ID

24288

Beschreibung

Study ID: 100468 Clinical Study ID: AVA100468 Study Title: An open-label extension to study AVA100193, to assess the long-term safety and efficacy of rosiglitazone (extended release tablets) in subjects with mild to moderate Alzheimer's disease Patient Level Data: Study Listed on ClinicalStudyDataRequest.com Clinicaltrials.gov Identifier: Sponsor: GlaxoSmithKline Collaborators: N/A Phase: phase 2 Study Recruitment Status: Completed Generic Name: rosiglitazone Trade Name: Avandia XR,Avandia; Avandia XR,Rosiglitazone XR,Avandia Study Indication: Alzheimer's Disease Non-Serious Adverse Event (AE)

Stichworte

  1. 28.07.17 28.07.17 -
Rechteinhaber

GlaxoSmithKline

Hochgeladen am

28. Juli 2017

DOI

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Creative Commons BY-NC-ND 3.0

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Non-Serious Adverse Event (AE) GSK Rosiglitazone Alzheimer's disease 100468

Non-Serious Adverse Event (AE) GSK Rosiglitazone Alzheimer's disease 100468

Patient Information
Beschreibung

Patient Information

Alias
UMLS CUI-1
C1955348
Subject Identifier
Beschreibung

Subject Identifier

Datentyp

text

Alias
UMLS CUI [1]
C2348585
Non-Serious Adverse Events - Note: If this is a Serious Adverse Event (SAE), do not complete this form, go to the SAE section and complete the SAE form.
Beschreibung

Non-Serious Adverse Events - Note: If this is a Serious Adverse Event (SAE), do not complete this form, go to the SAE section and complete the SAE form.

Alias
UMLS CUI-1
C1518404
Did the subject experience any non-serious adverse events during the study?
Beschreibung

If YES, record details below.

Datentyp

text

Alias
UMLS CUI [1]
C1518404
Event (e.g. Headache) Diagnosis Only (if known) otherwise Sign/Symptom. If a diagnosis subsequently becomes available, then this should be entered and the sign or symptom crossed out, initiated and dated by the investigator.
Beschreibung

Non-Serious Adverse Events Diagnosis

Datentyp

text

Alias
UMLS CUI [1,1]
C1518404
UMLS CUI [1,2]
C0011900
Start Date (e.g. 25 Jan 02) Record the start date of the first occurence of the AE.
Beschreibung

Start Date

Datentyp

date

Maßeinheiten
  • dd-mmm-yy
dd-mmm-yy
Outcome (e.g. 1) All AEs must be followed until the events are resolved, the condition stabilises, the events are otherwise explained, or the subject is lost to follow-up. Indicate if the event was 'Recovered/Resolved' or 'Recovered/Resolved with sequelae'. If the AE is ongoing at the time the subject completes the study or becomes lost to follow-up, the outcome must be recorded as 'Not recovered/Not resolved' or 'Recovering/Resolving'. Also enter 'Not recovered/Not resolved' if the AE was ongoing at the time of death, but was not the cause of death.
Beschreibung

Outcome

Datentyp

integer

End Date (e.g. 27 Jan 02) Record the end date. This is the date the AE Recovered/Resolved. If the event Recovered/Resolved with sequelae, enter the date the subject's medical condition resolved or stabilised. Leave blank if the AE is 'Not recovered/Not resolved' or 'Recovering/Resolving'.
Beschreibung

End Date

Datentyp

date

Maßeinheiten
  • dd-mmm-yy
dd-mmm-yy
Maximum Intesity (e.g. 1) Record the maximum intesity that occured over the duration of the event. Amend the intesity if it increases. Mild = An event that is easily tolerated by the subject, causing minimal discomfort and not interfering with everyday activities. Moderate = An event that is sufficiently discomforting to interfere with normal everyday activities. Severe = An event that prevents normal everday activities. Not applicable = those event(s) where intensity is meaningless or impossible to determine (i.e. blindness and coma)
Beschreibung

Maximum Intesity

Datentyp

text

Action Taken with Investigational Product(s) as a Result of the Non-Serious AE (e.g. 4) Investigational product(s) withdrawn = Administration of investigational product(s) was permanently discontinued. Dose reduced = Dose is reduced for one or more investigational product(s). Dose increased = Dose increased for one or more investigational product(s). Dose not changed = Investigational product(s) continues even though an adverse event has occured. Dose interrupted = Administration of one or more investigational product(s) was stopped temporarily but then restarted. Not applicable = Subject was not receiving investigational product(s) when the event occured (e.g. pre- or post-dosing).
Beschreibung

