ID

26030

Descrizione

Study ID: 100601 Clinical Study ID: LPL100601 Study Title: LPL100601, A Clinical Outcomes Study of Darapladib versus Placebo in Subjects with Chronic Coronary Heart Disease to Compare the Incidence of Major Adverse Cardiovascular Events (MACE) Patient Level Data: Study Listed on ClinicalStudyDataRequest.com Clinicaltrials.gov Identifier: NCT00799903 Sponsor: GlaxoSmithKline Collaborators: N/A Phase: phase 3 Study Recruitment Status: Completed Generic Name: darapladib Trade Name: darapladib Study Indication: Atherosclerosis Study part: Hypersensitivity Reaction Record - Repeating form (Scheduled visits)

Keywords

  1. 04/10/17 04/10/17 -
  2. 16/10/17 16/10/17 -
  3. 23/10/17 23/10/17 -
  4. 01/01/18 01/01/18 -
  5. 03/01/18 03/01/18 -
Titolare del copyright

GlaxoSmithKline

Caricato su

4 ottobre 2017

DOI

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Licenza

Creative Commons BY-NC 3.0

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Hypersensitivity Reaction Record GSK study Chronic Coronary Heart Disease NCT00799903

Hypersensitivity Reaction Record GSK study Chronic Coronary Heart Disease NCT00799903

1. Event number
Descrizione

1. Event number

Event number
Descrizione

Enter the Event Number from item 1 on the Anaphylaxis Diagnosis (ANA) form

Tipo di dati

text

Past medical conditions: 2. Food allergies
Descrizione

Past medical conditions: 2. Food allergies

Anaphylactic reaction to food
Descrizione

Anaphylactic reaction to food

Tipo di dati

integer

Angioedema
Descrizione

Angioedema food

Tipo di dati

integer

Urticaria
Descrizione

Urticaria food

Tipo di dati

integer

Past medical conditions: 3. Hymenoptera sting allergy
Descrizione

Past medical conditions: 3. Hymenoptera sting allergy

Anaphylaxis
Descrizione

Anaphylaxis Hymenoptera sting allergy

Tipo di dati

integer

Angioedema
Descrizione

Angioedema Hymenoptera sting allergy

Tipo di dati

integer

Urticaria
Descrizione

Urticaria Hymenoptera sting allergy

Tipo di dati

integer

Past medical conditions: 4. Latex allergy
Descrizione

Past medical conditions: 4. Latex allergy

Anaphylaxis
Descrizione

Anaphylaxis Latex

Tipo di dati

integer

Angioedema
Descrizione

Angioedema latex

Tipo di dati

integer

Urticaria
Descrizione

Urticaria latex

Tipo di dati

integer

Past medical conditions: 5. Penicillin allergy
Descrizione

Past medical conditions: 5. Penicillin allergy

Anaphylactic reaction to drug
Descrizione

Anaphylactic reaction penicillin

Tipo di dati

integer

Angioedema
Descrizione

Angioedema penicillin

Tipo di dati

integer

Drug induced urticaria
Descrizione

Drug induced urticaria penicillin

Tipo di dati

integer

Past medical conditions: 6. Cephalosporin allergy
Descrizione

Past medical conditions: 6. Cephalosporin allergy

Anaphylactic reaction to drug
Descrizione

Anaphylactic reaction to Cephalosporin

Tipo di dati

integer

Angioedema
Descrizione

Angioedema Cephalosporin

Tipo di dati

integer

Drug induced urticaria
Descrizione

Drug induced urticaria Cephalosporin

Tipo di dati

integer

Past medical conditions: 7. Aspirin allergy
Descrizione

Past medical conditions: 7. Aspirin allergy

Anaphylactic reaction to drug
Descrizione

Anaphylactic reaction to aspirin

Tipo di dati

integer

Angioedema
Descrizione

Angioedema aspirin

Tipo di dati

integer

Drug induced urticaria
Descrizione

Drug induced urticaria aspirin

Tipo di dati

integer

Past medical conditions: 8. NSAID allergy
Descrizione

Past medical conditions: 8. NSAID allergy

Anaphylactic reaction to drug
Descrizione

Anaphylactic reaction to NSAID

Tipo di dati

integer

Angioedema
Descrizione

Angioedema NSAID

Tipo di dati

integer

Drug induced urticaria
Descrizione

Drug induced urticaria NSAID

Tipo di dati

integer

Past medical conditions: 9. ACE inhibitor allergy
Descrizione

Past medical conditions: 9. ACE inhibitor allergy

Anaphylactic reaction to drug
Descrizione

Anaphylactic reaction to ACE inhibitor

Tipo di dati

integer

Angioedema
Descrizione

Angioedema ACE inhibitor

Tipo di dati

integer

Drug induced urticaria
Descrizione

Drug induced urticaria ACE inhibitor

Tipo di dati

integer

Other allergies
Descrizione

Other allergies

10.a Specific Condition
Descrizione

Specific Condition Other allergies

Tipo di dati

text

10.b Status
Descrizione

This item is optional

Tipo di dati

integer

Symptoms associated with this hypersensitivity reaction: 11. Stevens-Johnson syndrome
Descrizione

