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ID

32497

Description

Study ID: 106837 Clinical Study ID: HZA106837 Study Title: A Long-Term, Randomized, Double-Blind, Parallel Group Study of Fluticasone Furoate/GW642444 Inhalation Powder Once-Daily and Fluticasone Furoate Inhalation Powder Once-Daily in Subjects with Asthma Patient Level Data: Study Listed on ClinicalStudyDataRequest.com Clinicaltrials.gov Identifier: NCT01086384 Sponsor: GlaxoSmithKline Collaborators: N/A Phase: Phase 3 Study Recruitment Status: Completed Generic Name: fluticasone furoate/vilanterol Trade Name: Relvar Study Indication: Asthma

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Versions (4)
  1. 11/5/18 11/5/18 -
  2. 11/5/18 11/5/18 -
  3. 12/4/18 12/4/18 -
  4. 10/30/19 10/30/19 - Sarah Riepenhausen
Copyright Holder

GSK group of companies

Uploaded on

November 5, 2018

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License

Creative Commons BY-NC 3.0
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    A Parallel Group Study of Fluticasone Furoate/Vilanterol in Subjects with Asthma - 106837

    English

    Concomitant Medications Form

    1 forms  
    Concomitant Medication Details
    Description

    Concomitant Medication Details

    Sequence Number
    Description

    Sequence Number

    Data type

    text

    Drug Name
    Description

    Trade Name Preferred

    Data type

    text

    Unit Dose
    Description

    Unit Dose

    Data type

    integer

    Units
    Description

    Units

    Data type

    text

    Frequency
    Description

    Frequency

    Data type

    text

    Route
    Description

    Route

    Data type

    text

    Reason for Medication
    Description

    Reason for Medication

    Data type

    text

    Generic dispensed?
    Description

    Generic dispensed?

    Data type

    boolean

    Prescription or OTC?
    Description

    Prescription or OTC?

    Data type

    text

    Start Date
    Description

    Start Date

    Data type

    date

    Taken prior to study?
    Description

    Taken prior to study?

    Data type

    boolean

    Ongoing?
    Description

    Ongoing?

    Data type

    boolean

    If NO, record the End Date
    Description

    If NO, record the End Date

    Data type

    date

    Device Used to Administer Medication
    Description

    Device Used to Administer Medication

    Data type

    text

    Total Daily Dose
    Description

    Total Daily Dose

    Data type

    text

    Was drug administered for an exacerbation?
    Description

    Was drug administered for an exacerbation?

    Data type

    boolean

    Was drug administered as a rescue medication?
    Description

    Was drug administered as a rescue medication?

    Data type

    boolean

    Cumulative Dose Used?
    Description

    Cumulative Dose Used?

    Data type

    text

    Was drug ever used?
    Description

    Was drug ever used?

    Data type

    boolean

    Total duration
    Description

    Total duration

    Data type

    text

    Duration Unit
    Description

    Duration Unit

    Data type

    text

    Medication Type
    Description

    Medication Type

    Data type

    text

    Back to the top of the page

    Similar models

    Concomitant Medications Form

    1 forms
    Name
    Type
    Description | Question | Decode (Coded Value)
    Data type
    Alias
    Item Group
    Concomitant Medication Details
    Sequence Number
    Item
    Sequence Number
    text
    Drug Name
    Item
    Drug Name
    text
    Unit Dose
    Item
    Unit Dose
    integer
    Units
    Item
    Units
    text
    Frequency
    Item
    Frequency
    text
    Route
    Item
    Route
    text
    Reason for Medication
    Item
    Reason for Medication
    text
    Generic dispensed?
    Item
    Generic dispensed?
    boolean
    Item
    Prescription or OTC?
    text
    Prescription of OTC?
    Code List
    Prescription or OTC?
    CL Item
    Prescription (1)
    CL Item
    OTC (2)
    Start Date
    Item
    Start Date
    date
    Taken prior to study?
    Item
    Taken prior to study?
    boolean
    Ongoing?
    Item
    Ongoing?
    boolean
    If NO, record the End Date
    Item
    If NO, record the End Date
    date
    Device Used to Administer Medication
    Item
    Device Used to Administer Medication
    text
    Total Daily Dose
    Item
    Total Daily Dose
    text
    Was drug administered for an exacerbation?
    Item
    Was drug administered for an exacerbation?
    boolean
    Was drug administered as a rescue medication?
    Item
    Was drug administered as a rescue medication?
    boolean
    Cumulative Dose Used?
    Item
    Cumulative Dose Used?
    text
    Was drug ever used?
    Item
    Was drug ever used?
    boolean
    Total duration
    Item
    Total duration
    text
    Item
    Duration Unit
    text
    Duration Unit
    Code List
    Duration Unit
    CL Item
    Days (1)
    CL Item
    Months (2)
    CL Item
    Weeks (3)
    CL Item
    Years (4)
    Item
    Medication Type
    text
    Medication Type
    Code List
    Medication Type
    CL Item
    Non-Asthma (1)
    CL Item
    Asthma (2)
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