44 (0) Facsimile +44 (0) Send a question via our website An agency of the European Union

2 vaccine (MenB) in order to facilitate the administration of and Bexsero to infants and toddlers based on final results from clinical studies V72P12, V72P13 and V72P16. C.I.4 - Change(s) in the SPC, Labelling or PL due to new quality, preclinical, clinical or pharmacovigilance data conjugate vaccines, inconsistent results were seen across studies for responses to inactivated poliovirus type 2, pneumococcal conjugate serotype 6B antigen and to the pertussis pertactin antigen but these data do not suggest clinically significant interference. Due to an increased risk of fever, pain at the injection site, appetite lost and irritability when was coadministered with MenB vaccine and 7-valent pneumococcal conjugate vaccine, separate vaccinations can be considered when possible. II/0237/G This was an application for a group of variations. 15/03/2018 Annex II B.I.a.1.e - Change in the manufacturer of AS or of a starting material/reagent/intermediate for AS - The change relates to a biological AS or a starting material [-] used in the manufacture of a biological/immunological product B.I.a.2.c - Changes in the manufacturing process of the AS - The change refers to a [-] substance in the manufacture of a biological/immunological substance which may have a significant impact on the medicinal product and is not related to a protocol B.I.a.4.b - Change to in-process tests or limits applied during the manufacture of the AS - Addition of a new in-process test and limits B.I.b.2.b - Change in test procedure for AS or starting material/reagent/intermediate - Deletion of a test procedure for the AS or a starting material/reagent/intermediate, if an alternative test procedure is already authorised B.I.c.1.c - Change in immediate packaging of the AS EMA/357080/2018 Page 2/59

3 - Liquid ASs (non sterile) WS/1237/G This was an application for a group of variations following a worksharing procedure according to Article 20 of Commission Regulation (EC) No 1234/ /02/2018 n/a B.II.d.2.c - Change in test procedure for the finished product - Substantial change to or replacement of a biol/immunol/immunochemical test method or a method using a biol. reagent or replacement of a biol. reference preparation not covered by an approved protocol B.II.d.2.d - Change in test procedure for the finished product - Other changes to a test procedure (including replacement or addition) WS/ /02/2018 n/a B.I.b.2.d - Change in test procedure for AS or starting material/reagent/intermediate - Substantial change to or replacement of a biological/immunological/immunochemical test method or a method using a biological reagent for a biological AS WS/ /02/2018 n/a EMA/357080/2018 Page 3/59

4 B.II.d.2.d - Change in test procedure for the finished product - Other changes to a test procedure (including replacement or addition) II/0234 Update of section 5.1 of the SmPC in order to update the safety information regarding the long term immunity persistence to Hepatitis B at 12/13 years based on the final study CSR DTPa-HBV-IPV-114 in the framework of art. 46 submission (procedure number EMEA/H/C/000296/P46/117). In addition, minor editorial updates are included in section 4.4 of the SmPC to improve clarity. 08/02/2018 SmPC With regards to hepatitis B, protective immunity ( 10 miu/ml) following a 3-dose primary and booster schedule with has been shown to persist in 85% of subjects 4-5 years of age, in 72% of subjects 7-8 years of age and in 60% of subjects years of age. Additionally, following a 2-dose primary and booster schedule, protective immunity against hepatitis B persisted in 48% of subjects years of age. C.I.4 - Change(s) in the SPC, Labelling or PL due to new quality, preclinical, clinical or pharmacovigilance data WS/ /12/2017 n/a B.I.z - Quality change - Active substance - Other variation WS/1250/G This was an application for a group of variations following a worksharing procedure according to Article 20 of Commission Regulation (EC) No 1234/ /12/2017 n/a B.I.a.2.z - Changes in the manufacturing process of the AS - Other variation B.I.c.1.z - Change in immediate packaging of the AS EMA/357080/2018 Page 4/59

5 - Other variation WS/ /12/2017 n/a B.I.z - Quality change - Active substance - Other variation WS/ /11/2017 n/a B.I.a.2.a - Changes in the manufacturing process of the AS - Minor change in the manufacturing process of the AS WS/1239/G This was an application for a group of variations following a worksharing procedure according to Article 20 of Commission Regulation (EC) No 1234/ /11/2017 n/a B.III.1.b.3 - Submission of a new/updated or deletion of Ph. Eur. TSE Certificate of Suitability - Updated certificate from an already approved manufacturer B.III.1.b.3 - Submission of a new/updated or deletion of Ph. Eur. TSE Certificate of Suitability - Updated certificate from an already approved manufacturer B.III.1.b.4 - Submission of a new/updated or deletion of Ph. Eur. TSE Certificate of Suitability - EMA/357080/2018 Page 5/59

6 Deletion of certificates (in case multiple certificates exist per material) B.III.1.b.4 - Submission of a new/updated or deletion of Ph. Eur. TSE Certificate of Suitability - Deletion of certificates (in case multiple certificates exist per material) B.III.1.b.z - Submission of a new/updated or deletion of Ph. Eur. TSE Certificate of Suitability - Ph. Eur. TSE Certificate of suitability - Other variation WS/ /11/2017 n/a B.I.a.2.a - Changes in the manufacturing process of the AS - Minor change in the manufacturing process of the AS WS/ /11/2017 n/a B.I.b.2.e - Change in test procedure for AS or starting material/reagent/intermediate - Other changes to a test procedure (including replacement or addition) for the AS or a starting material/intermediate WS/ /10/2017 n/a EMA/357080/2018 Page 6/59

