ID

38536

Description

Study ID: 110948 Clinical Study ID: 110948 Study Title: Assessment of the effect of sumatriptan and naproxen sodium combination tablet, sumatriptan tablet, and naproxen sodium tablet treatment on blood pressure when administered intermittently for six months for the acute treatment of migraine attacks, with or without aura, in adults Patient Level Data: Study Listed on ClinicalStudyDataRequest.com Clinicaltrials.gov Identifier: NCT00792636 Sponsor: GlaxoSmithKline Collaborators: N/A Phase: Phase 4 Study Recruitment Status: Completed Generic Name: sumatriptan and naproxen sodium combination tablet Trade Name: sumatriptan tablet, naproxen sodium tablet Study Indication: Migraine Disorders

Keywords

  1. 9/22/19 9/22/19 -
  2. 10/24/19 10/24/19 -
Copyright Holder

GlaxoSmithKline

Uploaded on

October 24, 2019

DOI

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License

Creative Commons BY-NC 3.0

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Sumatriptan and Naproxen Sodium for Acute Treatment of Migraine Attacks; NCT00792636

Screening

  1. StudyEvent: ODM
    1. Screening
Administrative Data
Description

Administrative Data

Alias
UMLS CUI-1
C1320722
Site
Description

Study Site

Data type

text

Alias
UMLS CUI [1]
C2825164
Patient
Description

Patient name

Data type

text

Alias
UMLS CUI [1]
C1299487
Patient No
Description

Patients, Identification number

Data type

integer

Alias
UMLS CUI [1,1]
C0030705
UMLS CUI [1,2]
C1300638
Date of Visit/Assessment
Description

Date of Visit/Assessment

Alias
UMLS CUI-1
C1320303
UMLS CUI-2
C2985720
Date of visit/assessment
Description

Date of visit; Assessment Date

Data type

date

Alias
UMLS CUI [1,1]
C1320303
UMLS CUI [1,2]
C2985720
Subject Identification
Description

Subject Identification

Alias
UMLS CUI-1
C2348585
Subject number
Description

Clinical Trial Subject Unique Identifier

Data type

integer

Alias
UMLS CUI [1]
C2348585
Demography
Description

Demography

Alias
UMLS CUI-1
C0011298
Date of birth
Description

Patient date of birth

Data type

date

Alias
UMLS CUI [1]
C0421451
Sex
Description

Gender

Data type

text

Alias
UMLS CUI [1]
C0079399
Female: Record child-bearing potential
Description

Childbearing Potential

Data type

text

Alias
UMLS CUI [1]
C3831118
Ethnicity
Description

Ethnic group

Data type

text

Alias
UMLS CUI [1]
C0015031
Geographic Ancestry
Description

Your ancestry or national origin

Data type

text

Alias
UMLS CUI [1]
C3841890
Pharmacogenetic (PGx) Research Consent / Blood Sample Collection
Description

Pharmacogenetic (PGx) Research Consent / Blood Sample Collection

Alias
UMLS CUI-1
C2347500
UMLS CUI-2
C0021430
UMLS CUI-3
C0005834
Has informed consent been obtained for PGx research?
Description

Pharmacogenetic Test, Informed Consent

Data type

boolean

Alias
UMLS CUI [1,1]
C2347500
UMLS CUI [1,2]
C0021430
Yes, record Date informed consent obtained for PGx research
Description

Pharmacogenetic Test, Informed Consent, Date in time

Data type

date

Alias
UMLS CUI [1,1]
C2347500
UMLS CUI [1,2]
C0021430
UMLS CUI [1,3]
C0011008
Yes, record: Has Blood been collected for PGx research?
Description

Pharmacogenetic Test, Collection of blood specimen for laboratory procedure

Data type

boolean

Alias
UMLS CUI [1,1]
C2347500
UMLS CUI [1,2]
C0005834
No (informed consent obtained), check reason
Description

Pharmacogenetic Test, Informed Consent, Reason and justification

Data type

text

Alias
UMLS CUI [1,1]
C2347500
UMLS CUI [1,2]
C0021430
UMLS CUI [1,3]
C0566251
Specify
Description

Pharmacogenetic Test, Informed Consent, Reason and justification

Data type

text

Alias
UMLS CUI [1,1]
C2347500
UMLS CUI [1,2]
C0021430
UMLS CUI [1,3]
C0566251
Pharmacogenetic (PGx) Research Withdrawal of Consent
Description

