ID

22448

Descrição

Study part: HES History or Prior HES Therapies Screening Visit.A Phase 2 Multicenter, Double-blind, Placebo-controlled, Study to to Evaluate the Corticosteroid- sparing effects of Mepolizumab in Subjects with Hypereosinophilic Syndromes (HES) and Evaluate Efficacy and Safety of Mepolizumab in Controlling the Clinical Signs and Symptoms of subjects with HES Patient Level Data: Study Listed on ClinicalStudyDataRequest.com. Sponsor: GlaxoSmithKline. Study ID: 100185, Clinical Study ID:MHE100185.

Palavras-chave

  1. 04/06/2017 04/06/2017 -
Titular dos direitos

GlaxoSmithKline

Transferido a

4 de junho de 2017

DOI

Para um pedido faça login.

Licença

Creative Commons BY-NC 3.0

Comentários do modelo :

Aqui pode comentar o modelo. Pode comentá-lo especificamente através dos balões de texto nos grupos de itens e itens.

Comentários do grupo de itens para :

Comentários do item para :

Para descarregar formulários, precisa de ter uma sessão iniciada. Por favor faça login ou registe-se gratuitamente.

HES History or Prior HES Therapies Screening Visit Mepolizumab HES NCT00086658

HES History or Prior HES Therapies Screening Visit

DIAGNOSIS
Descrição

DIAGNOSIS

Alias
UMLS CUI-1
C0011900
Subject ID
Descrição

Subject ID

Tipo de dados

text

Alias
UMLS CUI [1]
C2348585
Year of diagnosis of HES
Descrição

year of diagnosis Hypereosinophilic Syndrome

Tipo de dados

partialDate

Alias
UMLS CUI [1,1]
C0439234
UMLS CUI [1,2]
C0011900
UMLS CUI [1,3]
C1540912
HISTORY OF HES THERAPY
Descrição

HISTORY OF HES THERAPY

Alias
UMLS CUI-1
C0087111
UMLS CUI-2
C1540912
Has the subject received any of the below therapies for HES within 5 years prior to the Screening Visit?
Descrição

Therapy HES

Tipo de dados

boolean

Alias
UMLS CUI [1,1]
C0087111
UMLS CUI [1,2]
C1540912
Interferon α
Descrição

Interferon alpha

Tipo de dados

boolean

Alias
UMLS CUI [1]
C0002199
Reason for Treatment Discontinuation
Descrição

Reason Treatment Discontinuation

Tipo de dados

text

Alias
UMLS CUI [1,1]
C0392360
UMLS CUI [1,2]
C0677162
Hydroxyurea
Descrição

Hydroxyurea

Tipo de dados

boolean

Alias
UMLS CUI [1]
C0020402
Reason for Treatment Discontinuation
Descrição

Reason Treatment Discontinuation

Tipo de dados

text

Alias
UMLS CUI [1,1]
C0392360
UMLS CUI [1,2]
C0677162
Cyclosporin
Descrição

Cyclosporin

Tipo de dados

boolean

Alias
UMLS CUI [1]
C0010592
Reason for Treatment Discontinuation
Descrição

Reason Treatment Discontinuation

Tipo de dados

text

Alias
UMLS CUI [1,1]
C0392360
UMLS CUI [1,2]
C0677162
Cyclophosphomide
Descrição

Cyclophosphamide

Tipo de dados

boolean

Alias
UMLS CUI [1]
C0010583
Reason for Treatment Discontinuation
Descrição

Reason Treatment Discontinuation

Tipo de dados

text

Alias
UMLS CUI [1,1]
C0392360
UMLS CUI [1,2]
C0677162
Imatinib Mesylate
Descrição

Imatinib Mesylate

Tipo de dados

boolean

Alias
UMLS CUI [1]
C0939537
Reason for Treatment Discontinuation
Descrição

Reason Treatment Discontinuation

Tipo de dados

text

Alias
UMLS CUI [1,1]
C0392360
UMLS CUI [1,2]
C0677162
Methotrexate
Descrição

Methotrexate

Tipo de dados

boolean

Alias
UMLS CUI [1]
C0025677
Reason for Treatment Discontinuation
Descrição

Reason Treatment Discontinuation

Tipo de dados

text

Alias
UMLS CUI [1,1]
C0392360
UMLS CUI [1,2]
C0677162
Vincristine
Descrição

Vincristine

Tipo de dados

boolean

Alias
UMLS CUI [1]
C0042679
Reason for Treatment Discontinuation
Descrição

Reason Treatment Discontinuation

Tipo de dados

text

Alias
UMLS CUI [1,1]
C0392360
UMLS CUI [1,2]
C0677162
Busulfan
Descrição

Busulfan

Tipo de dados

boolean

Alias
UMLS CUI [1]
C0006463
Reason for Treatment Discontinuation
Descrição

Reason Treatment Discontinuation

Tipo de dados

text

Alias
UMLS CUI [1,1]
C0392360
UMLS CUI [1,2]
C0677162
Chlorambucil
Descrição

Chlorambucil

Tipo de dados

boolean

Alias
UMLS CUI [1]
C0008163
Reason for Treatment Discontinuation
Descrição

Reason Treatment Discontinuation

Tipo de dados

text

Alias
UMLS CUI [1,1]
C0392360
UMLS CUI [1,2]
C0677162
Immunotherapy (other monoclonal antibodies or anti-T cell therapies eg., TNF α inhibitors, alefacept)
Descrição