Action Taken

Datentyp

text

Withdrawal (e.g. Y) Did the subject withdrawal from study as a result of this AE? Indicate 'YES' if the event(s) were directly responsible for the subject's withdrawal as a indicated on the Study Conclusion page, otherwise indicate 'NO'.
Beschreibung

* Complete Study Conclusion page and tick Adverse event as reason for withdrawal.

Datentyp

text

Relationship to Investigational Product(s) (e.g. Y) Is there a reasonable possibility that the AE may have been caused by the investigational product? It is a regulatory requirement for investigators to assess relationship to investigational product(s) based on information available. The assessment should be reviewed on receipt of any new information and amended if necessary. 'A reasonable possibility' is meant to convey that there are facts/evidence or arguments to suggest a causal relationship. Facts/evidence or arguments that may support 'a reasonable possibility' include, e.g. a temporal relationship, a pharmacologically-predicted event, or positive dechallenge or rechallenge. Confounding factors, such as concomitant medication, a concurrent illness, or relevant medical history, should also be considered.
Beschreibung

Relationship

Datentyp

text

Ähnliche Modelle

Non-Serious Adverse Event (AE) GSK Rosiglitazone Alzheimer's disease 100468

Name
Typ
Description | Question | Decode (Coded Value)
Datentyp
Alias
Item Group
Patient Information
C1955348 (UMLS CUI-1)
Subject Identifier
Item
Subject Identifier
text
C2348585 (UMLS CUI [1])
Item Group
Non-Serious Adverse Events - Note: If this is a Serious Adverse Event (SAE), do not complete this form, go to the SAE section and complete the SAE form.
C1518404 (UMLS CUI-1)
Item
Did the subject experience any non-serious adverse events during the study?
text
C1518404 (UMLS CUI [1])
Code List
Did the subject experience any non-serious adverse events during the study?
CL Item
Yes (Y)
CL Item
No (N)
Non-Serious Adverse Events Diagnosis
Item
Event (e.g. Headache) Diagnosis Only (if known) otherwise Sign/Symptom. If a diagnosis subsequently becomes available, then this should be entered and the sign or symptom crossed out, initiated and dated by the investigator.
text
C1518404 (UMLS CUI [1,1])
C0011900 (UMLS CUI [1,2])
Start Date
Item
Start Date (e.g. 25 Jan 02) Record the start date of the first occurence of the AE.
date
Item
Outcome (e.g. 1) All AEs must be followed until the events are resolved, the condition stabilises, the events are otherwise explained, or the subject is lost to follow-up. Indicate if the event was 'Recovered/Resolved' or 'Recovered/Resolved with sequelae'. If the AE is ongoing at the time the subject completes the study or becomes lost to follow-up, the outcome must be recorded as 'Not recovered/Not resolved' or 'Recovering/Resolving'. Also enter 'Not recovered/Not resolved' if the AE was ongoing at the time of death, but was not the cause of death.
integer
Code List
Outcome (e.g. 1) All AEs must be followed until the events are resolved, the condition stabilises, the events are otherwise explained, or the subject is lost to follow-up. Indicate if the event was 'Recovered/Resolved' or 'Recovered/Resolved with sequelae'. If the AE is ongoing at the time the subject completes the study or becomes lost to follow-up, the outcome must be recorded as 'Not recovered/Not resolved' or 'Recovering/Resolving'. Also enter 'Not recovered/Not resolved' if the AE was ongoing at the time of death, but was not the cause of death.
CL Item
Recovered/Resolved (1)
CL Item
Recovering/Resolving (2)
CL Item
Not recovered/Not resolved (3)
CL Item
Recovered/Resolved with sequelae (4)
End Date
Item
End Date (e.g. 27 Jan 02) Record the end date. This is the date the AE Recovered/Resolved. If the event Recovered/Resolved with sequelae, enter the date the subject's medical condition resolved or stabilised. Leave blank if the AE is 'Not recovered/Not resolved' or 'Recovering/Resolving'.
date
Item
Maximum Intesity (e.g. 1) Record the maximum intesity that occured over the duration of the event. Amend the intesity if it increases. Mild = An event that is easily tolerated by the subject, causing minimal discomfort and not interfering with everyday activities. Moderate = An event that is sufficiently discomforting to interfere with normal everyday activities. Severe = An event that prevents normal everday activities. Not applicable = those event(s) where intensity is meaningless or impossible to determine (i.e. blindness and coma)