Pharmacogenetic (PGx) Research Withdrawal of Consent

Alias
UMLS CUI-1
C2347500
UMLS CUI-2
C0021430
UMLS CUI-3
C2349954
Has subject withdrawn consent for PGx research?
Description

Pharmacogenetic Test, Informed Consent, Withdraw

Data type

boolean

Alias
UMLS CUI [1,1]
C2347500
UMLS CUI [1,2]
C0021430
UMLS CUI [1,3]
C2349954
Yes, date informed consent withdrawn
Description

Pharmacogenetic Test, Informed Consent, Withdraw, Date in time

Data type

date

Alias
UMLS CUI [1,1]
C2347500
UMLS CUI [1,2]
C0021430
UMLS CUI [1,3]
C2349954
UMLS CUI [1,4]
C0011008
Has a request been made for blood sample destruction?
Description

Pharmacogenetic Test, Blood specimen, Destruction, Request

Data type

boolean

Alias
UMLS CUI [1,1]
C2347500
UMLS CUI [1,2]
C0178913
UMLS CUI [1,3]
C1948029
UMLS CUI [1,4]
C1272683
Yes, check reason
Description

Pharmacogenetic Test, Blood specimen, Destruction, Request, Reason and justification

Data type

text

Alias
UMLS CUI [1,1]
C2347500
UMLS CUI [1,2]
C0178913
UMLS CUI [1,3]
C1948029
UMLS CUI [1,4]
C1272683
UMLS CUI [1,5]
C0566251
Specify
Description

Pharmacogenetic Test, Blood specimen, Destruction, Request, Reason and justification

Data type

text

Alias
UMLS CUI [1,1]
C2347500
UMLS CUI [1,2]
C0178913
UMLS CUI [1,3]
C1948029
UMLS CUI [1,4]
C1272683
UMLS CUI [1,5]
C0566251
Screen Failure
Description

Screen Failure

Alias
UMLS CUI-1
C1710476
Was this subject a screen failure?
Description

Trial Screen Failure

Data type

boolean

Alias
UMLS CUI [1]
C1710476
Yes, check all that apply
Description

Trial Screen Failure, Reason and justification

Data type

text

Alias
UMLS CUI [1,1]
C1710476
UMLS CUI [1,2]
C0566251
Specify
Description

Trial Screen Failure, Reason and justification

Data type

text

Alias
UMLS CUI [1,1]
C1710476
UMLS CUI [1,2]
C0566251
For Data Managers or Monitors only: Tick or untick this box to require the investigator to re- sign the case book
Description

Trial Screen Failure, Clinical Study Case, Investigator Signature

Data type

boolean

Alias
UMLS CUI [1,1]
C1710476
UMLS CUI [1,2]
C0566251
UMLS CUI [1,3]
C1706256
UMLS CUI [1,4]
C2346576
Eligibility Question
Description

Eligibility Question

Alias
UMLS CUI-1
C0013893
Did the subject meet all the entry criteria?
Description

Eligibility Determination

Data type

boolean

Alias
UMLS CUI [1]
C0013893
No, please select all boxes corresponding to violations of any inclusion/ exclusion criteria - Inclusion Criteria
Description

Inclusion

Data type

text

Alias
UMLS CUI [1]
C1512693
No, please select all boxes corresponding to violations of any inclusion/ exclusion criteria - Exclusion Criteria
Description

Exclusion Criteria

Data type

text

Alias
UMLS CUI [1]
C0680251
Status of Medications
Description

Status of Medications

Alias
UMLS CUI-1
C2347852
Were any medications recorded on the In-Clinic Medications Taken Diary?
Description

Concomitant Agent

Data type

boolean

Alias
UMLS CUI [1]
C2347852
Sequence Number
Description

Concomitant Agent, Sequence Number

Data type

integer

Alias
UMLS CUI [1,1]
C2347852
UMLS CUI [1,2]
C2348184
Drug Name (Trade Name preferred)
Description

Concomitant Agent, Medication name

Data type

text

Alias
UMLS CUI [1,1]
C2347852
UMLS CUI [1,2]
C2360065
Modified reported term
Description

Concomitant Agent, Medication name, Reported Term

Data type

text

Alias
UMLS CUI [1,1]
C2347852
UMLS CUI [1,2]
C2360065
UMLS CUI [1,3]
C2826302
GSK Drug synonym
Description

