ID

18382

Description

Study Type: Interventional Study Design: Endpoint Classification: Efficacy Study Intervention Model: Single Group Assignment Masking: Open Label Primary Purpose: Treatment Official Title: Therapy for Chronic Cold Agglutinin Disease: A Prospective, Non-Randomized Multi-Center Study Demonstrating the Efficacy of Terminal Complement Inhibition in Patients With Cold Agglutinin Disease Using Eculizumab EudraCT-Nummer 2009-01696697 ClinicalTrials.gov-Identifier NCT01303952 https://clinicaltrials.gov/ct2/show/NCT01303952 Genehmigung durch Frau Ose

Link

https://clinicaltrials.gov/ct2/show/NCT01303952

Keywords

  1. 10/7/16 10/7/16 -
  2. 10/10/16 10/10/16 -
  3. 10/11/16 10/11/16 -
  4. 10/17/16 10/17/16 -
  5. 10/18/16 10/18/16 -
  6. 10/21/16 10/21/16 -
  7. 10/23/16 10/23/16 -
  8. 10/24/16 10/24/16 -
  9. 10/27/16 10/27/16 -
  10. 11/2/16 11/2/16 -
Uploaded on

November 2, 2016

DOI

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License

Creative Commons BY 4.0

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Screening and Observation Period UK Essen Therapy of Chronic Cold Agglutinin Disease With Eculizumab NCT01303952

Screening and Observation Period UK Essen Therapy of Chronic Cold Agglutinin Disease With Eculizumab NCT01303952

In-/Exclusion Criteria
Description

In-/Exclusion Criteria

Alias
UMLS CUI-1
C1512693
UMLS CUI-2
C0680251
Pat.-No.
Description

Patient number

Data type

integer

Alias
UMLS CUI [1]
C1830427
The patient gave his or her consent on
Description

The patient gave his or her consent on

Data type

text

Measurement units
  • YYYY-MM-DD
Alias
UMLS CUI [1]
C2985782
YYYY-MM-DD
Are all inclusion criteria fulfilled?
Description

Are all inclusion criteria fulfilled?

Data type

integer

Alias
UMLS CUI [1]
C1512693
Are none of the exclusion criteria fulfilled?
Description

Are none of the exclusion criteria fulfilled?

Data type

integer

Alias
UMLS CUI [1]
C2828389
Demographics, Vital Signs and Examinations
Description

Demographics, Vital Signs and Examinations

Alias
UMLS CUI-1
C1955348
UMLS CUI-2
C0518766
UMLS CUI-3
C0582103
Date of Screening
Description

Itemgroup: Date of Screening

Data type

text

Measurement units
  • YYYY-MM-DD
Alias
UMLS CUI [1,1]
C0011008
UMLS CUI [1,2]
C1710477
YYYY-MM-DD
Date of Birth
Description

Sub-Itemgroup: Demographics

Data type

text

Measurement units
  • YYYY-MM
Alias
UMLS CUI [1]
C0421451
YYYY-MM
Sex
Description

Sex

Data type

integer

Alias
UMLS CUI [1]
C0079399
Nationality
Description

Sub-Itemgroup: Demographics

Data type

integer

Alias
UMLS CUI [1]
C0027473
specify nationality
Description

Sub-Itemgroup: Demographics

Data type

text

Alias
UMLS CUI [1]
C0027473
Height
Description

Sub-Itemgroup: Demographics

Data type

float

Measurement units
  • cm
Alias
UMLS CUI [1]
C0005890
cm
Weight
Description

Sub-Itemgroup: Demographics

Data type

float

Measurement units
  • kg
Alias
UMLS CUI [1]
C0005910
kg
LDH
Description

Sub-Itemgroup: Demographics

Data type

float

Measurement units
  • U/l
Alias
UMLS CUI [1]
C0202113
U/l
1. Systolic blood pressure
Description

Sub-Itemgroup: Vital Signs

Data type

integer

Measurement units
  • mmHg
Alias
UMLS CUI [1]
C0871470
mmHg
1. Diastolic blood pressure
Description

Sub-Itemgroup: Vital Signs

Data type

integer

Measurement units
  • mmHg
Alias
UMLS CUI [1]
C0428883
mmHg
2. Systolic blood pressure
Description

Sub-Itemgroup: Vital Signs

Data type

integer

Measurement units
  • mmHg
Alias
UMLS CUI [1]
C0871470
mmHg
2. Diastolic blood pressure
Description