Symptoms associated with this hypersensitivity reaction: 11. Stevens-Johnson syndrome

Symptoms
Descrizione

Symptoms Stevens-Johnson syndrome

Tipo di dati

text

Blisters
Descrizione

Blisters Stevens-Johnson syndrome

Tipo di dati

boolean

Biopsy confirmed
Descrizione

Biopsy confirmed Stevens-Johnson syndrome

Tipo di dati

boolean

Mucous membrane involvement
Descrizione

Mucous membrane involvement Stevens-Johnson syndrome

Tipo di dati

boolean

Symptom start date
Descrizione

Stevens-Johnson syndrome Symptom start date

Tipo di dati

date

Symptoms associated with this hypersensitivity reaction: 12. Toxic epidermal necrolysis
Descrizione

Symptoms associated with this hypersensitivity reaction: 12. Toxic epidermal necrolysis

Symptoms
Descrizione

Symptoms Toxic epidermal necrolysis

Tipo di dati

text

Blisters
Descrizione

Blisters Toxic epidermal necrolysis

Tipo di dati

boolean

Biopsy confirmed
Descrizione

Biopsy confirmed Toxic epidermal necrolysis

Tipo di dati

boolean

Mucous membrane involvement
Descrizione

Mucous membrane involvement Toxic epidermal necrolysis

Tipo di dati

boolean

Symptom start date
Descrizione

Symptom start date Toxic epidermal necrolysis

Tipo di dati

date

Symptoms associated with this hypersensitivity reaction: 13. Urticaria (hives)
Descrizione

Symptoms associated with this hypersensitivity reaction: 13. Urticaria (hives)

Symptoms
Descrizione

Symptoms Urticaria (hives)

Tipo di dati

text

Generalised
Descrizione

Generalised Urticaria (hives)

Tipo di dati

boolean

Localised
Descrizione

Localised Urticaria (hives)

Tipo di dati

boolean

Photosensitivity
Descrizione

Photosensitivity Urticaria (hives)

Tipo di dati

boolean

Other
Descrizione

Other symptoms Urticaria (hives)

Tipo di dati

boolean

Other, specify
Descrizione

Other symptoms Urticaria (hives) specification

Tipo di dati

text

Symptom start date
Descrizione

Symptom start date Urticaria (hives)

Tipo di dati

date

Symptoms associated with this hypersensitivity reaction: 14. Angioedema
Descrizione

Symptoms associated with this hypersensitivity reaction: 14. Angioedema

Symptoms
Descrizione

Symptoms Angioedema

Tipo di dati

text

Face (including eyes, lips)
Descrizione

Angioedema Face

Tipo di dati

boolean

Throat (including tongue, larynx)
Descrizione

Angioedema Throat

Tipo di dati

boolean

Laryngeal
Descrizione

Angioedema Laryngeal

Tipo di dati

boolean

Dyspnoea
Descrizione

Angioedema Dyspnoea

Tipo di dati

boolean

Dysphagia
Descrizione

Angioedema Dysphagia

Tipo di dati

boolean

Required intubation
Descrizione

Angioedema Required intubation

Tipo di dati

boolean

Other
Descrizione

Angioedema Other symptoms

Tipo di dati

boolean

Other, specify
Descrizione

Angioedema Other symptoms specification

Tipo di dati

text

Symptom start date
Descrizione

Symptom start date Angioedema

Tipo di dati

date

Symptoms associated with this hypersensitivity reaction: 15. Anaphylactic/Anaphylactoid reaction
Descrizione

Symptoms associated with this hypersensitivity reaction: 15. Anaphylactic/Anaphylactoid reaction

Symptoms
Descrizione

Anaphylactic/Anaphylactoid reaction symptoms

Tipo di dati

text

Dyspnoea
Descrizione

Dyspnoea Anaphylactic/Anaphylactoid reaction

Tipo di dati

boolean

Bronchospasm
Descrizione

Bronchospasm Anaphylactic/Anaphylactoid reaction

Tipo di dati

boolean

Hypotension
Descrizione

Hypotension Anaphylactic/Anaphylactoid reaction

Tipo di dati

boolean

Loss of consciousness
Descrizione

Loss of consciousness Anaphylactic/Anaphylactoid reaction

Tipo di dati

boolean

Persistent gastrointestinal symptoms (crampy abdominal pain, vomiting)
Descrizione

