ID
35931
Description
Study ID: 100565 Clinical Study ID: 100565 Study Title: An open study to evaluate the immunogenicity, safety and reactogenicity of GlaxoSmithKline Biologicals' commercially available combined hepatitis A / hepatitis B vaccine (TWINRIX ADULT) containing 720 ELISA units of hepatitis A antigen and 20 µg of hepatitis B surface antigen, administered following a two-dose (0, 6 months) schedule in healthy children between the ages of 1 and 11 years Patient Level Data: Study Listed on ClinicalStudyDataRequest.com Clinicaltrials.gov Identifier: Sponsor: GlaxoSmithKline Phase: phase 3 Study Recruitment Status: Completed Generic Name: Hepatitis A (Inactivated), Hepatitis B (Recombinant) Vaccine Trade Name: Twinrix Study Indication: Hepatitis A; Hepatitis B
Keywords
Versions (2)
- 4/4/19 4/4/19 -
- 4/6/19 4/6/19 -
Copyright Holder
GlaxoSmithKline
Uploaded on
April 4, 2019
DOI
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License
Creative Commons BY-NC 3.0
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Immunogenicity, safety and reactogenicity of combined hepatitis A / hepatitis B vaccine (TWINRIX ADULT) in healthy children (100565)
Study Conclusion - Follow-Up Studies; Study Conclusion; Tracking Document; Diary Card
Description
Follow-Up Studies
Alias
- UMLS CUI-1
- C0016441
Description
If No, please specify the most appropriate reason
Data type
boolean
Alias
- UMLS CUI [1,1]
- C0016441
- UMLS CUI [1,2]
- C0600109
Description
If subject would not be willing to participate in a follow-up study, please specify the most appropriate reason
Data type
integer
Alias
- UMLS CUI [1,1]
- C0016441
- UMLS CUI [1,2]
- C0558080
- UMLS CUI [1,3]
- C0392360
Description
If Adverse Event or Serious Adverse Event, please specify
Data type
text
Alias
- UMLS CUI [1,1]
- C0877248
- UMLS CUI [1,2]
- C2348235
- UMLS CUI [2,1]
- C1519255
- UMLS CUI [2,2]
- C2348235
Description
If other, please specify
Data type
text
Alias
- UMLS CUI [1,1]
- C0205394
- UMLS CUI [1,2]
- C2348235
Description
Investigator signature
Alias
- UMLS CUI-1
- C2346576
Description
I confirm that I have reviewed the data in this Case Report Form for this subject. All information entered by myself or my colleagues is, to the best of my knowledge, complete and accurate, as of the date below.
Data type
text
Alias
- UMLS CUI [1]
- C2346576
Description
Investigator Signature Date
Data type
date
Alias
- UMLS CUI [1,1]
- C2346576
- UMLS CUI [1,2]
- C0011008
Description
Investigator name
Data type
text
Alias
- UMLS CUI [1]
- C2826892
Description
Study Conclusion
Alias
- UMLS CUI-1
- C1707478
- UMLS CUI-2
- C0008972
Description
If Yes, specify total number of SAE's
Data type
boolean
Alias
- UMLS CUI [1]
- C1519255
- UMLS CUI [2]
- C2347804
- UMLS CUI [3]
- C2348563
Description
Total number of SAE's
Data type
integer
Alias
- UMLS CUI [1,1]
- C1519255
- UMLS CUI [1,2]
- C0449788
Description
If Yes, complete the Pregnancy notification form.
Data type
text
Alias
- UMLS CUI [1]
- C0032961
Description
If Yes, record major reason for withdrawal
Data type
boolean
Alias
- UMLS CUI [1]
- C0422727
Description
Tick one box only
Data type
text
Alias
- UMLS CUI [1,1]
- C2349954
- UMLS CUI [1,2]
- C0392360
Description
Please complete and submit SAE report
Data type
integer
Alias
- UMLS CUI [1,1]
- C1519255
- UMLS CUI [1,2]
- C0237753
Description
Please complete Non-serious Adverse Event section
Data type
text
Alias
- UMLS CUI [1,1]
- C1518404
- UMLS CUI [1,2]
- C0237753
- UMLS CUI [2,1]
- C1518404
- UMLS CUI [2,2]
- C0805701
Description
If protocol violation, please specify
Data type
text
Alias
- UMLS CUI [1,1]
- C1709750
- UMLS CUI [1,2]
- C2348235
Description
If other reason, please specify
Data type
text
Alias
- UMLS CUI [1,1]
- C3840932
- UMLS CUI [1,2]
- C2348235
Description
Who made the decision?
Data type
text
Alias
- UMLS CUI [1]
- C0679006
Description
Date of last contact
Data type
date
Alias
- UMLS CUI [1]
- C0805839
Description
If No, please give details in Adverse Events section.