Sub-Itemgroup: Vital Signs

Data type

integer

Measurement units
  • mmHg
Alias
UMLS CUI [1]
C0428883
mmHg
3. Systolic blood pressure
Description

Sub-Itemgroup: Vital Signs

Data type

integer

Measurement units
  • mmHg
Alias
UMLS CUI [1]
C0871470
mmHg
3. Diastolic blood pressure
Description

Sub-Itemgroup: Vital Signs

Data type

integer

Measurement units
  • mmHg
Alias
UMLS CUI [1]
C0428883
mmHg
Sitting heart rate
Description

Sub-Itemgroup: Vital Signs

Data type

integer

Measurement units
  • beats per minute
Alias
UMLS CUI [1]
C2029904
beats per minute
Body temperature
Description

Sub-Itemgroup: Vital Signs

Data type

float

Measurement units
  • °C
Alias
UMLS CUI [1]
C0005903
°C
Physical examination
Description

Sub-Itemgroup: Examinations

Data type

integer

Alias
UMLS CUI [1]
C0031809
Abdominal ultrasound
Description

Sub-Itemgroup: Examinations

Data type

integer

Alias
UMLS CUI [1]
C2348813
12-lead electrocardiogram
Description

Sub-Itemgroup: Examinations

Data type

integer

Alias
UMLS CUI [1]
C0430456
Bone marrow
Description

Sub-Itemgroup: Examinations

Data type

integer

Alias
UMLS CUI [1]
C0005957
Walk distance
Description

Sub-Itemgroup: Six-Minute Walk Test

Data type

integer

Measurement units
  • Meter
Alias
UMLS CUI [1]
C3854161
Meter
Does the patient report symptoms of dyspnea?
Description

Sub-Itemgroup: Six-Minute Walk Test

Data type

integer

Alias
UMLS CUI [1]
C0013404
Circulatory Symptoms
Description

Circulatory Symptoms

Alias
UMLS CUI-1
C0476270
Date of first Cold Agglutin Disease diagnosis
Description

Date of first Cold Agglutin Disease

Data type

date

Measurement units
  • YYYY-MM-DD
Alias
UMLS CUI [1,1]
C0011008
UMLS CUI [1,2]
C0175816
YYYY-MM-DD
Thrombophlebitis/Deep Vein Thrombosis
Description

Thrombophlebitis/Deep Vein Thrombosis

Data type

integer

Alias
UMLS CUI [1]
C0040046
UMLS CUI [2]
C0149871
Pulmonary Embolus
Description

Pulmonary Embolus

Data type

integer

Alias
UMLS CUI [1]
C0034065
Cerebrovascular Accident
Description

Cerebrovascular Accident

Data type

integer

Alias
UMLS CUI [1]
C0038454
Amputation
Description

Amputation

Data type

integer

Alias
UMLS CUI [1]
C0002688
Myocardial Infarction
Description

Myocardial Infarction

Data type

integer

Alias
UMLS CUI [1]
C0027051
Transient Ischemic Attack
Description

Transient Ischemic Attack

Data type

integer

Alias
UMLS CUI [1]
C0007787
Unstable Angina
Description

Unstable Angina

Data type

integer

Alias
UMLS CUI [1]
C0002965
Renal Vein Thrombosis
Description

Renal Vein Thrombosis

Data type

integer

Alias
UMLS CUI [1]
C0238457
Mesenteric Vein Thrombosis
Description

Mesenteric Vein Thrombosis

Data type

integer

Alias
UMLS CUI [1]
C0267412
Portal Vein Thrombosis (Budd-Chiari)
Description

Portal Vein Thrombosis (Budd-Chiari)

Data type

integer

Alias
UMLS CUI [1]
C0155773
Gangrene
Description

Gangrene

Data type

integer

Alias
UMLS CUI [1]
C0017086
Acute Peripheral Vascular Occlusion
Description

Acute Peripheral Vascular Occlusion

Data type

integer

Alias
UMLS CUI [1]
C0240728
Sudden Death
Description

Sudden Death

Data type

integer

Alias
UMLS CUI [1]
C0011071
Patient suffers from other accompanying illnesses?
Description

Patient suffers from other accompanying illnesses?

Data type

integer

Alias
UMLS CUI [1]
C0009488
Only for Woman (under 50): Is the pregnancy test negativ?
Description

Only for Woman (under 50): Is the pregnancy test negativ?