Concomitant Agent, Pharmaceutical Preparations, Synonym

Data type

text

Alias
UMLS CUI [1,1]
C2347852
UMLS CUI [1,2]
C0013227
UMLS CUI [1,3]
C0871468
GSK Drug Collection code
Description

Concomitant Agent, Code

Data type

text

Alias
UMLS CUI [1,1]
C2347852
UMLS CUI [1,2]
C0805701
Failed coding
Description

Concomitant Agent, Code, Failed

Data type

text

Alias
UMLS CUI [1,1]
C2347852
UMLS CUI [1,2]
C0805701
UMLS CUI [1,3]
C0231175
Date Taken
Description

Concomitant Agent, Date in time

Data type

date

Alias
UMLS CUI [1,1]
C2347852
UMLS CUI [1,2]
C0011008
Time Taken
Description

Concomitant Agent, Time

Data type

time

Alias
UMLS CUI [1,1]
C2347852
UMLS CUI [1,2]
C0040223
Vital Signs
Description

Vital Signs

Alias
UMLS CUI-1
C0518766
Height
Description

Body Height

Data type

integer

Measurement units
  • cm
Alias
UMLS CUI [1]
C0005890
cm
Weight
Description

Body Weight

Data type

float

Measurement units
  • kg
Alias
UMLS CUI [1]
C0005910
kg
Body mass index
Description

Body mass index

Data type

float

Measurement units
  • kg/m2
Alias
UMLS CUI [1]
C1305855
kg/m2
Blood pressure(1st Reading) - Systolic
Description

Systolic Pressure

Data type

integer

Measurement units
  • mmHg
Alias
UMLS CUI [1]
C0871470
mmHg
Blood pressure(1st Reading) - Diastolic
Description

Diastolic blood pressure

Data type

integer

Measurement units
  • mmHg
Alias
UMLS CUI [1]
C0428883
mmHg
Blood pressure(2nd Reading) - Systolic
Description

Systolic Pressure

Data type

integer

Measurement units
  • mmHg
Alias
UMLS CUI [1]
C0871470
mmHg
Blood pressure(2nd Reading) - Diastolic
Description

Diastolic blood pressure

Data type

integer

Measurement units
  • mmHg
Alias
UMLS CUI [1]
C0428883
mmHg
Blood pressure(3rd Reading) - Systolic
Description

Systolic Pressure

Data type

integer

Measurement units
  • mmHg
Alias
UMLS CUI [1]
C0871470
mmHg
Blood pressure(3rd Reading) - Diastolic
Description

Diastolic blood pressure

Data type

integer

Measurement units
  • mmHg
Alias
UMLS CUI [1]
C0428883
mmHg
Heart rate
Description

Heart rate

Data type

integer

Measurement units
  • bpm
Alias
UMLS CUI [1]
C0018810
bpm
Average of the lowest two blood pressure readings - Systolic
Description

Systolic Pressure, Low, Average

Data type

integer

Measurement units
  • mmHg
Alias
UMLS CUI [1,1]
C0871470
UMLS CUI [1,2]
C0205251
UMLS CUI [1,3]
C1510992
mmHg
Average of the lowest two blood pressure readings - Diastolic
Description

Diastolic blood pressure, Low, Average

Data type

integer

Measurement units
  • mmHg
Alias
UMLS CUI [1,1]
C0428883
UMLS CUI [1,2]
C0205251
UMLS CUI [1,3]
C1510992
mmHg
12-Lead ECG
Description

12-Lead ECG

Alias
UMLS CUI-1
C0430456
Date of ECG
Description

12 lead ECG, Date in time

Data type

date

Alias
UMLS CUI [1,1]
C0430456
UMLS CUI [1,2]
C0011008
Heart rate
Description

12 lead ECG, Heart rate

Data type

integer

Measurement units
  • bpm
Alias
UMLS CUI [1,1]
C0430456
UMLS CUI [1,2]
C0018810
bpm
PR Interval
Description

12 lead ECG, P-R Interval

Data type

integer

Measurement units
  • msec
Alias
UMLS CUI [1,1]
C0430456
UMLS CUI [1,2]
C0429087
msec
QRS Duration
Description

12 lead ECG, QRS complex duration

Data type

integer

Measurement units
  • msec
Alias
UMLS CUI [1,1]
C0430456
UMLS CUI [1,2]
C0429025
msec
Uncorrected QT Interval
Description

