ID
33832
Description
Study ID: 107032 Clinical Study ID: GLP107032 Study Title: An open-label study to evaluate the pharmacokinetics of an oral contraceptive containing Norethindrone and Ethinyl Estradiol when co-administered with GSK716155 in healthy adult female subjects Patient Level Data: Study Listed on ClinicalStudyDataRequest.com Clinicaltrials.gov Identifier: NCT01077505 Sponsor: GlaxoSmithKline Collaborators: N/A Phase: Phase 1 Study Recruitment Status: Completed Generic Name: albiglutide Trade Name: Tanzeum,Eperzan Study Indication: Diabetes Mellitus, Type 2
Keywords
Versions (1)
- 02-01-19 02-01-19 -
Copyright Holder
GSK group of companies
Uploaded on
2 januari 2019
DOI
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License
Creative Commons BY-NC 3.0
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Pharmacokinetics of an oral contraceptive co-administered with Albiglutide in women - 107032
Various Adverse Events: Hypoglycemia, Injection Site Reaction, Pancreatitis, Thyroid Nodes
Description
(Serious) Hypoglycaemic Events
Description
any protocol defined hypoglycaemic events?
Data type
boolean
Description
If Yes, please add Hypoglycaemic Event details on the following form.
Data type
text
Description
Serious Adverse Events
Description
AE/SAE Reference Number
Data type
integer
Description
Start date of Event
Data type
date
Description
Start Time of Event
Data type
time
Description
End date of Event
Data type
date
Description
End time of Event
Data type
time
Description
Blood Glucose Test Result at Time of Event
Data type
text
Description
Unit
Data type
text
Description
Frequency
Data type
text
Description
per ADA group guidelines
Data type
text
Description
at least one must be checked to fit the ADA criterion of severe
Data type
text
Description
number of hospitalization days
Data type
integer
Description
Intervention
Data type
text
Description
if Yes, please update Anti-Hyperglycaemic Medications page
Data type
text
Description
Injection Site Reaction
Description
AE/SAE Number
Data type
integer
Description
Date of Injection
Data type
date
Description
Date of Reaction
Data type
date
Description
maximum
Data type
integer
Measurement units
- mm
Description
maximum
Data type
integer
Measurement units
- mm
Description
Location of Injection
Data type
text
Description
If Other, specify
Data type
text
Description
timeframe of local reaction
Data type
boolean
Description
Redness / Erythema
Data type
text
Description
Itching / Pruritis
Data type
text
Description
Raised
Data type
text
Description
Warmth
Data type
text
Description
Other symptoms
Data type
text
Description
Specify Other symptoms
Data type
text
Description
Was treatment given for this local reaction?
Data type
boolean
Description
Subjects with a severe injection site reaction or a severe systemic allergic reaction must have three 1-mL serum samples obtained for immunogenicity testing.
Data type
boolean
Description
If Yes, please provide date
Data type
date
Description
Pancreatitis
Description
AE/SAE Number
Data type
integer
Description
Date of Onset
Data type
date
Description
Alcohol
Data type
text
Description
Average number of units consumed daily
Data type
integer
Description
Family History of Pancreatitis
Data type
boolean
Description
Grandmother (maternal)
Data type
text
Description
Grandfather (maternal)
Data type
text
Description
Grandmother (paternal)
Data type
text
Description
Grandfather (paternal)
Data type
text
Description
Mother
Data type
text
Description
Father
Data type
text
Description
Sibling 1
Data type
text
Description
specify
Data type
text
Description
Sibling 2
Data type
text
Description
specify
Data type
text
Description
Other
Data type
text
Description
specify
Data type
text
Description
Recent Trauma / Vascular Invasive Procedures or Surgery
Data type
text
Description
Date of Procedure
Data type
date
Description
Recent Trauma / Vascular Invasive Procedures or Surgery
Data type
text
Description
Date of Procedure
Data type
date
Description
Recent Trauma / Vascular Invasive Procedures or Surgery
Data type
text
Description
Date of Procedure
Data type
date
Description
Symptoms of Gastrointestinal Illness Associated with Pancreatitis
Description
Pain in the Epigastrium
Description
Pain in the Periumbical Region
Description
Pain in the Right Upper Quadrant
Description
Pain in the Left Upper Quadrant
Description
Pain in the Left Lower Quadrant
Description
Pain in the Right Lower Quadrant
Description
Pain in the Right Flank
Description
Pain in the Left Flank
Description
Pain in the Back
Description
Other Symptoms
Description
Nausea
Description
Vomiting
Description
Fever
Description
Biochemistry
Description
Alkaline phosphatase
Description
Was lab test performed?
Data type
boolean
Description
Lab Test Result
Data type
text
Description
Lab Unit
Data type
text
Description
Other lab unit, specify
Data type
text
Description
Lab LLN
Data type
text
Description
Lab ULN
Data type
text
Description
Total bilirubin
Description
Was lab test performed?
Data type
boolean
Description
Lab Test Result
Data type
text
Description
Lab Unit
Data type
text
Description
Other lab unit, specify
Data type
text
Description
Lab LLN
Data type
text
Description
Lab ULN
Data type
text
Description
Direct bilirubin
Description
Was lab test performed?
Data type
boolean
Description
Lab Test Result
Data type
text
Description
Lab Unit
Data type
text
Description
Other lab unit, specify
Data type
text
Description
Lab LLN
Data type
text
Description
Lab ULN
Data type
text
Description
Creatinine
Description
Was lab test performed?
Data type
boolean
Description
Lab Test Result
Data type
text
Description
Lab Unit
Data type
text
Description
Other lab unit, specify
Data type
text
Description
Lab LLN
Data type
text
Description
Lab ULN
Data type
text
Description
Other lab test
Description
Specify test
Data type
text
Description
Lab Test Result
Data type
text
Description
Lab Unit
Data type
text
Description
Other lab unit, specify
Data type
text
Description
Lab LLN
Data type
text
Description
Lab ULN
Data type
text
Description
Were additional Lab-Results Biochemistry evaluations performed?
Data type
boolean
Description
Diagnostic Studies - Pancreatitis
Description
Was Abdominal Ultrasound performed?
Data type
boolean
Description
Date of abdominal ultrasound
Data type
date
Description
If Yes, record the result
Data type
text
Description
Are there any evidence of cholelithiasis?
Data type
text
Description
Was an additional Abdominal Ultrasound performed?
Data type
boolean
Description
Abdominal CT Scan
Description
Was an abdominal CT Scan performed?
Data type
boolean
Description
If Yes, Date of Abdominal CT
Data type
date
Description
Record overall results
Data type
text
Description
If Abnormal, what are the diagnostic findings?
Data type
text
Description
Specify other
Data type
text
Description
Was an additional Abdominal CT Scan performed?
Data type
boolean
Description
MRI
Description
Was MRI performed?
Data type
boolean
Description
Date of MRI
Data type
date
Description
Results of MRI
Data type
text
Description
check all that apply
Data type
integer
Description
Was additional MRI performed?
Data type
boolean
Description
New Thyroid Nodules
Description
Bidimensional Measurement
Description
Thyroid Nodules AE Details
Description
Was an action taken?
Data type
boolean
Description
If Yes, please check all that apply
Data type
text
Description
check only one
Data type
text
Description
If Malignant, thyroid cancer, check all that apply
Data type
text
Description
Was an action taken due to fine needle aspirate pathology result?
Data type
boolean
Description
If Yes, please provide details:
Data type
text
Description
Thyroid function tests
Description
Free T4
Description
T4
Description
TSH
Description
Free T3
Description
T3 Uptake