Data type

integer

Alias
UMLS CUI [1]
C0032976
Comments
Description

Comments

Data type

text

Alias
UMLS CUI [1]
C0947611
Signature date
Description

Sub-Itemgroup: Investigator's signature

Data type

date

Alias
UMLS CUI [1]
C0807937
Investigator's signature
Description

Sub-Itemgroup: Investigator's signature

Data type

integer

Alias
UMLS CUI [1]
C2346576
One year transfusion history
Description

One year transfusion history

Alias
UMLS CUI-1
C1519604
Date of blood transfusion
Description

Date of blood transfusion

Data type

date

Measurement units
  • YYYY-MM-DD
Alias
UMLS CUI [1]
C1264703
YYYY-MM-DD
Number of units
Description

Number of units

Data type

integer

Alias
UMLS CUI [1,1]
C0086252
UMLS CUI [1,2]
C0449961
Hemoglobin before transfusion
Description

Hemoglobin before transfusion

Data type

float

Measurement units
  • ulHGB
Alias
UMLS CUI [1]
C0518015
ulHGB
Hemoglobin before transfusion
Description

Hemoglobin before transfusion2

Data type

integer

Measurement units
  • ulHGB
Alias
UMLS CUI [1]
C0518015
Any special events circumstances transfusion?
Description

Any special events circumstances transfusion?

Data type

integer

Alias
UMLS CUI [1,1]
C0877248
UMLS CUI [1,2]
C1879316
if yes, please specify
Description

if yes, please specify

Data type

text

Alias
UMLS CUI [1,1]
C0877248
UMLS CUI [1,2]
C1879316
Signature date
Description

Sub-Itemgroup: Investigator's signature

Data type

date

Alias
UMLS CUI [1]
C0807937
Investigator's signature
Description

Sub-Itemgroup: Investigator's signature

Data type

integer

Alias
UMLS CUI [1]
C2346576
Preexisting and concomitant diseases
Description

Preexisting and concomitant diseases

Alias
UMLS CUI-1
C0243087
The patient has no preexisting/concomitant diseases
Description

Concomitant disease

Data type

integer

Alias
UMLS CUI [1]
C0243087
Signature date
Description

Sub-Itemgroup: Investigator's signature

Data type

date

Alias
UMLS CUI [1]
C0807937
Investigator's signature
Description

Sub-Itemgroup: Investigator's signature

Data type

integer

Alias
UMLS CUI [1]
C2346576
Preexisting and concomitant
Description

Preexisting and concomitant

Alias
UMLS CUI-1
C0243087
CD No
Description

CD No

Data type

text

Description of concomitant diseases
Description

concomitant diseases

Data type

text

Alias
UMLS CUI [1]
C0150941
First occurred
Description

First occurred

Data type

date

Alias
UMLS CUI [1]
C2316983
Visit 0 - FACIT
Description

Visit 0 - FACIT

Alias
UMLS CUI-1
C1512346
UMLS CUI-2
C3476791
FACIT Score
Description

FACIT Score

Data type

integer

Alias
UMLS CUI [1,1]
C3476791
UMLS CUI [1,2]
C0449820
Visit 0 - SF36
Description

Visit 0 - SF36

Alias
UMLS CUI-1
C1512346
UMLS CUI-2
C3640521
SF36 Score
Description

SF36 Score

Data type

integer

Alias
UMLS CUI [1,1]
C3640521
UMLS CUI [1,2]
C0449820

Similar models

Screening and Observation Period UK Essen Therapy of Chronic Cold Agglutinin Disease With Eculizumab NCT01303952