Persistent gastrointestinal symptoms Anaphylactic/Anaphylactoid reaction

Tipo di dati

boolean

Other
Descrizione

Other symptoms Anaphylactic/Anaphylactoid reaction

Tipo di dati

boolean

Other, specify
Descrizione

Other symptoms specidication Anaphylactic/Anaphylactoid reaction

Tipo di dati

text

Symptom start date
Descrizione

Symptom start date Anaphylactic/Anaphylactoid reaction

Tipo di dati

date

Symptoms associated with this hypersensitivity reaction: 16. Other symptoms of hypersensitivity reaction
Descrizione

Symptoms associated with this hypersensitivity reaction: 16. Other symptoms of hypersensitivity reaction

Symptoms
Descrizione

Symptoms Other symptoms of hypersensitivity reaction

Tipo di dati

text

Rash
Descrizione

Other symptoms of hypersensitivity reaction Rash

Tipo di dati

boolean

Photosensitivity
Descrizione

Other symptoms of hypersensitivity reaction Photosensitivity

Tipo di dati

boolean

Other
Descrizione

Other symptoms of hypersensitivity reaction

Tipo di dati

boolean

Other, specify
Descrizione

Other symptoms of hypersensitivity reaction specification

Tipo di dati

text

Symptom start date
Descrizione

Start date Other symptoms of hypersensitivity reaction

Tipo di dati

date

Similar models

Hypersensitivity Reaction Record GSK study Chronic Coronary Heart Disease NCT00799903

