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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

  1. 24.01.19 24.01.19 -
  2. 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

    1. StudyEvent: ODM
      1. Concomitant Medication
    Administrative Data
    Beschreibung

    Administrative Data

    Alias
    UMLS CUI-1
    C1320722 (Administrative documentation)
    SNOMED
    405624007
    Subject Identifier
    Beschreibung

    Subject Identifier

    Datentyp

    integer

    Alias
    UMLS CUI [1]
    C2348585 (Clinical Trial Subject Unique Identifier)
    Concomitant Medication
    Beschreibung

    Concomitant Medication

    Alias
    UMLS CUI-1
    C2347852 (Concomitant Agent)
    Were any concomitant medications taken by the subject during the study?
    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)
    Concomitant Medication Record
    Beschreibung

    Concomitant Medication Record

    Alias
    UMLS CUI-1
    C2347852 (Concomitant Agent)
    Drug Name
    Beschreibung

    Trade Name preferred

    Datentyp

    text

    Alias
    UMLS CUI [1]
    C0013227 (Pharmaceutical Preparations)
    SNOMED
    763158003
    LOINC
    LP100609-9
    Reason for Medication
    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
    Start Date
    Beschreibung

    Day Month Year

    Datentyp

    text

    Alias
    UMLS CUI [1,1]
    C0808070 (Start Date)
    UMLS CUI [1,2]
    C2347852 (Concomitant Agent)
    Taken Prior to Study
    Beschreibung

    Concomitant Medicatino Taken Prior to Study

    Datentyp

    text

    Alias
    UMLS CUI [1]
    C2826667 (Concomitant Medication Previous Occurrence)
    Stop Date
    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)
    Ongoing Medication?
    Beschreibung

    Ongoing Medication

    Datentyp

    text

    Alias
    UMLS CUI [1]
    C2826666 (Concomitant Medication Ongoing)

    Ähnliche Modelle

    Concomitant Medication

    1. StudyEvent: ODM
      1. Concomitant Medication
    Name
    Typ
    Description | Question | Decode (Coded Value)
    Datentyp
    Alias
    Item Group
    Administrative Data
    C1320722 (UMLS CUI-1)
    Subject Identifier
    Item
    Subject Identifier
    integer
    C2348585 (UMLS CUI [1])
    Item Group
    Concomitant Medication
    C2347852 (UMLS CUI-1)
    Item
    Were any concomitant medications taken by the subject during the study?
    text
    C2347852 (UMLS CUI [1])
    Code List
    Were any concomitant medications taken by the subject during the study?
    CL Item
    Yes (Y)
    CL Item
    No (N)
    Item Group
    Concomitant Medication Record
    C2347852 (UMLS CUI-1)
    Drug Name
    Item
    Drug Name
    text
    C0013227 (UMLS CUI [1])
    Reason for Medication
    Item
    Reason for Medication
    text
    C0392360 (UMLS CUI [1,1])
    C0013227 (UMLS CUI [1,2])
    Start Date
    Item
    Start Date
    text
    C0808070 (UMLS CUI [1,1])
    C2347852 (UMLS CUI [1,2])
    Item
    Taken Prior to Study
    text
    C2826667 (UMLS CUI [1])
    Code List
    Taken Prior to Study
    CL Item
    Yes (Y)
    CL Item
    No (N)
    Stop Date
    Item
    Stop Date
    text
    C0806020 (UMLS CUI [1,1])
    C2347852 (UMLS CUI [1,2])
    Item
    Ongoing Medication?
    text
    C2826666 (UMLS CUI [1])
    Code List
    Ongoing Medication?
    CL Item
    Yes (Y)
    CL Item
    No (N)

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