Name
Type
Description | Question | Decode (Coded Value)
Data type
Alias
Item Group
In-/Exclusion Criteria
C1512693 (UMLS CUI-1)
C0680251 (UMLS CUI-2)
Patient number
Item
Pat.-No.
integer
C1830427 (UMLS CUI [1])
The patient gave his or her consent on
Item
The patient gave his or her consent on
text
C2985782 (UMLS CUI [1])
Item
Are all inclusion criteria fulfilled?
integer
C1512693 (UMLS CUI [1])
Code List
Are all inclusion criteria fulfilled?
CL Item
no (0)
CL Item
yes (1)
Item
Are none of the exclusion criteria fulfilled?
integer
C2828389 (UMLS CUI [1])
Code List
Are none of the exclusion criteria fulfilled?
CL Item
no (0)
CL Item
yes (1)
Item Group
Demographics, Vital Signs and Examinations
C1955348 (UMLS CUI-1)
C0518766 (UMLS CUI-2)
C0582103 (UMLS CUI-3)
Date of Screening
Item
Date of Screening
text
C0011008 (UMLS CUI [1,1])
C1710477 (UMLS CUI [1,2])
Date of Birth
Item
Date of Birth
text
C0421451 (UMLS CUI [1])
Item
Sex
integer
C0079399 (UMLS CUI [1])
Code List
Sex
CL Item
Male (1)
CL Item
Female (2)
Item
Nationality
integer
C0027473 (UMLS CUI [1])
Code List
Nationality
CL Item
German (1)
CL Item
other (2)
specify nationality
Item
specify nationality
text
C0027473 (UMLS CUI [1])
Height
Item
Height
float
C0005890 (UMLS CUI [1])
Weight
Item
Weight
float
C0005910 (UMLS CUI [1])
LDH
Item
LDH
float
C0202113 (UMLS CUI [1])
1. Systolic blood pressure
Item
1. Systolic blood pressure
integer
C0871470 (UMLS CUI [1])
1. Diastolic blood pressure
Item
1. Diastolic blood pressure
integer
C0428883 (UMLS CUI [1])
2. Systolic blood pressure
Item
2. Systolic blood pressure
integer
C0871470 (UMLS CUI [1])
2. Diastolic blood pressure
Item
2. Diastolic blood pressure
integer
C0428883 (UMLS CUI [1])
3. Systolic blood pressure
Item
3. Systolic blood pressure
integer
C0871470 (UMLS CUI [1])
3. Diastolic blood pressure
Item
3. Diastolic blood pressure
integer
C0428883 (UMLS CUI [1])
Sitting heart rate
Item
Sitting heart rate
integer
C2029904 (UMLS CUI [1])
Body temperature
Item
Body temperature
float
C0005903 (UMLS CUI [1])
Item
Physical examination
integer
C0031809 (UMLS CUI [1])
Code List
Physical examination
CL Item
without pathologic findings (0)
CL Item
with pathologic findings (1)
Item
Abdominal ultrasound
integer
C2348813 (UMLS CUI [1])
Code List
Abdominal ultrasound
CL Item
without pathologic findings (0)
CL Item
with pathologic findings (1)
Item
12-lead electrocardiogram
integer
C0430456 (UMLS CUI [1])
Code List
12-lead electrocardiogram
CL Item
without pathologic findings , 1=with pathologic findings (0)
CL Item
 (1)
Item
Bone marrow
integer
C0005957 (UMLS CUI [1])
Code List
Bone marrow
CL Item
without pathologic findings  (0)
CL Item
with pathologic findings (1)
Walk distance
Item
Walk distance
integer
C3854161 (UMLS CUI [1])
Item
Does the patient report symptoms of dyspnea?
integer
C0013404 (UMLS CUI [1])
Code List
Does the patient report symptoms of dyspnea?
CL Item
no (0)
CL Item
yes (1)
Item Group
Circulatory Symptoms
C0476270 (UMLS CUI-1)
Date of first Cold Agglutin Disease
Item
Date of first Cold Agglutin Disease diagnosis
date
C0011008 (UMLS CUI [1,1])
C0175816 (UMLS CUI [1,2])
Item
Thrombophlebitis/Deep Vein Thrombosis
integer
C0040046 (UMLS CUI [1])
C0149871 (UMLS CUI [2])
Code List
Thrombophlebitis/Deep Vein Thrombosis
CL Item
no (0)
CL Item
yes (1)
Item
Pulmonary Embolus
integer
C0034065 (UMLS CUI [1])
Code List
Pulmonary Embolus
CL Item
no (0)
CL Item
yes (1)
Item
Cerebrovascular Accident
integer
C0038454 (UMLS CUI [1])
Code List
Cerebrovascular Accident
CL Item
no (0)
CL Item
yes (1)
Item
Amputation
integer
C0002688 (UMLS CUI [1])
Code List
Amputation
CL Item
no (0)
CL Item
yes (1)
Item
Myocardial Infarction
integer
