Paul-Ehrlich-Institut

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Our Involvement in the PRAC

The Pharmacovigilance Risk Assessment Committee (PRAC) at the European Medicines Agency (EMA) is responsible for monitoring and evaluating the safety of medicines for human use.

The PRAC is composed of the following:

  • the Chair (elected by the PRAC members)
  • one expert plus an alternate of the medicines agency from each of the EU member states as well as the EEA member states Iceland and Norway. The German member and alternate are sent by the Federal Institute for Drugs and Medical Devices (BfArM) and the Paul-Ehrlich-Institut (PEI).
  • six independent scientific experts nominated by the European Commission
  • one member and an alternate from patients organisations nominated by the European Commission.

The Paul-Ehrlich-Institut (PEI) is currently represented on the PRAC by a pharmacovigilance expert and specialist in neurology from the Safety of Biomedicines and Diagnostics Division.

This page provides important safety information on vaccines and biomedicines from the PRAC meetings. Information on medicines for human use outside the area of responsibility of the Paul-Ehrlich-Institut can be found on the website of the Federal Institute for Drugs and Medical Devices (BfArM).

On this page you will find important information on the safety of vaccines and biomedicines from PRAC meetings. Information on medicinal products for human use outside the area of responsibility of the Paul-Ehrlich-Institut can be found on the website of the Federal Institute for Drugs and Medical Devices (BfArM).

PRAC Recommendations within EU Referral Procedures

An EU referral procedure is a risk assessment procedure carried out by an EMA committee. Referrals may be carried out for a variety of reasons, including an investigation into safety concerns.

The PRAC provides monthly information on recommendations as well as any EU referral assessments that have been initiated or are ongoing. The table below contains PRAC notices regarding centrally und nationally authorised vaccines and biomedicines.

PRAC Recommendations on Zolgensma (January 2023)

As part of its advice on safety-related aspects to other EMA committees, the PRAC discussed a direct healthcare professional communication (DHPC) containing important information on Zolgensma.

Fatal cases of acute liver failure were recently reported in patients treated with Zolgensma (onasemnogene abeparvovec), a gene therapy medicine for the treatment of spinal muscular atrophy (SMA), a serious rare condition of the nerves that causes muscle wasting and weakness. This DHPC informs healthcare professionals of the fatal cases of liver failure and the updated recommendations for monitoring liver function, assessing suspected liver injury after infusion and further advice regarding tapering the corticosteroid treatment. Healthcare professionals should promptly assess patients with worsening liver function tests and/or signs or symptoms of acute liver illness. If patients do not respond adequately to treatment with corticosteroids, treating physicians should consult a paediatric gastroenterologist or hepatologist and consider adjustment of the corticosteroid regimen.

The DHPC for Zolgensma will be forwarded to EMA’s committee for advanced therapies (CAT) and to EMA’s human medicines committee (CHMP). When adopted, the DHPC will be disseminated to healthcare professionals by the marketing authorisation holders, according to an agreed communication plan, and published on the ‘Direct healthcare professional communications’ page and in national registers in EU and EEA Member States.  

PRAC Recommendations on Safety Signals

Safety signals contain new information concerning the safety of an authorised medicinal product, such as previously unknown adverse events following the administration of a medicinal product or new aspects of already known events requiring further investigation. Safety signals are generated from various sources, such as the analysis of spontaneously reported suspected side effects, clinical trials, or scientific literature. The PRAC examines information on new safety signals and decides if any additional assessments should be carried out by the marketing authorisation holder, when the results must be presented to the PRAC, and whether risk-minimising measures need to be taken.

The detection of safety signals and risk management are important instruments of pharmacovigilance that allow for the early detection of previously unknown medicinal product risks or an unexplained sudden increase in medicinal product risks and to minimise them. Not every new piece of information in the field of pharmacovigilance automatically represents a new safety signal and not every safety signal represents a new medicinal product risk.

Every month, the EMA publishes an overview of all safety signals discussed at the last PRAC meeting, as well as any recommendations on signal management that may have been adopted. The table below contains PRAC recommendations for centrally and nationally authorised vaccines and biomedicines.