Data type
boolean
Alias
- UMLS CUI [1,1]
- C1142435
- UMLS CUI [1,2]
- C0681850
Description
Tracking Document - Reason for non participation
Alias
- UMLS CUI-1
- C3889409
- UMLS CUI-3
- C0558080
- UMLS CUI-4
- C0679823
- UMLS CUI-5
- C0392360
Description
Previous Subject Number
Data type
integer
Alias
- UMLS CUI [1,1]
- C2348585
- UMLS CUI [1,2]
- C2242969
Description
Date of birth
Data type
date
Alias
- UMLS CUI [1]
- C0421451
Description
Please document reason for non participation
Data type
integer
Alias
- UMLS CUI [1,1]
- C0558080
- UMLS CUI [1,2]
- C0679823
- UMLS CUI [1,3]
- C0392360
Description
Subject not eligible - Please specify criteria that are not fulfilled
Data type
text
Alias
- UMLS CUI [1,1]
- C1555471
- UMLS CUI [1,2]
- C3828770
- UMLS CUI [1,3]
- C2348235
Description
Subject eligible but not willing to participate due to adverse events, or serious adverse event,please specify
Data type
text
Alias
- UMLS CUI [1,1]
- C3846156
- UMLS CUI [1,2]
- C0877248
- UMLS CUI [1,3]
- C1519255
Description
If other Reason for Subject not willing to participate, please specify
Data type
text
Alias
- UMLS CUI [1,1]
- C0392360
- UMLS CUI [1,2]
- C1136454
- UMLS CUI [1,3]
- C0205394
- UMLS CUI [1,4]
- C2348235
Description
Date of contact
Data type
date
Alias
- UMLS CUI [1,1]
- C0011008
- UMLS CUI [1,2]
- C1705415
Description
Diary Card - Local Symptoms
Alias
- UMLS CUI-1
- C3890583
- UMLS CUI-2
- C1457887
- UMLS CUI-3
- C0205276
Description
Local Symptoms
Data type
integer
Alias
- UMLS CUI [1,1]
- C1457887
- UMLS CUI [1,2]
- C0205276
- UMLS CUI [2]
- C2700396
Description
Redness/ Swelling - Size in mm (Day 0)
Data type
integer
Measurement units
- mm
Alias
- UMLS CUI [1,1]
- C0332575
- UMLS CUI [1,2]
- C0456389
- UMLS CUI [2,1]
- C0038999
- UMLS CUI [2,2]
- C0456389
Description
Pain intensity (Day 0)
Data type
integer
Alias
- UMLS CUI [1]
- C1320357
Description
Redness/ Swelling - Size in mm (Day 1)
Data type
integer
Measurement units
- mm
Alias
- UMLS CUI [1,1]
- C0332575
- UMLS CUI [1,2]
- C0456389
- UMLS CUI [2,1]
- C0038999
- UMLS CUI [2,2]
- C0456389
Description
Pain intensity (Day 1)
Data type
integer
Alias
- UMLS CUI [1]
- C1320357
Description
Redness/ Swelling - Size in mm (Day 2)
Data type
integer
Measurement units
- mm
Alias
- UMLS CUI [1,1]
- C0332575
- UMLS CUI [1,2]
- C0456389
- UMLS CUI [2,1]
- C0038999
- UMLS CUI [2,2]
- C0456389
Description
Pain intensity (Day 2)
Data type
integer
Alias
- UMLS CUI [1]
- C1320357
Description
Redness/ Swelling - Size in mm (Day 3)
Data type
integer
Measurement units
- mm
Alias
- UMLS CUI [1,1]
- C0332575
- UMLS CUI [1,2]
- C0456389
- UMLS CUI [2,1]
- C0038999
- UMLS CUI [2,2]
- C0456389
Description
Pain intensity (Day 3)
Data type
integer
Alias
- UMLS CUI [1]
- C1320357
Description
Ongoing after Day 3?
