ID

15376

Beschreibung

Study documentation part: Discontinuation of Study 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.

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  1. 28.05.16 28.05.16 -
Hochgeladen am

28. Mai 2016

DOI

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Discontinuation of Study medication, DIMAT-MS Relapsing Remitting Multiple Sclerosis DRKS00008037 NCT02461069

Discontinuation of Study medication, DIMAT-MS Relapsing Remitting Multiple Sclerosis NCT02461069

Discontinuation of Study Medication
Beschreibung

Discontinuation of Study Medication

Date
Beschreibung

Date

Datentyp

date

Maßeinheiten
  • dd/mm/yy
Alias
UMLS CUI [1]
C0011008
dd/mm/yy
Primary reason for discontinuation of study medication
Beschreibung

Primary reason for discontinuation of study medication

Patient requests discontinuation of Study Medication
Beschreibung

Patient requests discontinuation of Study Medication

Datentyp

boolean

Alias
UMLS CUI [1,1]
C0332153
UMLS CUI [1,2]
C0558681
Investigator determines that continuing it would result in a significant risk for that patient
Beschreibung

Investigator determines that continuing it would result in a significant risk for that patient

Datentyp

boolean

Alias
UMLS CUI [1]
C0420243
Patient becomes pregnant
Beschreibung

Patient becomes pregnant

Datentyp

boolean

Alias
UMLS CUI [1]
C0549206
Patient withdraws informed consent
Beschreibung

Patient withdraws informed consent

Datentyp

boolean

Alias
UMLS CUI [1]
C1707492
Lymphocyte count is < 500/μl, confirmed by two independent measurements 2 weeks apart
Beschreibung

Lymphocyte count is < 500/μl, confirmed by two independent measurements 2 weeks apart

Datentyp

boolean

Alias
UMLS CUI [1]
C1845611
Leukocyte count is < 3,000/μl, confirmed by two independent measurements 2 weeks apart
Beschreibung

Leukocyte count is < 3,000/μl, confirmed by two independent measurements 2 weeks apart

Datentyp

boolean

Alias
UMLS CUI [1]
C0948695
Suspicion of a PML (progressive multifocal leukoencephalopathy)
Beschreibung

Suspicion of a PML (progressive multifocal leukoencephalopathy)

Datentyp

boolean

Alias
UMLS CUI [1]
C0023524
Adverse event
Beschreibung

Adverse event

Datentyp

boolean

Alias
UMLS CUI [1]
C0877248
Serious adverse event (e.g. cardiac failure, diagnosed malignancy, serious infections)
Beschreibung

Serious adverse event

Datentyp

boolean

Alias
UMLS CUI [1]
C1519255
Abnormal laboratory value(s) including liver function tests or abnormal test result(s)
Beschreibung

Abnormal laboratory value(s) including liver function tests or abnormal test result(s)

Datentyp

boolean

Alias
UMLS CUI [1]
C0438215
UMLS CUI [2]
C0151766
Use of prohibited medications
Beschreibung

Use of prohibited medications

Datentyp

boolean

Alias
UMLS CUI [1,1]
C0013227
UMLS CUI [1,2]
C0138547
Protocol deviation(s)
Beschreibung

Protocol deviation(s)

Datentyp

boolean

Alias
UMLS CUI [1]
C1705236
Unsatisfactory therapeutic effect
Beschreibung

Unsatisfactory therapeutic effect

Datentyp

boolean

Alias
UMLS CUI [1,1]
C1527144
UMLS CUI [1,2]
C0439856
Patient's condition no longer requires study treatment
Beschreibung

Patient's condition no longer requires study treatment

Datentyp

boolean

Alias
UMLS CUI [1,1]
C1318598
UMLS CUI [1,2]
C0683521
Administrative problems (e.g. patient's non-compliance)
Beschreibung

Administrative problems (e.g. patient's non-compliance)

Datentyp

boolean

Alias
UMLS CUI [1,1]
C3469597
UMLS CUI [1,2]
C0033213
Other reason:
Beschreibung

Other reason

Datentyp

text

Alias
UMLS CUI [1]
C3840932
Signature
Beschreibung

Signature

Date
Beschreibung

Investigator Signature Date

Datentyp

date

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

Signature Investigator

Datentyp

text

Alias
UMLS CUI [1]
C2346576

Ähnliche Modelle

Discontinuation of Study medication, DIMAT-MS Relapsing Remitting Multiple Sclerosis NCT02461069

Name
Typ
Description | Question | Decode (Coded Value)
Datentyp
Alias
Item Group
Discontinuation of Study Medication
Date
Item
Date
date
C0011008 (UMLS CUI [1])
Item Group
Primary reason for discontinuation of study medication
Patient requests discontinuation of Study Medication
Item
Patient requests discontinuation of Study Medication
boolean
C0332153 (UMLS CUI [1,1])
C0558681 (UMLS CUI [1,2])
Investigator determines that continuing it would result in a significant risk for that patient
Item
Investigator determines that continuing it would result in a significant risk for that patient
boolean
C0420243 (UMLS CUI [1])
Patient becomes pregnant
Item
Patient becomes pregnant
boolean
C0549206 (UMLS CUI [1])
Patient withdraws informed consent
Item
Patient withdraws informed consent
boolean
C1707492 (UMLS CUI [1])
Lymphocyte count is < 500/μl, confirmed by two independent measurements 2 weeks apart
Item
Lymphocyte count is < 500/μl, confirmed by two independent measurements 2 weeks apart
boolean
C1845611 (UMLS CUI [1])
Leukocyte count is < 3,000/μl, confirmed by two independent measurements 2 weeks apart
Item
Leukocyte count is < 3,000/μl, confirmed by two independent measurements 2 weeks apart
boolean
C0948695 (UMLS CUI [1])
Suspicion of a PML (progressive multifocal leukoencephalopathy)
Item
Suspicion of a PML (progressive multifocal leukoencephalopathy)
boolean
C0023524 (UMLS CUI [1])
Adverse event
Item
Adverse event
boolean
C0877248 (UMLS CUI [1])
Serious adverse event
Item
Serious adverse event (e.g. cardiac failure, diagnosed malignancy, serious infections)
boolean
C1519255 (UMLS CUI [1])
Abnormal laboratory value(s) including liver function tests or abnormal test result(s)
Item
Abnormal laboratory value(s) including liver function tests or abnormal test result(s)
boolean
C0438215 (UMLS CUI [1])
C0151766 (UMLS CUI [2])
Use of prohibited medications
Item
Use of prohibited medications
boolean
C0013227 (UMLS CUI [1,1])
C0138547 (UMLS CUI [1,2])
Protocol deviation(s)
Item
Protocol deviation(s)
boolean
C1705236 (UMLS CUI [1])
Unsatisfactory therapeutic effect
Item
Unsatisfactory therapeutic effect
boolean
C1527144 (UMLS CUI [1,1])
C0439856 (UMLS CUI [1,2])
Patient's condition no longer requires study treatment
Item
Patient's condition no longer requires study treatment
boolean
C1318598 (UMLS CUI [1,1])
C0683521 (UMLS CUI [1,2])
Administrative problems (e.g. patient's non-compliance)
Item
Administrative problems (e.g. patient's non-compliance)
boolean
C3469597 (UMLS CUI [1,1])
C0033213 (UMLS CUI [1,2])
Other reason
Item
Other reason:
text
C3840932 (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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