2024

PRAC Recommendations on Safety Signals from May 2024

Active Substance, Active Substance ClassesSignalPRAC Recommendation
Eptinezumab; Erenumab; Fremanezumab; GalcanezumabInsomniaSupplementary information requested (submission by 31 July 2024)
ErenumabHypertensionAssess in the next PSUR (submission by 25 July 2024)

PRAC Recommendations on Safety Signals from April 2024

Active Substance, Active Substance ClassesSignalPRAC Recommendation
Atezolizumab; Avelumab; Cemiplimab; Dostarlimab; Durvalumab; Ipilimumab; Nivolumab; Nivolumab, Relatlimab; Pembrolizumab; Tislelizumab; TremelimumabCoeliac diseaseUpdate of the product information
Atezolizumab; Avelumab; Cemiplimab; Dostarlimab; Durvalumab; Ipilimumab; Nivolumab; Nivolumab, Relatlimab; Pembrolizumab; Tislelizumab; TremelimumabPancreatic failureUpdate of the product information
Eptinezumab; Erenumab; Fremanezumab; GalcanezumabErectile dysfunctionSupplementary information requested (submission by 3 July 2024)
Axicabtagene ciloleucel; Idecabtagene vicleucel; Lisocabtagene maraleucel; Ciltabtagene autoleucel; Tisagenlecleucel; Brexucabtagene autoleucelSecondary malignancy of T-cell originRespond to list of questions (submission by 8 May 2024)

PRAC Recommendations on Safety Signals from March 2024

Active Substance, Active Substance ClassesSignalPRAC Recommendation
DupilumabThrombocytopeniaSupplementary information requested (submission by 8 May 2024)
EpcoritamabProgressive multifocal leukoencephalopathy (PML)Assess in the next PSUR (submission by 30 May 2024)
GlofitamabImmune effector cell-associated neurotoxicity syndromeSupplementary information requested (submission by 8 May 2024)
Human papillomavirus 9- valent vaccine (recombinant, adsorbed); human papillomavirus vaccine [types 6, 11, 16, 18] (recombinant, adsorbed)GranulomaSupplementary information requested (submission by 8 May 2024)
Elasomeran (COVID-19 mRNA vaccine) – SpikevaxPostmenopausal haemorrhageRoutine pharmacovigilance
Tozinameran (COVID-19 mRNA vaccine) – ComirnatyPostmenopausal haemorrhageRoutine pharmacovigilance

PRAC Recommendations on Safety Signals from February 2024

Active Substance, Active Substance ClassesSignalPRAC Recommendation
Atezolizumab; Avelumab; Cemiplimab; Dostarlimab; Durvalumab; Ipilimumab; Nivolumab; Nivolumab/Relatlimab; Pembrolizumab; Tislelizumab; TremelimumabCoeliac diseaseProvide ADR frequency and comments on the proposed amendments to the product information (submission by 7 March 2024)
Atezolizumab; Avelumab; Cemiplimab; Dostarlimab; Durvalumab; Ipilimumab; Nivolumab; Nivolumab/Relatlimab; Pembrolizumab; Tislelizumab; TremelimumabPancreatic failureProvide ADR frequency and comments on the proposed amendments to the product information (submission by 7 March 2024)

PRAC Recommendations on Safety Signals from January 2024

Active Substance, Active Substance ClassesSignalPRAC Recommendation
Aflibercept; RanibizumabNephropathy toxic after intravitreal administration
  • Aflibercept: supplementary information requested (submission by 13 March 2024)
  • Ranibizumab: no action for MAH
Axicabtagene ciloleucel; Idecabtagene vicleucel; Lisocabtagene maraleucel; Ciltabtagene autoleucel; Tisagenlecleucel; Brexucabtagene autoleucelSecondary malignancy of T-cell originSupplementary information requested (submission by 7 February 2024)

2023

PRAC Recommendations on Safety Signals from November 2023

Active Substance, Active Substance ClassesSignalPRAC Recommendation
Axicabtagene ciloleucelProgressive multifocal leukoencephalopathy (PML)Update of the product information
BrolucizumabScleritisAssess in the next PSUR (submission by 15 December 2023)

PRAC Recommendations on Safety Signals from October 2023

Active Substance, Active Substance ClassesSignalPRAC Recommendation
Elasomeran (COVID-19 mRNA vaccine) – SpikevaxPostmenopausal haemorrhageSupplementary information requested (submission by 3 January 2024)
Tozinameran (COVID-19 mRNA vaccine) – ComirnatyPostmenopausal haemorrhageSupplementary information requested (submission by 3 January 2024)
AmivantamabAnaphylactic reactionMonitor in PSURs

PRAC Recommendations on Safety Signals from September 2023

Active Substance, Active Substance ClassesSignalPRAC Recommendation
RituximabOral lichenoid reactionRoutine pharmacovigilance

