ID

15376

Beschrijving

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.

Trefwoorden

  1. 28-05-16 28-05-16 -
Geüploaded op

28 mei 2016

DOI

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Licentie

Creative Commons BY-NC 3.0

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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
Beschrijving

Discontinuation of Study Medication

Date
Beschrijving

Date

Datatype

date

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

Primary reason for discontinuation of study medication

Patient requests discontinuation of Study Medication
Beschrijving

Patient requests discontinuation of Study Medication

Datatype

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
Beschrijving

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

Datatype

boolean

Alias
UMLS CUI [1]
C0420243
Patient becomes pregnant
Beschrijving

Patient becomes pregnant

Datatype

boolean

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

Patient withdraws informed consent

Datatype

boolean

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

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

Datatype

boolean

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

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

Datatype

boolean

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

Suspicion of a PML (progressive multifocal leukoencephalopathy)

Datatype

boolean

Alias
UMLS CUI [1]
C0023524
Adverse event
Beschrijving

Adverse event

Datatype

boolean

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

Serious adverse event

Datatype

boolean

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

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

Datatype

boolean

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

Use of prohibited medications

Datatype

boolean

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

Protocol deviation(s)

Datatype

boolean

Alias
UMLS CUI [1]
C1705236
Unsatisfactory therapeutic effect
Beschrijving

Unsatisfactory therapeutic effect

Datatype

boolean

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

Patient's condition no longer requires study treatment

Datatype

boolean

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

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

Datatype

boolean

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

Other reason

Datatype

text

Alias
UMLS CUI [1]
C3840932
Signature
Beschrijving

Signature

Date
Beschrijving

Investigator Signature Date

Datatype

date

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

Signature Investigator

Datatype

text

Alias
UMLS CUI [1]
C2346576

Similar models

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

Name
Type
Description | Question | Decode (Coded Value)
Datatype
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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