Immunotherapy

Tipo de dados

boolean

Alias
UMLS CUI [1]
C0021083
Reason for Treatment Discontinuation
Descrição

Reason Treatment Discontinuation

Tipo de dados

text

Alias
UMLS CUI [1,1]
C0392360
UMLS CUI [1,2]
C0677162
Systemic Corticosteroid(s)
Descrição

Systemic Corticosteroid

Tipo de dados

boolean

Alias
UMLS CUI [1]
C4039704
Reason for Treatment Discontinuation
Descrição

Reason Treatment Discontinuation

Tipo de dados

text

Alias
UMLS CUI [1,1]
C0392360
UMLS CUI [1,2]
C0677162
Other (specify):
Descrição

Other

Tipo de dados

text

Alias
UMLS CUI [1]
C0205394
Reason for Treatment Discontinuation
Descrição

Reason Treatment Discontinuation

Tipo de dados

text

Alias
UMLS CUI [1,1]
C0392360
UMLS CUI [1,2]
C0677162

Similar models

HES History or Prior HES Therapies Screening Visit

Name
Tipo
Description | Question | Decode (Coded Value)
Tipo de dados
Alias
Item Group
DIAGNOSIS
C0011900 (UMLS CUI-1)
Subject ID
Item
Subject ID
text
C2348585 (UMLS CUI [1])
year of diagnosis Hypereosinophilic Syndrome
Item
Year of diagnosis of HES
partialDate
C0439234 (UMLS CUI [1,1])
C0011900 (UMLS CUI [1,2])
C1540912 (UMLS CUI [1,3])
Item Group
HISTORY OF HES THERAPY
C0087111 (UMLS CUI-1)
C1540912 (UMLS CUI-2)
Therapy HES
Item
Has the subject received any of the below therapies for HES within 5 years prior to the Screening Visit?
boolean
C0087111 (UMLS CUI [1,1])
C1540912 (UMLS CUI [1,2])
Interferon alpha
Item
Interferon α
boolean
C0002199 (UMLS CUI [1])
Item
Reason for Treatment Discontinuation
text
C0392360 (UMLS CUI [1,1])
C0677162 (UMLS CUI [1,2])
Code List
Reason for Treatment Discontinuation
CL Item
Lack of Efficacy (Lack of Efficacy)
CL Item
Adverse Event (Adverse Event)
CL Item
Treatment Related Toxicity (Treatment Related Toxicity)
CL Item
Unknown (Unknown)
CL Item
Ongoing (Ongoing)
Hydroxyurea
Item
Hydroxyurea
boolean
C0020402 (UMLS CUI [1])
Item
Reason for Treatment Discontinuation
text
C0392360 (UMLS CUI [1,1])
C0677162 (UMLS CUI [1,2])
Code List
Reason for Treatment Discontinuation
CL Item
Lack of Efficacy (Lack of Efficacy)
CL Item
Adverse Event (Adverse Event)
CL Item
Treatment Related Toxicity (Treatment Related Toxicity)
CL Item
Unknown (Unknown)
CL Item
Ongoing (Ongoing)
Cyclosporin
Item
Cyclosporin
boolean
C0010592 (UMLS CUI [1])
Item
Reason for Treatment Discontinuation
text
C0392360 (UMLS CUI [1,1])
C0677162 (UMLS CUI [1,2])
Code List
Reason for Treatment Discontinuation
CL Item
Lack of Efficacy (Lack of Efficacy)
CL Item
Adverse Event (Adverse Event)
CL Item
Treatment Related Toxicity (Treatment Related Toxicity)
CL Item
Unknown (Unknown)
CL Item
Ongoing (Ongoing)
Cyclophosphamide
Item
Cyclophosphomide
boolean
C0010583 (UMLS CUI [1])
Item
Reason for Treatment Discontinuation
text
C0392360 (UMLS CUI [1,1])
C0677162 (UMLS CUI [1,2])
Code List
Reason for Treatment Discontinuation
CL Item
Lack of Efficacy (Lack of Efficacy)
CL Item
Adverse Event (Adverse Event)
CL Item
Treatment Related Toxicity (Treatment Related Toxicity)
CL Item
Unknown (Unknown)
CL Item
Ongoing (Ongoing)
Imatinib Mesylate
Item
Imatinib Mesylate
boolean
C0939537 (UMLS CUI [1])
Item
Reason for Treatment Discontinuation
text
C0392360 (UMLS CUI [1,1])
C0677162 (UMLS CUI [1,2])
Code List
Reason for Treatment Discontinuation
CL Item
Lack of Efficacy (Lack of Efficacy)
CL Item
Adverse Event (Adverse Event)
CL Item