Name
genere
Description | Question | Decode (Coded Value)
Tipo di dati
Alias
Item Group
1. Event number
Event number
Item
Event number
text
Item Group
Past medical conditions: 2. Food allergies
Item
Anaphylactic reaction to food
integer
Code List
Anaphylactic reaction to food
CL Item
Past (2)
CL Item
No medical history (3)
Item
Angioedema
integer
Code List
Angioedema
CL Item
Past (2)
CL Item
No medical history (3)
Item
Urticaria
integer
CL Item
Past (2)
CL Item
No medical history (3)
Item Group
Past medical conditions: 3. Hymenoptera sting allergy
Code List
Anaphylaxis
CL Item
Past (2)
CL Item
No medical history (3)
Code List
Angioedema
CL Item
Past (2)
CL Item
No medical history (3)
CL Item
Past (2)
CL Item
No medical history (3)
Item Group
Past medical conditions: 4. Latex allergy
Item
Anaphylaxis
integer
Code List
Anaphylaxis
CL Item
Past (2)
CL Item
No medical history (3)
Item
Angioedema
integer
Code List
Angioedema
CL Item
Past (2)
CL Item
No medical history (3)
Item
Urticaria
integer
CL Item
Past (2)
CL Item
No medical history (3)
Item Group
Past medical conditions: 5. Penicillin allergy
Item
Anaphylactic reaction to drug
integer
Code List
Anaphylactic reaction to drug
CL Item
Past (2)
CL Item
No medical history (3)
Item
Angioedema
integer
Code List
Angioedema
CL Item
Past (2)
CL Item
No medical history (3)
Item
Drug induced urticaria
integer
Code List
Drug induced urticaria
CL Item
Past (2)
CL Item
No medical history (3)
Item Group
Past medical conditions: 6. Cephalosporin allergy
Item
Anaphylactic reaction to drug
integer
Code List
Anaphylactic reaction to drug
CL Item
Past (2)
CL Item
No medical history (3)
Item
Angioedema
integer
Code List
Angioedema
CL Item
Past (2)
CL Item
No medical history (3)
Item
Drug induced urticaria
integer
Code List
Drug induced urticaria
CL Item
Past (2)
CL Item
No medical history (3)
Item Group
Past medical conditions: 7. Aspirin allergy
Item
Anaphylactic reaction to drug
integer
Code List
Anaphylactic reaction to drug
CL Item
Past (2)
CL Item
No medical history (3)
Item
Angioedema
integer
Code List
Angioedema
CL Item
Past (2)
CL Item
No medical history (3)
Item
Drug induced urticaria
integer
Code List
Drug induced urticaria
CL Item
Past (2)
CL Item
No medical history (3)
Item Group
Past medical conditions: 8. NSAID allergy
Item
Anaphylactic reaction to drug
integer
Code List
Anaphylactic reaction to drug
CL Item
Past (2)
CL Item
No medical history (3)
Item
Angioedema
integer
Code List
Angioedema
CL Item
Past (2)
CL Item
No medical history (3)
Item
Drug induced urticaria
integer
Code List
Drug induced urticaria
CL Item
Past (2)
CL Item
No medical history (3)
Item Group
Past medical conditions: 9. ACE inhibitor allergy
Item
Anaphylactic reaction to drug
integer
Code List
Anaphylactic reaction to drug
CL Item
Past (2)
CL Item
No medical history (3)
Item
Angioedema
integer
Code List
Angioedema
CL Item
Past (2)
CL Item
No medical history (3)
Item
Drug induced urticaria
integer
Code List
Drug induced urticaria
CL Item
Past (2)
CL Item
No medical history (3)
Item Group
Other allergies
Specific Condition Other allergies
Item
10.a Specific Condition
text
Item
10.b Status
integer
Code List
10.b Status
CL Item
Past (2)
Item Group
Symptoms associated with this hypersensitivity reaction: 11. Stevens-Johnson syndrome
CL Item
None (None)
CL Item
Check all that apply (Check all that apply)
Blisters Stevens-Johnson syndrome
Item
Blisters
boolean
Biopsy confirmed Stevens-Johnson syndrome
Item
Biopsy confirmed
boolean
Mucous membrane involvement Stevens-Johnson syndrome
Item
Mucous membrane involvement
boolean
Stevens-Johnson syndrome Symptom start date
Item
Symptom start date
date
Item Group
Symptoms associated with this hypersensitivity reaction: 12. Toxic epidermal necrolysis
CL Item
None (None)
CL Item
Check all that apply (Check all that apply)
Blisters Toxic epidermal necrolysis
Item
Blisters
boolean
Biopsy confirmed Toxic epidermal necrolysis
Item
Biopsy confirmed
boolean
Mucous membrane involvement Toxic epidermal necrolysis
Item
Mucous membrane involvement
boolean
Symptom start date Toxic epidermal necrolysis
Item
Symptom start date
date
Item Group
Symptoms associated with this hypersensitivity reaction: 13. Urticaria (hives)
Item
Symptoms
text
CL Item
None (None)
CL Item
Check all that apply (Check all that apply)
Generalised Urticaria (hives)
Item
Generalised
boolean
Localised Urticaria (hives)
Item
Localised
boolean
Photosensitivity Urticaria (hives)
Item
Photosensitivity
boolean
Other symptoms Urticaria (hives)
Item
Other
boolean
Other symptoms Urticaria (hives) specification
Item
Other, specify
text
Symptom start date Urticaria (hives)
Item
Symptom start date
date
Item Group
Symptoms associated with this hypersensitivity reaction: 14. Angioedema
Item
Symptoms
text
CL Item
None (None)
CL Item
Check all that apply (Check all that apply)
Angioedema Face
Item
Face (including eyes, lips)
boolean
Angioedema Throat
Item
Throat (including tongue, larynx)
boolean
Angioedema Laryngeal
Item
Laryngeal
boolean
Angioedema Dyspnoea
Item
Dyspnoea
boolean
Angioedema Dysphagia
Item
Dysphagia
boolean
Angioedema Required intubation
Item
Required intubation
boolean
Angioedema Other symptoms
Item
Other
boolean
Angioedema Other symptoms specification
Item
Other, specify
text
Symptom start date Angioedema
Item
Symptom start date
date
Item Group
Symptoms associated with this hypersensitivity reaction: 15. Anaphylactic/Anaphylactoid reaction
CL Item
None (None)
CL Item
Check all that apply (Check all that apply)
Dyspnoea Anaphylactic/Anaphylactoid reaction
Item
Dyspnoea
boolean
Bronchospasm Anaphylactic/Anaphylactoid reaction
Item
Bronchospasm
boolean
Hypotension Anaphylactic/Anaphylactoid reaction
Item
Hypotension
boolean
Loss of consciousness Anaphylactic/Anaphylactoid reaction
Item
Loss of consciousness
boolean
Persistent gastrointestinal symptoms Anaphylactic/Anaphylactoid reaction
Item
Persistent gastrointestinal symptoms (crampy abdominal pain, vomiting)
boolean
Other symptoms Anaphylactic/Anaphylactoid reaction
Item
Other
boolean
Other symptoms specidication Anaphylactic/Anaphylactoid reaction
Item
Other, specify
text
Symptom start date Anaphylactic/Anaphylactoid reaction
Item
Symptom start date
date
Item Group
Symptoms associated with this hypersensitivity reaction: 16. Other symptoms of hypersensitivity reaction
CL Item
None (None)
CL Item
Check all that apply (Check all that apply)
Other symptoms of hypersensitivity reaction Rash
Item
Rash
boolean
Other symptoms of hypersensitivity reaction Photosensitivity
Item
Photosensitivity
boolean
Other symptoms of hypersensitivity reaction
Item
Other
boolean
Other symptoms of hypersensitivity reaction specification
Item
Other, specify
text
Start date Other symptoms of hypersensitivity reaction
Item
Symptom start date
date

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