PRAC Recommendations on Safety Signals from August 2023

Active Substance, Active Substance ClassesSignalPRAC Recommendation
Atezolizumab; Avelumab; Cemiplimab; Dostarlimab; Durvalumab; Ipilimumab; Nivolumab; Pembrolizumab; Tislelizumab; TremelimumabCoeliac diseaseSupplementary information requested (submission by 8 November 2023)
Atezolizumab; Avelumab; Cemiplimab; Dostarlimab; Durvalumab; Ipilimumab; Nivolumab; Pembrolizumab; Tislelizumab; TremelimumabPancreatic failureSupplementary information requested (submission by 8 November 2023)

PRAC Recommendations on Safety Signals from July 2023

Active Substance, Active Substance ClassesSignalPRAC Recommendation
Axicabtagene ciloleucelProgressive multifocal leukoencephalopathy (PML)Supplementary information requested (submission by 27 September 2023)

PRAC Recommendations on Safety Signals from June 2023

Active Substance, Active Substance ClassesSignalPRAC Recommendation
Ipilimumab; Nivolumab; PembrolizumabCapillary leak syndrome (Opdivo, Yervoy, Keytruda) and cytokine release syndrome (Opdivo)
  • Cytokine release syndrome and nivolumab (Opdivo): update of the product information
  • Routine pharmacovigilance for capillary leak syndrome and all three medicinal products
AmivantamabAnaphylactic reactionSupplementary information requested (submission by 23 August 2023)

PRAC Recommendations on Safety Signals from May 2023

Active Substance, Active Substance ClassesSignalPRAC Recommendation
MepolizumabArthralgiaAssess in the next PSUR (submission by 2 December 2023)
RituximabOral lichenoid reactionSupplementary information requested (submission by 26 July 2023)
Elasomeran (COVID-19 mRNA vaccine) – SpikevaxMyositis
  • Monitor idiopathic inflammatory myopathies (IIM)/ myositis in PSURs
  • Follow up on IIM/myositis in the final study report of EU PASS study mRNA-1273-P904 to be submitted in December 2023
Tozinameran (COVID-19 mRNA vaccine) – ComirnatyMyositis
  • Monitor idiopathic inflammatory myopathies (IIM)/ myositis in PSURs
  • Follow up on IIM/myositis in any of the ongoing PASS listed in the pharmacovigilance plan

PRAC Recommendations on Safety Signals from April 2023

Active Substance, Active Substance ClassesSignalPRAC Recommendation
Elasomeran (COVID-19 mRNA vaccine) – SpikevaxPemphigus and pemphigoidAssess in the next PSUR (submission by 26 August 2023)
Tozinameran (COVID-19 mRNA vaccine) – ComirnatyPemphigus and pemphigoidAssess in the next PSUR (submission by 27 August 2023)
COVID-19 vaccine (ChAdOx1-S [recombinant]) – VaxzevriaPemphigus and pemphigoidMonitor in PSURs
EvolocumabWeight increase and abnormal weight gainRoutine pharmacovigilance

PRAC Recommendations on Safety Signals from March 2023

Active Substance, Active Substance ClassesSignalPRAC Recommendation
DupilumabWeight decreased, abnormal loss of weight, cachexia, body mass index decreasedAssess in the next PSUR (submission by 6 June 2023)

PRAC Recommendations on Safety Signals from February 2023

Active Substance, Active Substance ClassesSignalPRAC Recommendation
Ipilimumab; Nivolumab; PembrolizumabCapillary leak syndrome (Opdivo, Yervoy, Keytruda) and cytokine release syndrome (Opdivo)Supplementary information requested (submission by 5 April 2023)
Adalimumab; InfliximabMenstrual disorderRoutine pharmacovigilance
NivolumabMyositisMonitor in PSURs

PRAC Recommendations on Safety Signals from January 2023

Active Substance, Active Substance ClassesSignalPRAC Recommendation
COVID-19 vaccine (ChAdOx1-S [recombinant]) – VaxzevriaMyositisAssess in the next PSUR (submission by 8 March 2023)
Elasomeran (COVID-19 mRNA vaccine) – SpikevaxMyositisSupplementary information requested (submission by 9 March 2023)
Tozinameran (COVID-19 mRNA vaccine) – ComirnatyMyositisSupplementary information requested (submission by 9 March 2023)
Tozinameran (COVID-19 mRNA vaccine) – ComirnatyVulval ulcerationAssess in the next PSUR (submission by 27 August 2023)

Updated: 12.06.2024