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ID

26167

Descrição

Study ID: 101468/196 Clinical Study ID: 101468/196 Study Title: 101468/196: A Long-Term, Open-Label Continuation Study of Once Daily Administration of Ropinirole CR Tablets to Patients with Parkinson's Disease who Completed the Previous Ropinirole CR Studies 167 or 164 Patient Level Data: Study Listed on ClinicalStudyDataRequest.com Clinicaltrials.gov Identifier: NCT00650104 Sponsor: GlaxoSmithKline Collaborators: N/A Phase: phase 3 Study Recruitment Status: Completed Generic Name: ropinirole Trade Name: Zygara,ZIPEREVE,ZEPREVE,Requip Depot,REQUIP,REPREVE,Modutab,ADARTREL Study Indication : Parkinson DiseaseA Long-Term, Open-Label Continuation Study of Once Daily Adminstration of Ropinirole CR Tablets to Patients with Parkinson's Disease Who Completed the Previous Ropinirole CR Studies - 167 & 164 End of Re-Enrollment Titration Period

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Versões (1)
  1. 10/10/2017 10/10/2017 -
Titular dos direitos

GlaxoSmithKline

Transferido a

10 de outubro de 2017

DOI

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Licença

Creative Commons BY-NC-ND 3.0
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    End of Re-Enrollment Titration Period Ropinirole in Parkinson's Disease GSK 101468/196

    Inglês

    End of Re-Enrollment Titration Period Ropinirole in Parkinson's Disease GSK 101468/196

    1 Formulários  
    Patient Information
    Descrição

    Patient Information

    Alias
    UMLS CUI-1
    C1955348
    Patient No.
    Descrição

    Patient Number

    Tipo de dados

    text

    Alias
    UMLS CUI [1]
    C1830427
    Date of Visit
    Descrição

    Date of Visit

    Tipo de dados

    date

    Unidades de medida
    • dd-mmm-yyyy
    Alias
    UMLS CUI [1]
    C1320303
    dd-mmm-yyyy
    End of Re-Enrollment Titration Period
    Descrição

    End of Re-Enrollment Titration Period

    Alias
    UMLS CUI-1
    C1516879
    UMLS CUI-2
    C1272693
    UMLS CUI-3
    C2983683
    Dose of Study Medication prescribed for Maintenance period:
    Descrição

    Dosage of study drug

    Tipo de dados

    float

    Unidades de medida
    • mg/d
    Alias
    UMLS CUI [1,1]
    C0178602
    UMLS CUI [1,2]
    C0304229
    mg/d
    At which week did Titration end?
    Descrição

    End Date of Titration

    Tipo de dados

    float

    Unidades de medida
    • week
    Alias
    UMLS CUI [1,1]
    C2983683
    UMLS CUI [1,2]
    C0806020
    week
    Investigator Signature
    Descrição

    Investigator Signature

    Alias
    UMLS CUI-1
    C2346576
    To be completed by the Principal Investigator: I have assumed responsibility for completeness and accurancy of all data recorded on these Titration Case Report Forms. Signature
    Descrição

    Signature

    Tipo de dados

    text

    Alias
    UMLS CUI [1]
    C1519316
    To be completed by the Principal Investigator: I have assumed responsibility for completeness and accurancy of all data recorded on these Titration Case Report Forms. Print Name:
    Descrição

    Investigator's Name

    Tipo de dados

    text

    Alias
    UMLS CUI [1]
    C2826892
    Date
    Descrição

    Date of Report

    Tipo de dados

    date

    Unidades de medida
    • dd-mmm-yyyy
    Alias
    UMLS CUI [1]
    C1302584
    dd-mmm-yyyy
    Voltar ao início da página

    Similar models

    End of Re-Enrollment Titration Period Ropinirole in Parkinson's Disease GSK 101468/196

    1 Formulários
    Name
    Tipo
    Description | Question | Decode (Coded Value)
    Tipo de dados
    Alias
    Item Group
    Patient Information
    C1955348 (UMLS CUI-1)
    Patient Number
    Item
    Patient No.
    text
    C1830427 (UMLS CUI [1])
    Date of Visit
    Item
    Date of Visit
    date
    C1320303 (UMLS CUI [1])
    Item Group
    End of Re-Enrollment Titration Period
    C1516879 (UMLS CUI-1)
    C1272693 (UMLS CUI-2)
    C2983683 (UMLS CUI-3)
    Dosage of study drug
    Item
    Dose of Study Medication prescribed for Maintenance period:
    float
    C0178602 (UMLS CUI [1,1])
    C0304229 (UMLS CUI [1,2])
    End Date of Titration
    Item
    At which week did Titration end?
    float
    C2983683 (UMLS CUI [1,1])
    C0806020 (UMLS CUI [1,2])
    Item Group
    Investigator Signature
    C2346576 (UMLS CUI-1)
    Signature
    Item
    To be completed by the Principal Investigator: I have assumed responsibility for completeness and accurancy of all data recorded on these Titration Case Report Forms. Signature
    text
    C1519316 (UMLS CUI [1])
    Investigator's Name
    Item
    To be completed by the Principal Investigator: I have assumed responsibility for completeness and accurancy of all data recorded on these Titration Case Report Forms. Print Name:
    text
    C2826892 (UMLS CUI [1])
    Date of Report
    Item
    Date
    date
    C1302584 (UMLS CUI [1])
    Voltar ao início da página 

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