C0027051 (UMLS CUI [1])
Code List
Myocardial Infarction
CL Item
no (0)
CL Item
yes (1)
Item
Transient Ischemic Attack
integer
C0007787 (UMLS CUI [1])
Code List
Transient Ischemic Attack
CL Item
no (0)
CL Item
yes (1)
Item
Unstable Angina
integer
C0002965 (UMLS CUI [1])
Code List
Unstable Angina
CL Item
no (0)
CL Item
yes (1)
Item
Renal Vein Thrombosis
integer
C0238457 (UMLS CUI [1])
Code List
Renal Vein Thrombosis
CL Item
no (0)
CL Item
yes (1)
Item
Mesenteric Vein Thrombosis
integer
C0267412 (UMLS CUI [1])
Code List
Mesenteric Vein Thrombosis
CL Item
no (0)
CL Item
yes (1)
Item
Portal Vein Thrombosis (Budd-Chiari)
integer
C0155773 (UMLS CUI [1])
Code List
Portal Vein Thrombosis (Budd-Chiari)
CL Item
no (0)
CL Item
yes (1)
Item
Gangrene
integer
C0017086 (UMLS CUI [1])
CL Item
no (0)
CL Item
yes (1)
Item
Acute Peripheral Vascular Occlusion
integer
C0240728 (UMLS CUI [1])
Code List
Acute Peripheral Vascular Occlusion
CL Item
no (0)
CL Item
yes (1)
Item
Sudden Death
integer
C0011071 (UMLS CUI [1])
CL Item
no (0)
CL Item
yes (1)
Item
Patient suffers from other accompanying illnesses?
integer
C0009488 (UMLS CUI [1])
Code List
Patient suffers from other accompanying illnesses?
CL Item
no (0)
CL Item
yes (1)
Item
Only for Woman (under 50): Is the pregnancy test negativ?
integer
C0032976 (UMLS CUI [1])
Code List
Only for Woman (under 50): Is the pregnancy test negativ?
CL Item
no (0)
CL Item
yes (1)
Comments
Item
Comments
text
C0947611 (UMLS CUI [1])
Signature date
Item
Signature date
date
C0807937 (UMLS CUI [1])
Item
Investigator's signature
integer
C2346576 (UMLS CUI [1])
Code List
Investigator's signature
CL Item
no (0)
CL Item
yes (1)
Item Group
One year transfusion history
C1519604 (UMLS CUI-1)
Date of blood transfusion
Item
Date of blood transfusion
date
C1264703 (UMLS CUI [1])
Number of units
Item
Number of units
integer
C0086252 (UMLS CUI [1,1])
C0449961 (UMLS CUI [1,2])
Hemoglobin before transfusion
Item
Hemoglobin before transfusion
float
C0518015 (UMLS CUI [1])
Item
Hemoglobin before transfusion
integer
C0518015 (UMLS CUI [1])
Code List
Hemoglobin before transfusion
CL Item
g/dl (1)
CL Item
mmol/l (2)
Item
Any special events circumstances transfusion?
integer
C0877248 (UMLS CUI [1,1])
C1879316 (UMLS CUI [1,2])
Code List
Any special events circumstances transfusion?
CL Item
no (0)
CL Item
yes (1)
if yes, please specify
Item
if yes, please specify
text
C0877248 (UMLS CUI [1,1])
C1879316 (UMLS CUI [1,2])
Signature date
Item
Signature date
date
C0807937 (UMLS CUI [1])
Item
Investigator's signature
integer
C2346576 (UMLS CUI [1])
Code List
Investigator's signature
CL Item
no (0)
CL Item
yes (1)
Item Group
Preexisting and concomitant diseases
C0243087 (UMLS CUI-1)
Item
The patient has no preexisting/concomitant diseases
integer
C0243087 (UMLS CUI [1])
Code List
The patient has no preexisting/concomitant diseases
CL Item
no (0)
CL Item
yes (1)
Signature date
Item
Signature date
date
C0807937 (UMLS CUI [1])
Item
Investigator's signature
integer
C2346576 (UMLS CUI [1])
Code List
Investigator's signature
CL Item
no (0)
CL Item
yes (1)
Item Group
Preexisting and concomitant
C0243087 (UMLS CUI-1)
CD No
Item
text
concomitant diseases
Item
Description of concomitant diseases
text
C0150941 (UMLS CUI [1])
First occurred
Item
First occurred
date
C2316983 (UMLS CUI [1])
Item Group
Visit 0 - FACIT
C1512346 (UMLS CUI-1)
C3476791 (UMLS CUI-2)
FACIT Score
Item
FACIT Score
integer
C3476791 (UMLS CUI [1,1])
C0449820 (UMLS CUI [1,2])
Item Group
Visit 0 - SF36
C1512346 (UMLS CUI-1)
C3640521 (UMLS CUI-2)
SF36 Score
Item
SF36 Score
integer
C3640521 (UMLS CUI [1,1])
C0449820 (UMLS CUI [1,2])

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