7 B.I.b.2.a - Change in test procedure for AS or starting material/reagent/intermediate - Minor changes to an approved test procedure WS/ /10/2017 n/a B.I.b.1.i - Change in the specification parameters and/or limits of an AS, starting material/intermediate/reagent - Where there is no monograph in the European/National Ph. for the AS, a change in specification from in-house to a nonofficial/third country Ph. WS/ /09/2017 n/a B.I.b.2.e - Change in test procedure for AS or starting material/reagent/intermediate - Other changes to a test procedure (including replacement or addition) for the AS or a starting material/intermediate WS/ /09/2017 n/a B.I.b.2.e - Change in test procedure for AS or starting material/reagent/intermediate - Other changes to a test procedure (including replacement EMA/357080/2018 Page 7/59

8 or addition) for the AS or a starting material/intermediate IB/0220 WS/1166 C.I.z - Changes (Safety/Efficacy) of Human and Veterinary Medicinal Products - Other variation 07/07/ /09/2017 SmPC, Labelling and PL 22/06/2017 n/a B.I.a.2.c - Changes in the manufacturing process of the AS - The change refers to a [-] substance in the manufacture of a biological/immunological substance which may have a significant impact on the medicinal product and is not related to a protocol WS/1150/G This was an application for a group of variations following a worksharing procedure according to Article 20 of Commission Regulation (EC) No 1234/ /06/2017 n/a B.I.a.2.c - Changes in the manufacturing process of the AS - The change refers to a [-] substance in the manufacture of a biological/immunological substance which may have a significant impact on the medicinal product and is not related to a protocol B.I.e.2 - Introduction of a post approval change management protocol related to the AS WS/ /05/2017 n/a EMA/357080/2018 Page 8/59

9 B.I.c.1.z - Change in immediate packaging of the AS - Other variation WS/1048/G This was an application for a group of variations following a worksharing procedure according to Article 20 of Commission Regulation (EC) No 1234/ /03/2017 n/a B.I.a.2.a - Changes in the manufacturing process of the AS - Minor change in the manufacturing process of the AS B.I.a.4.f - Change to in-process tests or limits applied during the manufacture of the AS - Addition or replacement of an in-process test as a result of a safety or quality issue WS/0972/G This was an application for a group of variations following a worksharing procedure according to Article 20 of Commission Regulation (EC) No 1234/ /03/2017 n/a B.I.a.2.z - Changes in the manufacturing process of the AS - Other variation B.I.b.1.z - Change in the specification parameters and/or limits of an AS, starting material/intermediate/reagent - Other variation B.III.2.a.2 - Change of specification(s) of a former non EU Pharmacopoeial substance to fully comply with the Ph. Eur. or with a national pharmacopoeia of a Member State - Excipient/AS starting material EMA/357080/2018 Page 9/59

10 B.III.2.a.2 - Change of specification(s) of a former non EU Pharmacopoeial substance to fully comply with the Ph. Eur. or with a national pharmacopoeia of a Member State - Excipient/AS starting material WS/1068/G This was an application for a group of variations following a worksharing procedure according to Article 20 of Commission Regulation (EC) No 1234/ /02/2017 n/a B.I.b.1.e - Change in the specification parameters and/or limits of an AS, starting material/intermediate/reagent - Deletion of a specification parameter which may have a significant effect on the overall quality of the AS and/or the FP B.I.b.1.z - Change in the specification parameters and/or limits of an AS, starting material/intermediate/reagent - Other variation B.I.b.1.z - Change in the specification parameters and/or limits of an AS, starting material/intermediate/reagent - Other variation WS/1069/G This was an application for a group of variations following a worksharing procedure according to Article 20 of Commission Regulation (EC) No 1234/ /02/2017 n/a B.I.b.2.e - Change in test procedure for AS or starting material/reagent/intermediate - Other changes to a test procedure (including replacement or addition) for the AS or a starting material/intermediate EMA/357080/2018 Page 10/59

11 B.I.d.1.z - Stability of AS - Change in the re-test period/storage period or storage conditions - Other variation WS/1067/G This was an application for a group of variations following a worksharing procedure according to Article 20 of Commission Regulation (EC) No 1234/ /02/2017 n/a B.I.b.2.z - Change in test procedure for AS or starting material/reagent/intermediate - Other variation B.II.d.2.z - Change in test procedure for the finished product - Other variation WS/ /01/ /09/2017 SmPC and PL C.I.z - Changes (Safety/Efficacy) of Human and Veterinary Medicinal Products - Other variation IG/0738 B.I.b.1.d - Change in the specification parameters and/or limits of an AS, starting material/intermediate/reagent - Deletion of a nonsignificant specification parameter (e.g. deletion of an obsolete parameter) 16/12/2016 n/a WS/ /12/2016 n/a EMA/357080/2018 Page 11/59

12 B.I.b.2.e - Change in test procedure for AS or starting material/reagent/intermediate - Other changes to a test procedure (including replacement or addition) for the AS or a starting material/intermediate WS/0976/G This was an application for a group of variations following a worksharing procedure according to Article 20 of Commission Regulation (EC) No 1234/ /12/2016 n/a B.I.a.1.e - Change in the manufacturer of AS or of a starting material/reagent/intermediate for AS - The change relates to a biological AS or a starting material [-] used in the manufacture of a biological/immunological product B.I.b.1.c - Change in the specification parameters and/or limits of an AS, starting material/intermediate/reagent - Addition of a new specification parameter to the specification with its corresponding test method WS/ /11/2016 n/a B.I.a.2.c - Changes in the manufacturing process of the AS - The change refers to a [-] substance in the manufacture of a biological/immunological substance which may have a significant impact on the medicinal product and is not related to a protocol EMA/357080/2018 Page 12/59