Treatment Related Toxicity (Treatment Related Toxicity)
CL Item
Unknown (Unknown)
CL Item
Ongoing (Ongoing)
Methotrexate
Item
Methotrexate
boolean
C0025677 (UMLS CUI [1])
Item
Reason for Treatment Discontinuation
text
C0392360 (UMLS CUI [1,1])
C0677162 (UMLS CUI [1,2])
Code List
Reason for Treatment Discontinuation
CL Item
Lack of Efficacy (Lack of Efficacy)
CL Item
Adverse Event (Adverse Event)
CL Item
Treatment Related Toxicity (Treatment Related Toxicity)
CL Item
Unknown (Unknown)
CL Item
Ongoing (Ongoing)
Vincristine
Item
Vincristine
boolean
C0042679 (UMLS CUI [1])
Item
Reason for Treatment Discontinuation
text
C0392360 (UMLS CUI [1,1])
C0677162 (UMLS CUI [1,2])
Code List
Reason for Treatment Discontinuation
CL Item
Lack of Efficacy (Lack of Efficacy)
CL Item
Adverse Event (Adverse Event)
CL Item
Treatment Related Toxicity (Treatment Related Toxicity)
CL Item
Unknown (Unknown)
CL Item
Ongoing (Ongoing)
Busulfan
Item
Busulfan
boolean
C0006463 (UMLS CUI [1])
Item
Reason for Treatment Discontinuation
text
C0392360 (UMLS CUI [1,1])
C0677162 (UMLS CUI [1,2])
Code List
Reason for Treatment Discontinuation
CL Item
Lack of Efficacy (Lack of Efficacy)
CL Item
Adverse Event (Adverse Event)
CL Item
Treatment Related Toxicity (Treatment Related Toxicity)
CL Item
Unknown (Unknown)
CL Item
Ongoing (Ongoing)
Chlorambucil
Item
Chlorambucil
boolean
C0008163 (UMLS CUI [1])
Item
Reason for Treatment Discontinuation
text
C0392360 (UMLS CUI [1,1])
C0677162 (UMLS CUI [1,2])
Code List
Reason for Treatment Discontinuation
CL Item
Lack of Efficacy (Lack of Efficacy)
CL Item
Adverse Event (Adverse Event)
CL Item
Treatment Related Toxicity (Treatment Related Toxicity)
CL Item
Unknown (Unknown)
CL Item
Ongoing (Ongoing)
Immunotherapy
Item
Immunotherapy (other monoclonal antibodies or anti-T cell therapies eg., TNF α inhibitors, alefacept)
boolean
C0021083 (UMLS CUI [1])
Item
Reason for Treatment Discontinuation
text
C0392360 (UMLS CUI [1,1])
C0677162 (UMLS CUI [1,2])
Code List
Reason for Treatment Discontinuation
CL Item
Lack of Efficacy (Lack of Efficacy)
CL Item
Adverse Event (Adverse Event)
CL Item
Treatment Related Toxicity (Treatment Related Toxicity)
CL Item
Unknown (Unknown)
CL Item
Ongoing (Ongoing)
Systemic Corticosteroid
Item
Systemic Corticosteroid(s)
boolean
C4039704 (UMLS CUI [1])
Item
Reason for Treatment Discontinuation
text
C0392360 (UMLS CUI [1,1])
C0677162 (UMLS CUI [1,2])
Code List
Reason for Treatment Discontinuation
CL Item
Lack of Efficacy (Lack of Efficacy)
CL Item
Adverse Event (Adverse Event)
CL Item
Treatment Related Toxicity (Treatment Related Toxicity)
CL Item
Unknown (Unknown)
CL Item
Ongoing (Ongoing)
Other
Item
Other (specify):
text
C0205394 (UMLS CUI [1])
Item
Reason for Treatment Discontinuation
text
C0392360 (UMLS CUI [1,1])
C0677162 (UMLS CUI [1,2])
Code List
Reason for Treatment Discontinuation
CL Item
Lack of Efficacy (Lack of Efficacy)
CL Item
Adverse Event (Adverse Event)
CL Item
Treatment Related Toxicity (Treatment Related Toxicity)
CL Item
Unknown (Unknown)
CL Item
Ongoing (Ongoing)

Use este formulário para feedback, perguntas e sugestões de aperfeiçoamento.

Campos marcados com * são obrigatórios.

Do you need help on how to use the search function? Please watch the corresponding tutorial video for more details and learn how to use the search function most efficiently.

Watch Tutorial