ID
26766
Beschreibung
Study ID: 101468/125 Clinical Study ID: SKF-101468/125 Study Title: A double-blind, multicentre, flexible dose, L-dopa controlled study of ropinirole to investigate A) neuroprotective effect as measured by 3D PET scanning, and B) ophthalmological safety, in patients with early Parkinson’s disease Patient Level Data: Study Listed on ClinicalStudyDataRequest.com Clinicaltrials.gov Identifier: Sponsor: GlaxoSmithKline Collaborators: N/A Phase: phase 3 Study Recruitment Status: Completed Generic Name: ropinirole Trade Name: requip Study Indication: Restless Legs Syndrome
Stichworte
Versionen (1)
- 24.10.17 24.10.17 -
Rechteinhaber
GlaxoSmithKline
Hochgeladen am
24. Oktober 2017
DOI
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Lizenz
Creative Commons BY-NC 3.0
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L-dopa controlled study of ropinirole, neuroprotective effect and ophthalmological safety in early Parkinson’s disease 101468/125 Module 2 Visit 5 Month 3
L-dopa controlled study of ropinirole, neuroprotective effect and ophthalmological safety in early Parkinson’s disease 101468/125 Module 2 Visit 5 Month 3
Beschreibung
Flexible Dose Start Date and Current Dose Level
Beschreibung
Vital signs
Beschreibung
Sitting Blood Pressure
Datentyp
integer
Maßeinheiten
- mmHg
Beschreibung
Sitting Blood Pressure
Datentyp
integer
Maßeinheiten
- mmHg
Beschreibung
Sitting Heart Rate
Datentyp
integer
Maßeinheiten
- beats/min
Beschreibung
Concomitant Medication
Beschreibung
Adverse Experiences
Beschreibung
Transcribe any ongoing adverse experiences from the previous module, record any changes to ongoing adverse experiences, and details of any new adverse experiences observed or reported by the patient in the Adverse Experiences section towards the back of this module.
Datentyp
boolean
Beschreibung
Study Medication Compliance
Beschreibung
Compliance is defined as taking between approximately 80-120% of medication.
Datentyp
integer
Beschreibung
End of visit instructions for patients continuing
Datentyp
text
Beschreibung
End of visit constructions for patients not continuing
Datentyp
text
Beschreibung
Concomitant medication
Beschreibung
Permitted Concomitant medication
Datentyp
text
Beschreibung
Transcribe any ongoing concomitant medication from the previous module, and record any concomitant medication changes since the last visit. Any new medical illness/diagnosis or symptoms in the absence of a diagnosis should be recorded in the Adverse Experience section utilising the same terminology. lf a medication was marked 'Continuing' at the last visit, but has since had a dosage change or has been stopped, it must be recorded as a change with the start and end date.
Datentyp
boolean
Beschreibung
Details of Concomitant Medication
Beschreibung
Drug Name
Datentyp
text
Beschreibung
Total Daily Dose
Datentyp
integer
Maßeinheiten
- mg
Beschreibung
Medical Condition
Datentyp
text
Beschreibung
Approximate Start Date
Datentyp
date
Beschreibung
End Date
Datentyp
date
Beschreibung
Continuing
Datentyp
boolean
Beschreibung
For SB
Datentyp
text
Beschreibung
Levodopa rescue
Beschreibung
Patients must complete as a minimum the initial dose level 5. Titration of the dose of study medication to the maximum tolerated dose is encouraged. However if the patient´s symptoms remain inadequately controlled, open label L-dopa may be prescribed as a rescue medication.
Datentyp
text
Beschreibung
Levodopa - Rescue Therapy
Datentyp
text
Beschreibung
Levodopa - Rescue Therapy
Datentyp
text
Beschreibung
Primary reason
Datentyp
text
Beschreibung
Details of Ledopa Rescue Therapy
Beschreibung
Adverse Experiences
Beschreibung
Details on adverse experiences
Beschreibung
Experience
Datentyp
text
Beschreibung
For SB
Datentyp
text
Beschreibung
Date started
Datentyp
date
Beschreibung
Date stopped
Datentyp
date
Beschreibung
Duration if if less than 24 hrs
Datentyp
integer
Beschreibung
Experience continuing
Datentyp
boolean
Beschreibung
Course
Datentyp
boolean
Beschreibung
Number of episodes
Datentyp
integer
Beschreibung
Intensity
Datentyp
text
Beschreibung
Action taken on Study Medication
Datentyp
text
Beschreibung
Suspected relationship
Datentyp
text
Beschreibung
Corrective therapy
Datentyp
integer
Beschreibung
Serious adverse experience
Datentyp
boolean
Beschreibung
AEGIS
Datentyp
text
Beschreibung
Investigator´s signature
Datentyp
text
Beschreibung
Patient Continuation/Withdrawal
Beschreibung
Patient Continuation/Withdrawal
Datentyp
integer
Beschreibung
Most appropriate reason for withdrawal
Datentyp
integer
Beschreibung
Specification of other
Datentyp
text
Beschreibung
Date of last dose
Datentyp
date
Beschreibung
Investigator´s signature
Datentyp
text
Beschreibung
Date
Datentyp
date