13 IG/0721 A.7 - Administrative change - Deletion of manufacturing sites 10/10/2016 n/a WS/ /09/2016 n/a B.I.a.2.a - Changes in the manufacturing process of the AS - Minor change in the manufacturing process of the AS IG/0719/G This was an application for a group of variations. 21/09/2016 n/a B.II.e.2.b - Change in the specification parameters and/or limits of the immediate packaging of the finished product - Addition of a new specification parameter to the specification with its corresponding test method B.II.e.2.b - Change in the specification parameters and/or limits of the immediate packaging of the finished product - Addition of a new specification parameter to the specification with its corresponding test method B.II.e.2.b - Change in the specification parameters and/or limits of the immediate packaging of the finished product - Addition of a new specification parameter to the specification with its corresponding test method B.II.e.6.b - Change in any part of the (primary) packaging material not in contact with the finished product formulation - Change that does not affect the product information EMA/357080/2018 Page 13/59

14 IA/0207 A.4 - Administrative change - Change in the name and/or address of a manufacturer or an ASMF holder or supplier of the AS, starting material, reagent or intermediate used in the manufacture of the AS or manufacturer of a novel excipient 20/09/ /09/2017 Annex II II/0202/G This was an application for a group of variations. B.I.a.1.e - Change in the manufacturer of AS or of a starting material/reagent/intermediate for AS - The change relates to a biological AS or a starting material [-] used in the manufacture of a biological/immunological product B.I.a.2.c - Changes in the manufacturing process of the AS - The change refers to a [-] substance in the manufacture of a biological/immunological substance which may have a significant impact on the medicinal product and is not related to a protocol B.I.a.3.c - Change in batch size (including batch size ranges) of AS or intermediate - The change requires assessment of the comparability of a biological/immunological AS B.I.a.4.b - Change to in-process tests or limits applied during the manufacture of the AS - Addition of a new in-process test and limits B.I.a.4.z - Change to in-process tests or limits applied during the manufacture of the AS - Other variation B.II.b.5.b - Change to in-process tests or limits applied during the manufacture of the finished product - Addition of a new test(s) and limits 15/09/ /09/2017 SmPC, Annex II, Labelling and PL EMA/357080/2018 Page 14/59

15 B.II.b.5.b - Change to in-process tests or limits applied during the manufacture of the finished product - Addition of a new test(s) and limits B.II.b.5.b - Change to in-process tests or limits applied during the manufacture of the finished product - Addition of a new test(s) and limits B.II.b.5.b - Change to in-process tests or limits applied during the manufacture of the finished product - Addition of a new test(s) and limits IA/0201 B.I.a.4.b - Change to in-process tests or limits applied during the manufacture of the AS - Addition of a new in-process test and limits 09/06/2016 n/a IG/0679 B.II.e.2.b - Change in the specification parameters and/or limits of the immediate packaging of the finished product - Addition of a new specification parameter to the specification with its corresponding test method 01/06/2016 n/a IA/0199 B.I.b.1.d - Change in the specification parameters and/or limits of an AS, starting material/intermediate/reagent - Deletion of a nonsignificant specification parameter (e.g. deletion of an obsolete parameter) 19/05/2016 n/a WS/ /05/2016 n/a B.II.h.1.b.2 - Update to the Adventitious Agents Safety Evaluation information - Replacement of EMA/357080/2018 Page 15/59

16 obsolete studies related to manufacturing steps and adventitious agents already reported in the dossier - without modifications of risk assessment IA/0198 A.7 - Administrative change - Deletion of manufacturing sites 04/05/2016 n/a WS/ /04/2016 n/a B.II.d.1.z - Change in the specification parameters and/or limits of the finished product - Other variation WS/0854/G This was an application for a group of variations following a worksharing procedure according to Article 20 of Commission Regulation (EC) No 1234/ /02/2016 n/a B.I.b.1.d - Change in the specification parameters and/or limits of an AS, starting material/intermediate/reagent - Deletion of a nonsignificant specification parameter (e.g. deletion of an obsolete parameter) B.I.b.1.z - Change in the specification parameters and/or limits of an AS, starting material/intermediate/reagent - Other variation WS/ /12/2015 n/a EMA/357080/2018 Page 16/59

17 B.II.d.2.d - Change in test procedure for the finished product - Other changes to a test procedure (including replacement or addition) IA/0195/G This was an application for a group of variations. 09/12/2015 n/a B.I.b.1.d - Change in the specification parameters and/or limits of an AS, starting material/intermediate/reagent - Deletion of a nonsignificant specification parameter (e.g. deletion of an obsolete parameter) B.II.d.1.d - Change in the specification parameters and/or limits of the finished product - Deletion of a non-significant specification parameter IA/0194 B.I.b.1.c - Change in the specification parameters and/or limits of an AS, starting material/intermediate/reagent - Addition of a new specification parameter to the specification with its corresponding test method 09/12/2015 n/a II/0190 B.I.a.1.e - Change in the manufacturer of AS or of a starting material/reagent/intermediate for AS - The change relates to a biological AS or a starting material [-] used in the manufacture of a biological/immunological product 26/11/2015 n/a WS/ /11/2015 n/a B.I.b.2.e - Change in test procedure for AS or EMA/357080/2018 Page 17/59

