ID
35167
Beskrivning
Study ID: 107495 Clinical Study ID: 107495 Study Title: A phase II, open, randomized study in adults aged between 18 and 60 years designed to evaluate the reactogenicity and immunogenicity of a 1- and 2-dose prime-boost concept of pandemic monovalent (H5N1) influenza vaccine (split virus formulation) adjuvanted with AS03, administered according to different vaccination schedules. Patient Level Data: Study Listed on ClinicalStudyDataRequest.com Clinicaltrials.gov Identifier: NCT00430521 https://clinicaltrials.gov/ct2/show/NCT00430521 Sponsor: GlaxoSmithKline Collaborators: N/A Phase: Phase 2 Study Recruitment Status: Completed Generic Name: Pandemic influenza vaccine (GSK1119711A)-formulation 1, Pandemic influenza vaccine (GSK1119711A)-formulation 2 Trade Name: N/A Study Indication: Influenza There are 4 workbooks (WB): WB 1: Protocol 107495, (H5N1-012), Groups: VT/VT/6Mo, VT/IN/6Mo WB 2: Protocol 107495, (H5N1-012), Groups: VT/VT/12Mo, VT/IN/12Mo WB 3: Protocol 107495 (H5N1-012) GROUPS: 2VT/VT/6MO, 2VT/IN/6MO WB 4: Protocol 107495 (H5N1-012) Groups: 2VT/VT/12Mo, 2VT/IN/12Mo Every Workbook has the following visits: Visit Day 0 (Screening, Dose 1), Visit Day 21, Visit Month 6, Visit Month 12 and Visit Month 18. After Month 6 (+30 days, if applicable) and Month 12 (+30 days, if applicable) there is a Core Analysis section, followed by a final study conclusion after Month 18. Workbook 1 schedules a vaccination at screening and Month 6 each, Workbook 2 at Screening and Month 12. 30 days after the first vaccination there is an additional telephone contact. After the second vaccination additional visits/contacts are necessary in both workbooks: a visit at Month 6/12 + 7 and 21 days and a telephone contact on Month 6/12 + 30 days. Workbook 3 schedules a vaccination at screening, Day 21 and Month 6 and Workbook 4 at screening, Day 21 and Month 12. After the second vaccination there is an additional visit on Day 42 and a telephone contact on day 51. After the third vaccination there are additional visits/contacts: visits at Month 6/12 + 7 and 21 days and a telephone contact at Month 6/12 + 30 days. After Month 6 (+30 days, if applicable) and Month 12 (+30 days, if applicable) there is a Core Analysis section. This document contains the Concomitant medication form. It has to be filled in for all Visits/contacts (except screening) for each workbook. All concomitant medication, with the exception of vitamins and/or dietary supplements, administered at ANY time during the period starting with administration of each dose of study vaccine and ending 21 days after each vaccination after each dose of study vaccine are to be recorded with generic name of the medication (trade names are allowed for combination drugs, i.e. multi-component drugs), medical indication, total daily dose, route of administration, start and end dates of treatment. Any treatments and/or medications specifically contraindicated, e.g., any immunoglobulins, other blood products and any immune modifying drugs administered within three months preceding the vaccination or at any time during the study period are to be recorded with generic name of the medication (trade names are allowed for combination drugs only), medical indication, total daily dose, route of administration, start and end dates of treatment. Concomitant medication administered for the treatment of an AE or SAE within the follow-up period for adverse events must be recorded in the CRF with generic name of the medication (trade names are allowed for combination drugs only), medical indication (including which AE/SAE), total daily dose, route of administration,start and end dates of treatment. Similarly, concomitant medication administered for the treatment of an SAE, at any time, must be recorded on the SAE Report Form.
Länk
https://clinicaltrials.gov/ct2/show/NCT00430521
Nyckelord
Versioner (3)
- 2019-02-18 2019-02-18 -
- 2019-02-20 2019-02-20 -
- 2019-02-20 2019-02-20 - Sarah Riepenhausen
Rättsinnehavare
GlaxoSmithKline
Uppladdad den
20 februari 2019
DOI
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Licens
Creative Commons BY-NC 3.0
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Evaluation of reactogenicity and immunogenicity of pandemic monovalent (H5N1) influenza vaccine in adults, NCT00430521
Concomitant Medication
- StudyEvent: ODM
Beskrivning
Concomitant medication
Alias
- UMLS CUI-1
- C2347852
Beskrivning
day month year
Datatyp
date
Alias
- UMLS CUI [1]
- C1317250
Beskrivning
If you tick "yes" please fill in following items. At each study visit/contact, the investigator should question the subject about any medication(s) taken.
Datatyp
text
Alias
- UMLS CUI [1]
- C2347852
Beskrivning
Trade/ (Generic) Name
Datatyp
text
Alias
- UMLS CUI [1,1]
- C0027365
- UMLS CUI [1,2]
- C2347852
Beskrivning
A prophylactic medication is a medication administered in the absence of ANY symptom and in anticipation of a reaction to the vaccination (e.g. an anti-pyretic is considered to be prophylactic when it is given in the absence of fever [rectal temperature < 38°C] and any other symptom, to prevent fever from occurring). Any concomitant medication administered prophylactically in anticipation of reaction to the vaccination must be recorded in the CRF with generic name of the medication (trade names are allowed for combination drugs only), total daily dose, route of administration, start and end dates of treatment and coded as ‘Prophylactic’.
Datatyp
boolean
Alias
- UMLS CUI [1,1]
- C3146298
- UMLS CUI [1,2]
- C2347852
- UMLS CUI [1,3]
- C0199176
Beskrivning
Medical Indication
Datatyp
text
Alias
- UMLS CUI [1,1]
- C3146298
- UMLS CUI [1,2]
- C2347852
Beskrivning
Total daily dose
Datatyp
text
Alias
- UMLS CUI [1]
- C2826638
Beskrivning
Route of administration
Datatyp
text
Alias
- UMLS CUI [1,1]
- C0013153
- UMLS CUI [1,2]
- C2347852
Beskrivning
day month year
Datatyp
date
Alias
- UMLS CUI [1]
- C2826734
Beskrivning
day month year
Datatyp
date
Alias
- UMLS CUI [1]
- C2826744
Beskrivning
Tick if medication is continuing
Datatyp
boolean
Alias
- UMLS CUI [1]
- C2826666
Beskrivning
For GSK
Datatyp
text
Alias
- UMLS CUI [1]
- C0947611
Similar models
Concomitant Medication
- StudyEvent: ODM
C2347852 (UMLS CUI [1,2])
C2347852 (UMLS CUI [1,2])
C0199176 (UMLS CUI [1,3])
C2347852 (UMLS CUI [1,2])
C2347852 (UMLS CUI [1,2])
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