ID

15375

Description

Study documentation part: Concomitant medication Study short name: DIMAT MS Study Details: A 24-week, multicenter, exploratory, two arm study to assess the effect of Dimethyl fumarate on ImmuneModulatory Action on T cells in patients with relapsing remitting Multiple Sclerosis. Principal Investigator PD Dr. Luisa Klotz, University Hospital Münster EudraCT - No.: 2014-003481-25. Clinical Trial No.: NCT02461069. Please list below concomitant medications which are taken within a period from 30 days prior to Screening until the end of the study participation. Please list below signi cant non-drug therapies which are performed over the course of study participation.

Keywords

Versions (2)
  1. 5/28/16 5/28/16 -
  2. 5/28/16 5/28/16 -
Uploaded on

May 28, 2016

DOI

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License

Creative Commons BY-NC 3.0
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Concomitant medication, DIMAT-MS Relapsing Remitting Multiple Sclerosis DRKS00008037 NCT02461069

English

Concomitant medication, DIMAT-MS Relapsing Remitting Multiple Sclerosis NCT02461069

1 forms  
Concomitant medication
Description

Concomitant medication

Sheet No.
Description

Sheet No.

Data type

integer

Alias
UMLS CUI [1]
C0449788
Concomitant medication (Generic Name or Trade Name)/NON-drug therapy (e.g. physical therapy, blood transfusion)
Description

Concomitant medication/Non-drug therapy

Data type

text

Alias
UMLS CUI [1]
C2347852
UMLS CUI [2]
C0599938
Indication
Description

Indication

Data type

text

Alias
UMLS CUI [1]
C3146298
Start date
Description

Start date

Data type

date

Measurement units
  • dd/mm/yy
Alias
UMLS CUI [1]
C0808070
dd/mm/yy
End date
Description

End date

Data type

date

Measurement units
  • dd/mm/yy
Alias
UMLS CUI [1]
C0806020
dd/mm/yy
or ongoing at End of Study
Description

or ongoing at End of Study

Data type

boolean

Alias
UMLS CUI [1]
C0549178
Signature
Description

Signature

Date
Description

Investigator Signature Date

Data type

date

Alias
UMLS CUI [1,1]
C2346576
UMLS CUI [1,2]
C0011008
Signature Investigator
Description

Signature Investigator

Data type

text

Alias
UMLS CUI [1]
C2346576
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Similar models

Concomitant medication, DIMAT-MS Relapsing Remitting Multiple Sclerosis NCT02461069

1 forms
Name
Type
Description | Question | Decode (Coded Value)
Data type
Alias
Item Group
Concomitant medication
Sheet No.
Item
Sheet No.
integer
C0449788 (UMLS CUI [1])
Concomitant medication/Non-drug therapy
Item
Concomitant medication (Generic Name or Trade Name)/NON-drug therapy (e.g. physical therapy, blood transfusion)
text
C2347852 (UMLS CUI [1])
C0599938 (UMLS CUI [2])
Indication
Item
Indication
text
C3146298 (UMLS CUI [1])
Start date
Item
Start date
date
C0808070 (UMLS CUI [1])
End date
Item
End date
date
C0806020 (UMLS CUI [1])
or ongoing at End of Study
Item
or ongoing at End of Study
boolean
C0549178 (UMLS CUI [1])
Item Group
Signature
Investigator Signature Date
Item
Date
date
C2346576 (UMLS CUI [1,1])
C0011008 (UMLS CUI [1,2])
Signature Investigator
Item
Signature Investigator
text
C2346576 (UMLS CUI [1])
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