18 starting material/reagent/intermediate - Other changes to a test procedure (including replacement or addition) for the AS or a starting material/intermediate IB/0192 B.I.e.5.c - Implementation of changes foreseen in an 28/10/2015 n/a approved change management protocol - For a biological/immunological medicinal product II/0178 Update of sections 4.2, 4.4, 4.8 and 5.1 of the SmPC 24/09/ /10/2015 SmPC and Update of sections 4.2, 4.4, 4.8 and 5.1 of the SmPC in in order to include more information on the use of Annex II order to include information on the use of in in premature infants. In addition, some premature infants. In addition, some lay-out changes lay-out changes are proposed in Annex II. (addition of bullets) are proposed in Annex II. C.I.4 - Change(s) in the SPC, Labelling or PL due to new quality, preclinical, clinical or pharmacovigilance data WS/0794/G This was an application for a group of variations 15/10/2015 n/a following a worksharing procedure according to Article 20 of Commission Regulation (EC) No 1234/2008. B.I.b.2.a - Change in test procedure for AS or starting material/reagent/intermediate - Minor changes to an approved test procedure B.I.b.2.a - Change in test procedure for AS or starting material/reagent/intermediate - Minor changes to an approved test procedure B.I.b.2.a - Change in test procedure for AS or starting material/reagent/intermediate - Minor changes to an approved test procedure EMA/357080/2018 Page 18/59

19 B.I.b.2.a - Change in test procedure for AS or starting material/reagent/intermediate - Minor changes to an approved test procedure WS/ /10/2015 n/a B.I.a.2.a - Changes in the manufacturing process of the AS - Minor change in the manufacturing process of the AS II/0180 II/0179 Update of section 5.1 of the SmPC in order to describe the results of the Hepatitis B immunity persistence data gathered. C.I.4 - Change(s) in the SPC, Labelling or PL due to new quality, preclinical, clinical or pharmacovigilance data Update of sections 2 and 5.1 of the SmPC to add data generated in study DTPa-HBV-IPV/Hib-MenC- TT-003 for the new 2+1 schedule (2, 4 and 12 months of age). C.I.4 - Change(s) in the SPC, Labelling or PL due to new quality, preclinical, clinical or pharmacovigilance data 24/09/ /10/2015 SmPC This submission intends to describe the results of the Hepatitis B immunity persistence data gathered so far in the Summary of Product Characteristics of, section 5.1 Pharmacodynamic properties. Moreover, studies DTPa-HBV-IPV-110 and -111 also evaluated the persistence of the immune response induced by against diphtheria, tetanus, pertussis, poliovirus and Haemophilus influenzae type b. Update of section 5.1 of the SmPC in order to describe the results of the Hepatitis B immunity persistence data gathered. 24/09/ /10/2015 SmPC In the clinical study DTPa-HBV-IPV/Hib-MenC-TT-003, co-administered with Prevenar 13, Menjugate and Rotarix was administered to infants randomized to the control group and the vaccines were administered according to a 2+1 schedule, with two primary vaccination doses at 2 and 4 months of age and a booster dose at 12 months of age. This submission intends to include the immunogenicity data generated in this study for the new 2+1 schedule (2, 4 and 12 months of age) in the SmPC, EMA/357080/2018 Page 19/59

20 II/0177 Update of sections 4.4, 4.5 and 4.8 of the SmPC in order to update the safety information of Infanrix hexa on the co-adminstration with several other paediatric vaccines. In addition, the MAH is updating the details for some of the local representatives. section 5.1 Pharmacodynamic properties. Update of sections 2 and 5.1 to add data generated in study DTPa-HBV-IPV/Hib-MenC-TT-003 for the new 2+1 schedule (2, 4 and 12 months of age). 24/09/ /10/2015 SmPC and PL Update of sections 4.4, 4.5 and 4.8 of the SmPC in order to update the safety information of on the coadministration with several other paediatric vaccines. The package leaflet has been amended accordingly. C.I.4 - Change(s) in the SPC, Labelling or PL due to new quality, preclinical, clinical or pharmacovigilance data WS/ /09/2015 n/a B.I.b.2.e - Change in test procedure for AS or starting material/reagent/intermediate - Other changes to a test procedure (including replacement or addition) for the AS or a starting material/intermediate PSUSA/1122/ Periodic Safety Update EU Single assessment - 25/06/ /08/2015 SmPC, Annex Refer to Scientific conclusions and grounds recommending diphtheria / tetanus / pertussis antigens (pertussis II, Labelling the variation to terms of the Marketing Authorisation(s) for toxoid, filamentous haemagglutinin, pertactin) and PL PSUSA/1122/ (acellular, component) / hepatitis b (rdna) / poliomyelitis (inactivated) / haemophilus type b conjugate vaccines (adsorbed) EMA/357080/2018 Page 20/59

21 IG/0540 A.7 - Administrative change - Deletion of manufacturing sites 26/06/2015 n/a WS/ /06/2015 n/a B.I.b.2.z - Change in test procedure for AS or starting material/reagent/intermediate - Other variation WS/ /06/2015 n/a B.I.b.2.z - Change in test procedure for AS or starting material/reagent/intermediate - Other variation WS/ /06/2015 n/a B.I.b.2.z - Change in test procedure for AS or starting material/reagent/intermediate - Other variation IB/0181 B.II.d.2.d - Change in test procedure for the finished product - Other changes to a test procedure (including replacement or addition) 23/04/2015 n/a EMA/357080/2018 Page 21/59

