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  • Under evaluation
  • CHMP opinion
  • European Commission final decision
Current status:
European Commission final decision


Norditropin, which contains the active ingredient somatropin, is a potent metabolic hormone of importance for the metabolism of lipids, carbohydrates and proteins. In children with inadequate endogenous growth hormone, somatropin stimulates linear growth and increases growth rate. In adults, as well as in children, somatropin maintains a normal body composition by increasing nitrogen retention and stimulation of skeletal muscle growth and by mobilisation of body fat. The first national Marketing Authorisation was granted in Denmark on 28 April 1988 and subsequently in all Member States.

On 2 May 2002, Sweden made a referral to the EMEA under article 7(5) of Commission Regulation 541/95. Sweden considered that the optimal duration of treatment had not been established in the extended indication to include children born small for gestational age (SGA) as applied by the Marketing Authorisation Holders in the variations submitted within the Mutual Recognition Procedure (MRP) and that the limits for catch-up growth to base the initiation of treatment had not been justified, together with safety concerns regarding the increased risk at high doses for development of diabetes mellitus later in life.

The referral procedure started on 30 May 2002. The Rapporteur and Co-Rapporteur appointed were Dr. F. Lekkerkerker and Dr. P. Rossi, respectively. Written explanations were provided by the Marketing Authorisation Holders on 12 July 2002, 6 December 2002 and 25 February 2003.

Based on evaluation of the currently available data and the Rapporteurs' assessment reports, the CPMP considered that the benefit/risk profile of Norditropin in the indication “growth disturbance (current height SDS -2.5 and parental adjusted height SDS -1) in short children born small for gestational age (SGA), with a birth weight and/or length below –2 SD, who failed to show catch-up growth (HV SDS 0 during the last year) by 4 years of age or later” was favourable and therefore adopted an opinion on 19 March 2003 recommending the variation to the Marketing Authorisations in accordance with the ammended Summary of Product Characteristics.

The competent authorites of the Member States will continue to keep the product under regular review. A list of product names concerned is given in Annex I. The scientific conclusions are provided in Annex II, together with the amended Summary of Product Characteristics in Annex III.

The final opinion was converted into a Decision by the European Commission on 26 June 2003.

Key facts

Approved name
International non-proprietary name (INN) or common name
Reference number
Article 6(12) referrals (prior to January 2010)

This type of referral was triggered for a medicine that had been authorised by mutual recognition or via the decentralised procedure when there was disagreement between Member States on a variation (type II). This referral has been replaced by Article 13 referrals.

European Commission final decision
Opinion date

All documents

Document description

  • Questions and answers (Q&A) - easy-to-understand summary of key issues and Committee conclusions
  • Summary of Opinion - contains the CHMP opinion of the referred medicine(s)
  • List of the medicines affected by the referral (Annex I)
  • Scientific conclusions of the Committee (Annex II)

The following two documents are sometimes available:

  • Changes to the summary of product characteristics, labeling or package leaflet (also known as Annex III) - available when changes havebeen recommended by the Committee
  • Conditions of the marketing authorisation (also known as Annex IV) - available when the Committee recommends measures to be taken for the marketing authorisation(s) such as safety measures or extra studies

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