ID

22448

Beskrivning

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.

Nyckelord

Versioner (1)
  1. 2017-06-04 2017-06-04 -
Rättsinnehavare

GlaxoSmithKline

Uppladdad den

4 juni 2017

DOI

För en begäran logga in.

Licens

Creative Commons BY-NC 3.0
Modellkommentarer :

Här kan du kommentera modellen. Med hjälp av pratbubblor i Item-grupperna och Item kan du lägga in specifika kommentarer.

Tillbaka till modellkommentarer
Itemgroup-kommentar för :

Item-kommentar för :

  • Senaste
  • Äldsta
  • Önskad
  • Senaste
    • Senaste
    • Äldsta
    • Önskad

Inga kommentarer

Du måste vara inloggad för att kunna ladda ner formulär. Var vänlig logga in eller registrera dig utan kostnad.

HES History or Prior HES Therapies Screening Visit Mepolizumab HES NCT00086658

Engelsk

HES History or Prior HES Therapies Screening Visit

1 Formulär  
DIAGNOSIS
Beskrivning

DIAGNOSIS

Alias
UMLS CUI-1
C0011900
Subject ID
Beskrivning

Subject ID

Datatyp

text

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

year of diagnosis Hypereosinophilic Syndrome

Datatyp

partialDate

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

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?
Beskrivning

Therapy HES

Datatyp

boolean

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

Interferon alpha

Datatyp

boolean

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

Reason Treatment Discontinuation

Datatyp

text

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

Hydroxyurea

Datatyp

boolean

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

Reason Treatment Discontinuation

Datatyp

text

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

Cyclosporin

Datatyp

boolean

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

Reason Treatment Discontinuation

Datatyp

text

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

Cyclophosphamide

Datatyp

boolean

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

Reason Treatment Discontinuation

Datatyp

text

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

Imatinib Mesylate

Datatyp

boolean

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

Reason Treatment Discontinuation

Datatyp

text

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

Methotrexate

Datatyp

boolean

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

Reason Treatment Discontinuation

Datatyp

text

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

Vincristine

Datatyp

boolean

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

Reason Treatment Discontinuation

Datatyp

text

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

Busulfan

Datatyp

boolean

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

Reason Treatment Discontinuation

Datatyp

text

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

Chlorambucil

Datatyp

boolean

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

Reason Treatment Discontinuation

Datatyp

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)
Beskrivning

Immunotherapy

Datatyp

boolean

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

Reason Treatment Discontinuation

Datatyp

text

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

Systemic Corticosteroid

Datatyp

boolean

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

Reason Treatment Discontinuation

Datatyp

text

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

Other

Datatyp

text

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

Reason Treatment Discontinuation

Datatyp

text

Alias
UMLS CUI [1,1]
C0392360
UMLS CUI [1,2]
C0677162
Tillbaka till toppen

Similar models

HES History or Prior HES Therapies Screening Visit

1 Formulär
Name
Typ
Description | Question | Decode (Coded Value)
Datatyp
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])
Reason Treatment Discontinuation
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])
Reason Treatment Discontinuation
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])
Reason Treatment Discontinuation
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])
Reason Treatment Discontinuation
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])
Reason Treatment Discontinuation
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])
Reason Treatment Discontinuation
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])
Reason Treatment Discontinuation
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])
Reason Treatment Discontinuation
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])
Reason Treatment Discontinuation
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])
Reason Treatment Discontinuation
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])
Reason Treatment Discontinuation
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])
Reason Treatment Discontinuation
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)
Tillbaka till toppen 

Kontakt

Använd detta formulär för feedback, frågor och förslag på förbättringar.

Fält markerade med * är obligatoriska.

Hjälp

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