22 WS/0430/G This was an application for a group of variations following a worksharing procedure according to Article 20 of Commission Regulation (EC) No 1234/ /04/2015 n/a B.I.a.1.j - Change in the manufacturer of AS or of a starting material/reagent/intermediate for AS - Replacement or addition of a site where batch control/testing takes place and any of the test method at the site is a biol/immunol method B.I.b.2.e - Change in test procedure for AS or starting material/reagent/intermediate - Other changes to a test procedure (including replacement or addition) for the AS or a starting material/intermediate WS/ /03/2015 n/a B.I.d.1.a.3 - Stability of AS - Change in the re-test period/storage period - Extension of storage period of a biological/immunological AS not in accordance with an approved stability protocol WS/ /03/2015 n/a B.I.d.1.a.3 - Stability of AS - Change in the re-test period/storage period - Extension of storage period of a biological/immunological AS not in accordance EMA/357080/2018 Page 22/59

23 with an approved stability protocol IA/0175 B.I.b.1.d - Change in the specification parameters and/or limits of an AS, starting material/intermediate/reagent - Deletion of a nonsignificant specification parameter (e.g. deletion of an obsolete parameter) 10/02/2015 n/a WS/0610/G This was an application for a group of variations following a worksharing procedure according to Article 20 of Commission Regulation (EC) No 1234/ /01/2015 n/a B.I.b.2.d - Change in test procedure for AS or starting material/reagent/intermediate - Substantial change to or replacement of a biological/immunological/immunochemical test method or a method using a biological reagent for a biological AS B.II.b.5.b - Change to in-process tests or limits applied during the manufacture of the finished product - Addition of a new test(s) and limits IG/0499 A.7 - Administrative change - Deletion of manufacturing sites 05/12/2014 n/a IG/0498 B.II.e.3.c - Change in test procedure for the immediate packaging of the finished product - Deletion of a test procedure if an alternative test procedure is already authorised 21/11/2014 n/a EMA/357080/2018 Page 23/59

24 WS/ /11/2014 n/a B.II.c.1.z - Change in the specification parameters and/or limits of an excipient - Other variation WS/ /11/2014 n/a Submission of final study report of a post-approval clinical study to compare the current and the new plunger stoppers and tip caps in response to a CHMP recommendation. C.I.13 - Other variations not specifically covered elsewhere in this Annex which involve the submission of studies to the competent authority WS/ /10/2014 n/a B.II.d.1.c - Change in the specification parameters and/or limits of the finished product - Addition of a new specification parameter to the specification with its corresponding test method II/0154 Update of sections 4.4, 4.5 and 4.8 of the SmPC with information that increased rates of convulsions and hypotonic hyporesponsive episodes are observed 23/10/ /08/2015 SmPC and PL The MAH has provided analyses of post-marketing reports when is co-administered with Prevenar (pneumococcal saccharide conjugated vaccine, adsorbed). EMA/357080/2018 Page 24/59

25 with concomitant administration with Prevenar 13 vaccine in follow up to the outcome of a PSUR assessment for Prevenar 13. Section 2 of the package leaflet on warnings and precautions is updated to reflect the changes of the SmPC. Results show an increased reporting rates of convulsions (with or without fever) and hypotonic hyporesponsive episode (HHE) with concomitant administration of Infanrix hexa and Prevenar 13. C.I.4 - Change(s) in the SPC, Labelling or PL due to new quality, preclinical, clinical or pharmacovigilance data WS/ /09/2014 n/a B.I.b.2.e - Change in test procedure for AS or starting material/reagent/intermediate - Other changes to a test procedure (including replacement or addition) for the AS or a starting material/intermediate IB/0167 B.I.e.4.b - Changes to an approved change management protocol - Minor changes that do not change the strategy defined in the protocol 01/09/2014 n/a IG/0467 B.II.e.2.c - Change in the specification parameters and/or limits of the immediate packaging of the finished product - Deletion of a non-significant specification parameter (e.g. deletion of an obsolete parameter) 20/08/2014 n/a IG/0468 B.II.e.2.c - Change in the specification parameters and/or limits of the immediate packaging of the 20/08/2014 n/a EMA/357080/2018 Page 25/59

26 finished product - Deletion of a non-significant specification parameter (e.g. deletion of an obsolete parameter) WS/ /07/2014 n/a B.I.b.2.a - Change in test procedure for AS or starting material/reagent/intermediate - Minor changes to an approved test procedure WS/ /07/2014 n/a B.II.d.2.a - Change in test procedure for the finished product - Minor changes to an approved test procedure WS/ /06/2014 n/a B.II.d.2.a - Change in test procedure for the finished product - Minor changes to an approved test procedure WS/ /06/2014 n/a EMA/357080/2018 Page 26/59

27 B.I.b.2.a - Change in test procedure for AS or starting material/reagent/intermediate - Minor changes to an approved test procedure WS/ /06/2014 n/a B.II.d.2.d - Change in test procedure for the finished product - Other changes to a test procedure (including replacement or addition) WS/0498/G This was an application for a group of variations following a worksharing procedure according to Article 20 of Commission Regulation (EC) No 1234/ /06/2014 n/a B.II.d.2.d - Change in test procedure for the finished product - Other changes to a test procedure (including replacement or addition) B.II.d.2.d - Change in test procedure for the finished product - Other changes to a test procedure (including replacement or addition) IG/0446 C.I.8.a - Introduction of or changes to a summary of Pharmacovigilance system - Changes in QPPV (including contact details) and/or changes in the PSMF location 24/06/2014 n/a IAIN/0160 B.II.e.5.a.1 - Change in pack size of the finished product - Change in the number of units (e.g. tablets, ampoules, etc.) in a pack - Change within 17/06/ /09/2014 SmPC, Labelling and EMA/357080/2018 Page 27/59