Data type
boolean
Alias
- UMLS CUI [1,1]
- C1457887
- UMLS CUI [1,2]
- C0549178
Description
Date of last day of symptom
Data type
date
Alias
- UMLS CUI [1,1]
- C0011008
- UMLS CUI [1,2]
- C1517741
- UMLS CUI [1,3]
- C1457887
Description
Diary Card - Other local symptoms
Alias
- UMLS CUI-1
- C3890583
- UMLS CUI-2
- C1457887
- UMLS CUI-3
- C0205276
- UMLS CUI-4
- C0205394
Description
Please specify side(s) and site(s)
Data type
text
Alias
- UMLS CUI [1]
- C0678257
Description
Intensity
Data type
integer
Alias
- UMLS CUI [1]
- C0518690
Description
Symptoms start date
Data type
date
Alias
- UMLS CUI [1,1]
- C1457887
- UMLS CUI [1,2]
- C0808070
Description
Or check box if continuing
Data type
date
Alias
- UMLS CUI [1,1]
- C1457887
- UMLS CUI [1,2]
- C0806020
Description
Check box if symptoms are continuing
Data type
integer
Alias
- UMLS CUI [1,1]
- C1457887
- UMLS CUI [1,2]
- C0549178
Description
Diary Card - Medication
Alias
- UMLS CUI-1
- C3890583
- UMLS CUI-2
- C0013227
Description
Trade/ Generic Name
Data type
text
Alias
- UMLS CUI [1]
- C2360065
- UMLS CUI [2]
- C0592502
Description
Reason for medication
Data type
text
Alias
- UMLS CUI [1,1]
- C0392360
- UMLS CUI [1,2]
- C0013227
Description
Total Daily Dose
Data type
text
Alias
- UMLS CUI [1,1]
- C2348070
- UMLS CUI [1,2]
- C0439810
Description
Medication Start Date
Data type
date
Alias
- UMLS CUI [1,1]
- C0013227
- UMLS CUI [1,2]
- C0808070
Description
Medication End date or check box if continuing
Data type
date
Alias
- UMLS CUI [1,1]
- C0013227
- UMLS CUI [1,2]
- C0806020
- UMLS CUI [2,1]
- C0013227
- UMLS CUI [2,2]
- C0549178
Description
Check box if medication continuing
Data type
integer
Alias
- UMLS CUI [1,1]
- C0013227
- UMLS CUI [1,2]
- C0549178
Description
Diary Card - General Symptoms
Alias
- UMLS CUI-1
- C3890583
- UMLS CUI-2
- C0159028
Description
General Symptom
Data type
integer
Alias
- UMLS CUI [1]
- C0159028
Description
Please record the temperature every day in the evening. If temperature has been taken more than once a day, please report the highest value for the day.
Data type
integer
Alias
- UMLS CUI [1,1]
- C0886414
- UMLS CUI [1,2]
- C0449444
Description
Record Temperature on Day 0, Day1, Day2, Day3
Data type
float
Measurement units
- °C
Alias
- UMLS CUI [1]
- C0886414
Description
Record Intensity of Fatigue on Day0, Day1, Day2, Day3
Data type
integer
Alias
- UMLS CUI [1,1]
- C0015672
- UMLS CUI [1,2]
- C0518690
Description
Headache intensity on Day0, Day1, Day2, Day3
Data type
integer
Alias
- UMLS CUI [1,1]
- C0018681
- UMLS CUI [1,2]
- C0518690
Description
Gastrointestinal symptoms intensity on Day0, Day1, Day2, Day3
Data type
integer
Alias
- UMLS CUI [1,1]
- C0426576
- UMLS CUI [1,2]
- C0518690
Description
Symptoms ongoing after Day 3?
Data type
boolean
Alias
- UMLS CUI [1,1]
- C1457887
- UMLS CUI [1,2]
- C0549178
Description
Date of last Day of Symptoms
Data type
date
Alias
- UMLS CUI [1,1]
- C0011008
- UMLS CUI [1,2]
- C0030193
- UMLS CUI [1,3]
- C2700396
Description
Diary Card - Other general Symptoms
Alias
- UMLS CUI-1
- C3890583
- UMLS CUI-2
- C0029625
Description
Description - please give details below
Data type
text
Alias
- UMLS CUI [1]
- C0678257
Description
Symptom intensity
Data type
text
Alias
- UMLS CUI [1]
- C0518690
Description
Symptom Start date
Data type
date
Alias
- UMLS CUI [1,1]
- C1457887
- UMLS CUI [1,2]
- C0808070
Description
Symptoms End date or check box if continuing
Data type
date
Alias
- UMLS CUI [1,1]
- C1457887
- UMLS CUI [1,2]
- C0806020
- UMLS CUI [2,1]
- C1457887
- UMLS CUI [2,2]
- C0549178
Description
Check box if symptoms continuing
Data type
integer
Alias
- UMLS CUI [1,1]
- C1457887
- UMLS CUI [1,2]
- C0549178
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C1136454 (UMLS CUI [1,2])
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C0456389 (UMLS CUI [1,2])
C0038999 (UMLS CUI [2,1])
C0456389 (UMLS CUI [2,2])
C0456389 (UMLS CUI [1,2])
C0038999 (UMLS CUI [2,1])
C0456389 (UMLS CUI [2,2])
C0456389 (UMLS CUI [1,2])
C0038999 (UMLS CUI [2,1])
C0456389 (UMLS CUI [2,2])
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C0013227 (UMLS CUI-2)
C0592502 (UMLS CUI [2])
C0013227 (UMLS CUI [1,2])
C0439810 (UMLS CUI [1,2])
C0808070 (UMLS CUI [1,2])
C0806020 (UMLS CUI [1,2])
C0013227 (UMLS CUI [2,1])
C0549178 (UMLS CUI [2,2])
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