ID

34425

Description

Study ID: 101998 Clinical Study ID: 101998 Study Title: A randomized, double-blind, parallel group, placebo-controlled, single-attack evaluation of the efficacy and tolerability of TREXIMA™ (sumatriptan 85mg/naproxen sodium 500mg)* tablets vs placebo when administered during the mild pain phase of a migraine 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 sumatriptan Trade Name Imitrex ,Imiject ,Imigran Study Indication Migraine Disorders The purpose of this form is to document the current medical condition of the subject. It should be filled out at the screening visit.

Keywords

Versions (3)
  1. 1/11/19 1/11/19 -
  2. 1/13/19 1/13/19 -
  3. 1/17/19 1/17/19 -
Copyright Holder

GlaxoSmithKline

Uploaded on

January 17, 2019

DOI

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License

Creative Commons BY-NC 3.0
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Efficacy and Tolerability of TREXIMA Tablets vs. Placebo During Mild Migraine Study ID 101998

English

Medical Conditions

1 forms  
  1. StudyEvent: ODM
    1. Medical Conditions
Statement by Doctor, Nurse or Project Assistant who conducted the informed consent discussion
Description

Statement by Doctor, Nurse or Project Assistant who conducted the informed consent discussion

Alias
UMLS CUI-1
C0021430
UMLS CUI-2
C0035173
Name
Description

I have carefully explained the nature, demands and foreseeable risks and benefits of the vaccination study to the person named above and witnessed the completion of the written consent form.

Data type

text

Alias
UMLS CUI [1,1]
C0021430
UMLS CUI [1,2]
C0035173
UMLS CUI [1,3]
C0027365
Signature
Description

Informed Consent, Research Personnel, Signature

Data type

text

Alias
UMLS CUI [1,1]
C0021430
UMLS CUI [1,2]
C0035173
UMLS CUI [1,3]
C1519316
Designation
Description

Informed Consent, Research Personnel, Occupations

Data type

text

Alias
UMLS CUI [1,1]
C0021430
UMLS CUI [1,2]
C0035173
UMLS CUI [1,3]
C0028811
Date
Description

Informed Consent, Research Personnel, Date in time

Data type

date

Alias
UMLS CUI [1,1]
C0021430
UMLS CUI [1,2]
C0035173
UMLS CUI [1,3]
C0011008
Time
Description

Informed Consent, Research Personnel, Time

Data type

time

Alias
UMLS CUI [1,1]
C0021430
UMLS CUI [1,2]
C0035173
UMLS CUI [1,3]
C0040223
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Similar models

Medical Conditions

1 forms
  1. StudyEvent: ODM
    1. Medical Conditions
Name
Type
Description | Question | Decode (Coded Value)
Data type
Alias
Item Group
Statement by Doctor, Nurse or Project Assistant who conducted the informed consent discussion
C0021430 (UMLS CUI-1)
C0035173 (UMLS CUI-2)
Informed Consent, Research Personnel, Name
Item
Name
text
C0021430 (UMLS CUI [1,1])
C0035173 (UMLS CUI [1,2])
C0027365 (UMLS CUI [1,3])
Informed Consent, Research Personnel, Signature
Item
Signature
text
C0021430 (UMLS CUI [1,1])
C0035173 (UMLS CUI [1,2])
C1519316 (UMLS CUI [1,3])
Informed Consent, Research Personnel, Occupations
Item
Designation
text
C0021430 (UMLS CUI [1,1])
C0035173 (UMLS CUI [1,2])
C0028811 (UMLS CUI [1,3])
Informed Consent, Research Personnel, Date in time
Item
Date
date
C0021430 (UMLS CUI [1,1])
C0035173 (UMLS CUI [1,2])
C0011008 (UMLS CUI [1,3])
Informed Consent, Research Personnel, Time
Item
Time
time
C0021430 (UMLS CUI [1,1])
C0035173 (UMLS CUI [1,2])
C0040223 (UMLS CUI [1,3])
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