28 the range of the currently approved pack sizes PL WS/0512/G This was an application for a group of variations following a worksharing procedure according to Article 20 of Commission Regulation (EC) No 1234/ /05/2014 n/a B.I.b.2.a - Change in test procedure for AS or starting material/reagent/intermediate - Minor changes to an approved test procedure B.I.b.2.a - Change in test procedure for AS or starting material/reagent/intermediate - Minor changes to an approved test procedure B.I.b.2.a - Change in test procedure for AS or starting material/reagent/intermediate - Minor changes to an approved test procedure WS/ /05/2014 n/a B.I.b.2.e - Change in test procedure for AS or starting material/reagent/intermediate - Other changes to a test procedure (including replacement or addition) for the AS or a starting material/intermediate WS/0505/G This was an application for a group of variations following a worksharing procedure according to Article 20 of Commission Regulation (EC) No 1234/ /05/2014 n/a EMA/357080/2018 Page 28/59

29 B.II.b.1.c - Replacement or addition of a manufacturing site for the FP - Site where any manufacturing operation(s) take place, except batch release/control, and secondary packaging, for biol/immunol medicinal products or pharmaceutical forms manufactured by complex manufacturing processes B.I.c.1.b - Change in immediate packaging of the AS - Qualitative and/or quantitative composition for sterile and non-frozen biological/immunological ASs II/0139 Update of section 5.1 of the SmPC with data from 22/05/ /09/2014 SmPC, Annex Results of ongoing routine national surveillance in Italy routine surveillance of Haemophilus influenzae type b II, Labelling demonstrate that is effective in controlling (Hib) disease in Italy. In addition, reference to and PL Hib disease in infants when the vaccine is administered official recommendations is included in section 4.2 of according to the 3 and 5 months primary vaccination the SmPC and the presentation of data is simplified schedule, with a booster dose administered at in section 5.1 of the SmPC. Section 4.8 of the SmPC approximately 11 months. Over a six year period starting in was revised according to the SmPC guideline. 2006, where was the principal Hib-containing Furthermore, the PI is being brought in line with the vaccine in use with vaccination coverage exceeding 95%, latest QRD template version 9. Hib invasive disease continued to be well controlled, with Following CHMP request section 2 of the SmPC was four confirmed Hib cases reported in Italian children aged updated to include traces of formaldehyde, neomycin less than 5 years through passive surveillance. and polymyxin which are used during the manufacturing process and section 4.3 was revised accordingly to add formaldehyde. In addition, the MAH took the opportunity to update the list of local representatives in the Package Leaflet. The requested variation proposed amendments to the Summary of Product Characteristics, Annex II, Labelling and Package Leaflet. EMA/357080/2018 Page 29/59

30 C.I.4 - Change(s) in the SPC, Labelling or PL due to new quality, preclinical, clinical or pharmacovigilance data WS/ /04/2014 n/a B.I.b.2.e - Change in test procedure for AS or starting material/reagent/intermediate - Other changes to a test procedure (including replacement or addition) for the AS or a starting material/intermediate WS/ /04/2014 n/a B.II.c.2.a - Change in test procedure for an excipient - Minor changes to an approved test procedure WS/ /04/2014 n/a B.I.b.2.a - Change in test procedure for AS or starting material/reagent/intermediate - Minor changes to an approved test procedure WS/ /04/2014 n/a EMA/357080/2018 Page 30/59

31 B.I.b.2.e - Change in test procedure for AS or starting material/reagent/intermediate - Other changes to a test procedure (including replacement or addition) for the AS or a starting material/intermediate WS/0445/G This was an application for a group of variations following a worksharing procedure according to Article 20 of Commission Regulation (EC) No 1234/ /03/2014 n/a -Additional manufacturer of finished product. -Additional quality control testing manufacturer of the product. -Scale up of active substance of vaccine. -Introduction of alternative containers for the active substance. B.II.b.1.c - Replacement or addition of a manufacturing site for the FP - Site where any manufacturing operation(s) take place, except batch release/control, and secondary packaging, for biol/immunol medicinal products or pharmaceutical forms manufactured by complex manufacturing processes B.II.b.2.a - Change to importer, batch release arrangements and quality control testing of the FP - Replacement/addition of a site where batch control/testing takes place B.II.b.4.f - Change in the batch size (including batch size ranges) of the finished product - The scale for a EMA/357080/2018 Page 31/59

32 biological/immunological medicinal product is increased/decreased without process change (e.g. duplication of line) B.I.c.1.b - Change in immediate packaging of the AS - Qualitative and/or quantitative composition for sterile and non-frozen biological/immunological ASs II/0138 Addition to the Product Information of clear guidance for Health professionals regarding the use of the vaccine in case of accidental temperature excursion and other minor changes to improve handling instructions. 20/03/ /09/2014 SmPC and PL C.I.4 - Change(s) in the SPC, Labelling or PL due to new quality, preclinical, clinical or pharmacovigilance data WS/0478/G This was an application for a group of variations following a worksharing procedure according to Article 20 of Commission Regulation (EC) No 1234/ /02/2014 n/a B.I.a.4.z - Change to in-process tests or limits applied during the manufacture of the AS - Other variation B.I.a.4.z - Change to in-process tests or limits applied during the manufacture of the AS - Other variation WS/ /02/2014 n/a EMA/357080/2018 Page 32/59

