ID
34718
Beschreibung
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 subjects concomitant medication. Check that either ’Yes’ or ’No’ box at the top of the page has been completed. • Ensure that the spelling of the Drug Name(s) is correct (use of Trade Names is preferred). • Check that either medication start date is completed or ’Taken Prior to Study?’ is ’Yes’. • It is acceptable for start date to be missing if ’Taken Prior to Study?’ is ’Yes’. • It is acceptable if ’Taken Prior to Study?’ is ’Yes’ and a start date is present, as long as the start date is prior to the date of the subject’s initial visit. • Check that either medication stop date is completed or ’Ongoing Medication?’ is ’Yes’. • It is acceptable for stop date to be missing if ’Ongoing Medication?’ is ’Yes’. • Ensure that the ’Reason for Medication’ is recorded on one of the following pages using the same terms: • Medical Conditions • Non-Serious Adverse Events • Serious Adverse Events Form
Stichworte
Versionen (2)
- 24.01.19 24.01.19 -
- 24.01.19 24.01.19 -
Rechteinhaber
GlaxoSmithKline
Hochgeladen am
24. Januar 2019
DOI
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Lizenz
Creative Commons BY-NC 3.0
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Efficacy and Tolerability of TREXIMA Tablets vs. Placebo During Mild Migraine Study ID 101998
Concomitant Medication
- StudyEvent: ODM
Beschreibung
Concomitant Medication
Alias
- UMLS CUI-1
- C2347852 (Concomitant Agent)
Beschreibung
If Yes, record each medication on a separate line using Trade Names where possible. If the medication is related to a Non-Serious Adverse Event or Serious Adverse Event, details should be expressed using the same terminology.
Datentyp
text
Alias
- UMLS CUI [1]
- C2347852 (Concomitant Agent)
Beschreibung
Concomitant Medication Record
Alias
- UMLS CUI-1
- C2347852 (Concomitant Agent)
Beschreibung
Trade Name preferred
Datentyp
text
Alias
- UMLS CUI [1]
- C0013227 (Pharmaceutical Preparations)
- SNOMED
- 763158003
- LOINC
- LP100609-9
Beschreibung
Reason for Medication
Datentyp
text
Alias
- UMLS CUI [1,1]
- C0392360 (Indication of (contextual qualifier))
- SNOMED
- 230165009
- LOINC
- MTHU008319
- UMLS CUI [1,2]
- C0013227 (Pharmaceutical Preparations)
- SNOMED
- 763158003
- LOINC
- LP100609-9
Beschreibung
Day Month Year
Datentyp
text
Alias
- UMLS CUI [1,1]
- C0808070 (Start Date)
- UMLS CUI [1,2]
- C2347852 (Concomitant Agent)
Beschreibung
Concomitant Medicatino Taken Prior to Study
Datentyp
text
Alias
- UMLS CUI [1]
- C2826667 (Concomitant Medication Previous Occurrence)
Beschreibung
Day Month Year
Datentyp
text
Alias
- UMLS CUI [1,1]
- C0806020 (End date)
- SNOMED
- 454551000124105
- LOINC
- MTHU008302
- UMLS CUI [1,2]
- C2347852 (Concomitant Agent)
Beschreibung
Ongoing Medication
Datentyp
text
Alias
- UMLS CUI [1]
- C2826666 (Concomitant Medication Ongoing)
Ähnliche Modelle
Concomitant Medication
- StudyEvent: ODM
C0013227 (UMLS CUI [1,2])
C2347852 (UMLS CUI [1,2])
C2347852 (UMLS CUI [1,2])
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