text
Code List
Maximum Intesity (e.g. 1) Record the maximum intesity that occured over the duration of the event. Amend the intesity if it increases. Mild = An event that is easily tolerated by the subject, causing minimal discomfort and not interfering with everyday activities. Moderate = An event that is sufficiently discomforting to interfere with normal everyday activities. Severe = An event that prevents normal everday activities. Not applicable = those event(s) where intensity is meaningless or impossible to determine (i.e. blindness and coma)
CL Item
Mild (1)
CL Item
Moderate (2)
CL Item
Severe (3)
CL Item
Not applicable (X)
Item
Action Taken with Investigational Product(s) as a Result of the Non-Serious AE (e.g. 4) Investigational product(s) withdrawn = Administration of investigational product(s) was permanently discontinued. Dose reduced = Dose is reduced for one or more investigational product(s). Dose increased = Dose increased for one or more investigational product(s). Dose not changed = Investigational product(s) continues even though an adverse event has occured. Dose interrupted = Administration of one or more investigational product(s) was stopped temporarily but then restarted. Not applicable = Subject was not receiving investigational product(s) when the event occured (e.g. pre- or post-dosing).
text
Code List
Action Taken with Investigational Product(s) as a Result of the Non-Serious AE (e.g. 4) Investigational product(s) withdrawn = Administration of investigational product(s) was permanently discontinued. Dose reduced = Dose is reduced for one or more investigational product(s). Dose increased = Dose increased for one or more investigational product(s). Dose not changed = Investigational product(s) continues even though an adverse event has occured. Dose interrupted = Administration of one or more investigational product(s) was stopped temporarily but then restarted. Not applicable = Subject was not receiving investigational product(s) when the event occured (e.g. pre- or post-dosing).
CL Item
Investigational product(s) withdrawn (1)
CL Item
Dose reduced (2)
CL Item
Dose increased (3)
CL Item
Dose not changed (4)
CL Item
Dose interrupted (5)
CL Item
Not applicable (X)
Item
Withdrawal (e.g. Y) Did the subject withdrawal from study as a result of this AE? Indicate 'YES' if the event(s) were directly responsible for the subject's withdrawal as a indicated on the Study Conclusion page, otherwise indicate 'NO'.
text
Code List
Withdrawal (e.g. Y) Did the subject withdrawal from study as a result of this AE? Indicate 'YES' if the event(s) were directly responsible for the subject's withdrawal as a indicated on the Study Conclusion page, otherwise indicate 'NO'.
CL Item
Yes* (Y)
CL Item
No (N)
Item
Relationship to Investigational Product(s) (e.g. Y) Is there a reasonable possibility that the AE may have been caused by the investigational product? It is a regulatory requirement for investigators to assess relationship to investigational product(s) based on information available. The assessment should be reviewed on receipt of any new information and amended if necessary. 'A reasonable possibility' is meant to convey that there are facts/evidence or arguments to suggest a causal relationship. Facts/evidence or arguments that may support 'a reasonable possibility' include, e.g. a temporal relationship, a pharmacologically-predicted event, or positive dechallenge or rechallenge. Confounding factors, such as concomitant medication, a concurrent illness, or relevant medical history, should also be considered.
text
Code List
Relationship to Investigational Product(s) (e.g. Y) Is there a reasonable possibility that the AE may have been caused by the investigational product? It is a regulatory requirement for investigators to assess relationship to investigational product(s) based on information available. The assessment should be reviewed on receipt of any new information and amended if necessary. 'A reasonable possibility' is meant to convey that there are facts/evidence or arguments to suggest a causal relationship. Facts/evidence or arguments that may support 'a reasonable possibility' include, e.g. a temporal relationship, a pharmacologically-predicted event, or positive dechallenge or rechallenge. Confounding factors, such as concomitant medication, a concurrent illness, or relevant medical history, should also be considered.
CL Item
Yes (Y)
CL Item
No (N)

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