ID
13260
Beschreibung
Prospective,multicentric,double blind and placebo-controlled Phase III clinical trial to determine efficacy and tolerability of subcutaneous hyposensitization with CLUSTOID in patients with allergic rhinoconjunctivits caused by grass or rye pollen. EudraCT-Nr. 2008-000513-29 Study-code:CLU-2008-001 Sponsor: ROXALL Medizin GmbH Carl-Petersen-Straße 4 20535 Hamburg Phone:040-8972520 Fax:040-89725223 Project coordinator: Dr.Jenny Uhlig ROXALL Medizin GmbH Head of clinical investigation: Prof.Dr.med.Ludger Klimek An den Quellen 10 65183 Wiesbaden Phone:0611-8904381 Fax:0611-3082360 Monitoring,data management and statistical evaluation: IMSIE- Institut for medical statistics,computer sciences and epidemiology University hospital Cologne Lindenburger Allee 42 50931 Cologne Phone:0221-4783456 Fax:0221-4783465
Stichworte
Versionen (1)
- 27.01.16 27.01.16 -
Hochgeladen am
27. Januar 2016
DOI
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Lizenz
Creative Commons BY-NC 3.0
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Efficacy and tolerability of subcutaneous hyposensitization with CLUSTOID in Patients with allergic rhinoconjunctivits Additional Visit
Case report form: Additional Visit
- StudyEvent: ODM
Beschreibung
Safety Laboratory parameter
Beschreibung
Please collect every one of the listed parameters below and add units as applicable
Datentyp
text
Alias
- UMLS CUI [1,1]
- C1254595
- UMLS CUI [1,2]
- C1269689
Beschreibung
Laboratory results, safety parameter
Datentyp
text
Alias
- UMLS CUI [1,1]
- C1254595
- UMLS CUI [1,2]
- C1269689
Beschreibung
Laboratory results, safety parameter
Datentyp
text
Alias
- UMLS CUI [1,1]
- C1254595
- UMLS CUI [1,2]
- C1269689
Beschreibung
Laboratory results, safety parameter
Datentyp
text
Alias
- UMLS CUI [1,1]
- C1254595
- UMLS CUI [1,2]
- C1269689
Beschreibung
Laboratory results, safety parameter
Datentyp
text
Alias
- UMLS CUI [1,1]
- C1254595
- UMLS CUI [1,2]
- C1269689
Beschreibung
Laboratory results, safety parameter
Datentyp
text
Alias
- UMLS CUI [1,1]
- C1254595
- UMLS CUI [1,2]
- C1269689
Beschreibung
Laboratory results, safety parameter
Datentyp
text
Alias
- UMLS CUI [1,1]
- C1254595
- UMLS CUI [1,2]
- C1269689
Beschreibung
Laboratory results, safety parameter
Datentyp
text
Alias
- UMLS CUI [1,1]
- C1254595
- UMLS CUI [1,2]
- C1269689
Beschreibung
Laboratory results, safety parameter
Datentyp
text
Alias
- UMLS CUI [1,1]
- C1254595
- UMLS CUI [1,2]
- C1269689
Beschreibung
Laboratory results, safety parameter
Datentyp
text
Alias
- UMLS CUI [1,1]
- C1254595
- UMLS CUI [1,2]
- C1269689
Beschreibung
Laboratory results, safety parameter
Datentyp
text
Alias
- UMLS CUI [1,1]
- C1254595
- UMLS CUI [1,2]
- C1269689
Beschreibung
Laboratory results, safety parameter
Datentyp
text
Alias
- UMLS CUI [1,1]
- C1254595
- UMLS CUI [1,2]
- C1269689
Beschreibung
Laboratory results, safety parameter
Datentyp
text
Alias
- UMLS CUI [1,1]
- C1254595
- UMLS CUI [1,2]
- C1269689
Beschreibung
Laboratory results, safety parameter
Datentyp
text
Alias
- UMLS CUI [1,1]
- C1254595
- UMLS CUI [1,2]
- C1269689
Beschreibung
Laboratory results, safety parameter
Datentyp
text
Alias
- UMLS CUI [1,1]
- C1254595
- UMLS CUI [1,2]
- C1269689
Beschreibung
Laboratory results, safety parameter
Datentyp
text
Alias
- UMLS CUI [1,1]
- C1254595
- UMLS CUI [1,2]
- C1269689
Beschreibung
Diagnosis
Datentyp
text
Alias
- UMLS CUI [1]
- C0011900
Beschreibung
Treatment
Datentyp
text
Alias
- UMLS CUI [1]
- C0087111
Beschreibung
Adverse Events
Beschreibung
In case of SAE please fill in the SAE-form at the end of this CRF asap (24h) and send via FAX to Roxall Medical GmbH (040/89725223)
Datentyp
text
Alias
- UMLS CUI [1]
- C0877248
Beschreibung
Adverse Event Start Date
Datentyp
date
Alias
- UMLS CUI [1]
- C2697888
Beschreibung
Adverse Event End Date
Datentyp
date
Alias
- UMLS CUI [1]
- C2697886
Beschreibung
Adverse event occurrence
Datentyp
text
Alias
- UMLS CUI [1]
- C2697887
Beschreibung
Adverse event severity
Datentyp
text
Alias
- UMLS CUI [1]
- C1710066
Beschreibung
Adverse Event Outcome
Datentyp
text
Alias
- UMLS CUI [1]
- C1705586
Beschreibung
Adverse Event actions taken
Datentyp
text
Alias
- UMLS CUI [1]
- C2826626
Beschreibung
Adverse event actions taken
Datentyp
text
Alias
- UMLS CUI [1]
- C2826719
Beschreibung
Adverse event context to trial substance
Datentyp
text
Alias
- UMLS CUI [1,1]
- C2983596
- UMLS CUI [1,2]
- C0041755
Beschreibung
Date
Datentyp
date
Alias
- UMLS CUI [1]
- C0011008
Beschreibung
Signature
Datentyp
text
Alias
- UMLS CUI [1]
- C1519316
Ähnliche Modelle
Case report form: Additional Visit
- StudyEvent: ODM
C0178628 (UMLS CUI [1,2])
C0178628 (UMLS CUI [1,2])
C0178628 (UMLS CUI [1,2])
C1269689 (UMLS CUI [1,2])
C1269689 (UMLS CUI [1,2])
C1269689 (UMLS CUI [1,2])
C1269689 (UMLS CUI [1,2])
C1269689 (UMLS CUI [1,2])
C1269689 (UMLS CUI [1,2])
C1269689 (UMLS CUI [1,2])
C1269689 (UMLS CUI [1,2])
C1269689 (UMLS CUI [1,2])
C1269689 (UMLS CUI [1,2])
C1269689 (UMLS CUI [1,2])
C1269689 (UMLS CUI [1,2])
C1269689 (UMLS CUI [1,2])
C1269689 (UMLS CUI [1,2])
C1269689 (UMLS CUI [1,2])
C1269689 (UMLS CUI [1,2])
C0041755 (UMLS CUI [1,2])