33 Changes in the manufacturing process of the active substance. B.I.a.2.a - Changes in the manufacturing process of the AS - Minor change in the manufacturing process of the AS WS/0419/G This was an application for a group of variations following a worksharing procedure according to Article 20 of Commission Regulation (EC) No 1234/ /01/2014 n/a - Change in a test procedure for quality control testing of active substances. - Change in the specification parameters for active substances. B.I.b.1.c - Change in the specification parameters and/or limits of an AS, starting material/intermediate/reagent - Addition of a new specification parameter to the specification with its corresponding test method B.I.b.2.e - Change in test procedure for AS or starting material/reagent/intermediate - Other changes to a test procedure (including replacement or addition) for the AS or a starting material/intermediate B.I.b.1.c - Change in the specification parameters and/or limits of an AS, starting material/intermediate/reagent - Addition of a new specification parameter to the specification with its EMA/357080/2018 Page 33/59

34 corresponding test method B.I.b.2.e - Change in test procedure for AS or starting material/reagent/intermediate - Other changes to a test procedure (including replacement or addition) for the AS or a starting material/intermediate B.I.b.1.c - Change in the specification parameters and/or limits of an AS, starting material/intermediate/reagent - Addition of a new specification parameter to the specification with its corresponding test method B.I.b.2.e - Change in test procedure for AS or starting material/reagent/intermediate - Other changes to a test procedure (including replacement or addition) for the AS or a starting material/intermediate WS/ /01/2014 n/a Change in specifications of active substance. B.I.b.1.f - Change in the specification parameters and/or limits of an AS, starting material/intermediate/reagent - Change outside the approved specifications limits range for the AS WS/0439/G This was an application for a group of variations following a worksharing procedure according to Article 20 of Commission Regulation (EC) No 1234/ /12/2013 n/a EMA/357080/2018 Page 34/59

35 Change in the specification parameters of a raw material. B.I.b.1.c - Change in the specification parameters and/or limits of an AS, starting material/intermediate/reagent - Addition of a new specification parameter to the specification with its corresponding test method B.I.b.1.z - Change in the specification parameters and/or limits of an AS, starting material/intermediate/reagent - Other variation B.I.b.1.d - Change in the specification parameters and/or limits of an AS, starting material/intermediate/reagent - Deletion of a nonsignificant specification parameter (e.g. deletion of an obsolete parameter) WS/ /11/2013 n/a Change in the immediate packaging of the active substance. B.I.c.1.b - Change in immediate packaging of the AS - Qualitative and/or quantitative composition for sterile and non-frozen biological/immunological ASs WS/ /10/2013 n/a EMA/357080/2018 Page 35/59

36 B.I.b.2.z - Change in test procedure for AS or starting material/reagent/intermediate - Other variation WS/ /10/2013 n/a B.II.b.3.b - Change in the manufacturing process of the finished product - Substantial changes to a manufacturing process that may have a significant impact on the quality, safety and efficacy of the medicinal product IAIN/0137 C.I.10 - Change in the frequency and/or date of submission of PSURs for human medicinal products 15/10/ /09/2014 Annex II II/0131 Introduction of a post approval change management protocol related to the AS. 25/07/2013 n/a B.I.e.2 - Design Space - Introduction of a post approval change management protocol related to the AS WS/ /07/2013 n/a B.I.b.2.e - Change in test procedure for AS or starting material/reagent/intermediate - Other changes to a test procedure (including replacement EMA/357080/2018 Page 36/59

37 or addition) for the AS or a starting material/intermediate WS/ /06/2013 n/a To replace the current FHA reference standard with a new lot. B.I.b.2.e - Change in test procedure for AS or starting material/reagent/intermediate - Other changes to a test procedure (including replacement or addition) for the AS or a starting material/intermediate IG/0306 C.I.z - Changes (Safety/Efficacy) of Human and Veterinary Medicinal Products - Other variation 12/06/2013 n/a WS/ /05/2013 n/a To introduce a new working seed lot used for the manufacturing process of the acellular pertussis (Pa) antigens. B.I.a.2.c - Changes in the manufacturing process of the AS - The change refers to a [-] substance in the manufacture of a biological/immunological medicinal product and is not related to a protocol EMA/357080/2018 Page 37/59

38 IG/0297 C.I.z - Changes (Safety/Efficacy) of Human and Veterinary Medicinal Products - Other variation 19/04/2013 n/a II/0125 Replacement of the current screwcaps used for the purified bulk transfer and storage. 21/02/2013 n/a B.I.c.1.b - Change in immediate packaging of the AS - Qualitative and/or quantitative composition for sterile and non-frozen biological/immunological ASs IG/0265/G This was an application for a group of variations. 28/01/2013 n/a C.I.9.e - Changes to an existing pharmacovigilance system as described in the DDPS - Changes in the major contractual arrangements with other persons or organisations involved in the fulfilment of pharmacovigilance obligations and described in the DD C.I.9.h - Changes to an existing pharmacovigilance system as described in the DDPS - Other change(s) to the DDPS that does not impact on the operation of the pharmacovigilance system WS/ /01/2013 n/a Change of specifications of reagent. B.I.b.1.z - Change in the specification parameters and/or limits of an AS, starting material/intermediate/reagent - Other variation EMA/357080/2018 Page 38/59

39 WS/ /01/2013 n/a To introduce a new method for monitoring homogeneity during filling. B.II.b.5.z - Change to in-process tests or limits applied during the manufacture of the finished product - Other variation II/0120/G This was an application for a group of variations. 21/06/2012 n/a B.II.b.1.c - Replacement or addition of a manufacturing site for the FP - Site where any manufacturing operation(s) take place, except batch release, batch control, and secondary packaging, for biological/immunological medicinal products. B.II.b.2.a - Change to batch release arrangements and quality control testing of the FP - Replacement or addition of a site where batch control/testing takes place WS/ /04/2012 n/a Registration of an additional site for QC sterility testing activities for pre-filled syringes, following a The EMA/357080/2018 Page 39/59

40 batch release site remains unchanged. B.II.b.2.a - Change to batch release arrangements and quality control testing of the FP - Replacement or addition of a site where batch control/testing takes place IG/0160 A.7 - Administrative change - Deletion of manufacturing sites 09/03/2012 n/a WS/0201/G This was an application for a group of variations following a worksharing procedure according to Article 20 of Commission Regulation (EC) No 1234/ /01/2012 n/a To propose new target fill volume controls. To align the volume specifications to be applied at release and during stability evaluation. To revise QC release procedures for final container volume determination. B.II.d.1.z - Change in the specification parameters and/or limits of the finished product - Other variation B.II.b.3.b - Change in the manufacturing process of the finished product - Substantial changes to a manufacturing process that may have a significant impact on the quality, safety and efficacy of the medicinal product B.II.d.2.a - Change in test procedure for the finished product - Minor changes to an approved test procedure EMA/357080/2018 Page 40/59

41 IG/0133 C.I.9.h - Changes to an existing pharmacovigilance 22/11/2011 n/a system as described in the DDPS - Other change(s) to the DDPS that does not impact on the operation of the pharmacovigilance system WS/ /10/ /10/2011 Registration of an additional facility for filling of finished product. The change relates to pre-filled syringes only. B.II.b.1.c - Replacement or addition of a manufacturing site for the FP - Site where any manufacturing operation(s) take place, except batch release, batch control, and secondary packaging, for biological/immunological medicinal products. II/0106 To update section 5.1 of the SmPC based on the final 23/06/ /07/2011 SmPC, The Marketing Authorisation Holder has provided the final report of the ESPED study (Hib effectiveness study) Labelling and report of a case-cohort study performed by the ESPED covering seven years of post-licensure surveillance. PL study group and conducted in Germany to estimate vaccine The MAH has also taken the opportunity to make effectiveness of the Hib component against Hib disease. some changes in relation to the QRD template, The study covered the years (seven years of formatting changes and typos correction. The details surveillance associated to the use of the hexavalent of the Czech and Maltese local representatives are vaccines). also revised in the package leaflet. Annex A is also The effectiveness of the Hib component of two hexavalent revised to provide a more precise value for the vaccines, of which one was, was 89.6% (95% quantity of tetanus toxoid carrier contained in the CI: ) for a full primary series and 100% (95% CI: vaccine ) for a full primary series plus booster dose, irrespective of the Hib vaccine used for priming. C.I.4 - Variations related to significant modifications Effectiveness was 78.9% (95% CI: ) for an EMA/357080/2018 Page 41/59

42 of the SPC due in particular to new quality, preclinical, clinical or pharmacovigilance data incomplete primary series, and 100% (95% CI: ) for a 2nd year dose without full immunisation. Vaccine effectiveness for DTaP-IPV-HB/Hib combination vaccines against invasive Hib was 92.8% (95% CI: ) for children vaccinated according to their age and to the German recommended vaccination schedule. Section 5.1 of the SmPC has been updated to reflect the results of this surveillance study. IG/0081 C.I.9.c - Changes to an existing pharmacovigilance system as described in the DDPS - Change of the back-up procedure of the QPPV 07/07/2011 n/a WS/ /05/ /05/2011 Changes to the manufacturing process of the FHA and PRN acellular pertussis antigens. B.I.a.2.c - Changes in the manufacturing process of the AS - The change refers to a [-] substance in the manufacture of a biological/immunological medicinal product and is not related to a protocol IG/0064/G This was an application for a group of variations. Update of section 4.8 of the SmPC to include immediate injection site pain, stinging and burning sensation. The PL is updated in accordance. The MAH has also taken the opportunity to align section 4.6 of the prefilled syringe presentation with the vial 04/05/2011 n/a Following clusters of spontaneous reports of immediate onset injection site pain reported in certain batches of the preservative-free formulation of Twinrix Adult, immediate pain, stinging and burning at the injection site has been reflected in section 4.8 of the SmPC and section 4 of the package leaflet. The MAH s investigation report revealed no specific root cause for the clusters of reports of immediate EMA/357080/2018 Page 42/59

43 presentation. Furthermore, the Labelling is updated to specify the container prefilled syringe. In addition, the MAH has taken the opportunity to update the list of local representatives in the PL. injection site pain. The injection site reactions were nonserious and self-limited in all cases. The benefit-risk of Twinrix Adult remains positive. B.II.e.2.a - Change in the specification parameters and/or limits of the immediate packaging of the finished product - Tightening of specification limits B.II.e.2.b - Change in the specification parameters and/or limits of the immediate packaging of the finished product - Addition of a new specification parameter to the specification with its corresponding test method B.II.e.3.a - Change in test procedure for the immediate packaging of the finished product - Minor changes to an approved test procedure B.II.e.3.c - Change in test procedure for the immediate packaging of the finished product - Deletion of a test procedure if an alternative test procedure is already authorised B.II.e.6.b - Change in any part of the (primary) packaging material not in contact with the finished product formulation - Change that does not affect the product information B.II.e.7.a - Change in supplier of packaging components or devices (when mentioned in the dossier) - Deletion of a supplier IG/0062/G This was an application for a group of variations. 27/04/2011 n/a C.I.9.e - Changes to an existing pharmacovigilance system as described in the DDPS - Changes in the EMA/357080/2018 Page 43/59