12 lead ECG, QT Interval

Data type

integer

Measurement units
  • msec
Alias
UMLS CUI [1,1]
C0430456
UMLS CUI [1,2]
C1287082
msec
QTc Interval
Description

12 lead ECG, Electrocardiogram QT corrected interval

Data type

integer

Measurement units
  • msec
Alias
UMLS CUI [1,1]
C0430456
UMLS CUI [1,2]
C0855331
msec
Result of the ECG
Description

12 lead ECG, Result

Data type

text

Alias
UMLS CUI [1,1]
C0430456
UMLS CUI [1,2]
C1274040
QRS Axis
Description

12 lead ECG, QRS Axis

Data type

text

Alias
UMLS CUI [1,1]
C0430456
UMLS CUI [1,2]
C0429012
RR interval
Description

12 lead ECG, RR interval

Data type

integer

Measurement units
  • msec
Alias
UMLS CUI [1,1]
C0430456
UMLS CUI [1,2]
C0489636
msec
Investigator Signature
Description

Investigator Signature

Alias
UMLS CUI-1
C2346576
Is this casebook ready to sign?
Description

Clinical Study Case, Investigator Signature

Data type

boolean

Alias
UMLS CUI [1,1]
C1706256
UMLS CUI [1,2]
C2346576
For Data Managers or Monitors only: Tick or untick this box to require the investigator to re- sign the case book
Description

Clinical Study Case, Investigator Signature

Data type

boolean

Alias
UMLS CUI [1,1]
C1706256
UMLS CUI [1,2]
C2346576

Similar models

Screening

  1. StudyEvent: ODM
    1. Screening
Name
Type
Description | Question | Decode (Coded Value)
Data type
Alias
Item Group
Administrative Data
C1320722 (UMLS CUI-1)
Study Site
Item
Site
text
C2825164 (UMLS CUI [1])
Patient name
Item
Patient
text
C1299487 (UMLS CUI [1])
Patients, Identification number
Item
Patient No
integer
C0030705 (UMLS CUI [1,1])
C1300638 (UMLS CUI [1,2])
Item Group
Date of Visit/Assessment
C1320303 (UMLS CUI-1)
C2985720 (UMLS CUI-2)
Date of visit; Assessment Date
Item
Date of visit/assessment
date
C1320303 (UMLS CUI [1,1])
C2985720 (UMLS CUI [1,2])
Item Group
Subject Identification
C2348585 (UMLS CUI-1)
Clinical Trial Subject Unique Identifier
Item
Subject number
integer
C2348585 (UMLS CUI [1])
Item Group
Demography
C0011298 (UMLS CUI-1)
Patient date of birth
Item
Date of birth
date
C0421451 (UMLS CUI [1])
Item
Sex
text
C0079399 (UMLS CUI [1])
Code List
Sex
CL Item
Male (1)
CL Item
Female (2)
Item
Female: Record child-bearing potential
text
C3831118 (UMLS CUI [1])
Code List
Female: Record child-bearing potential
CL Item
Pre-menarcheal  (1)
CL Item
Post-menopausal (2)
CL Item
Sterile (of child-bearing age)  (3)
CL Item
Potentially able to bear children (4)
Item
Ethnicity
text
C0015031 (UMLS CUI [1])
Code List
Ethnicity
CL Item
Hispanic or Latino (1)
CL Item
Not Hispanic or Latino (2)
Item
Geographic Ancestry
text
C3841890 (UMLS CUI [1])
Code List
Geographic Ancestry
CL Item
African American/African Heritage  (1)
CL Item
American Indian or Alaskan Native (2)
CL Item
Asian - Central/South Asian Heritage (3)
CL Item
Asian - East Asian Heritage (4)
CL Item
Asian - Japanese Heritage (5)
CL Item
Asian - South East Asian Heritage (6)
CL Item
Native Hawaiian or Other Pacific Islander  (7)
CL Item
White - Arabic/North African Heritage  (8)
CL Item
White - White/Caucasian/European Heritage (9)
Item Group
Pharmacogenetic (PGx) Research Consent / Blood Sample Collection
C2347500 (UMLS CUI-1)
C0021430 (UMLS CUI-2)
C0005834 (UMLS CUI-3)
Pharmacogenetic Test, Informed Consent
Item
Has informed consent been obtained for PGx research?
boolean
C2347500 (UMLS CUI [1,1])
C0021430 (UMLS CUI [1,2])
Pharmacogenetic Test, Informed Consent, Date in time
Item
Yes, record Date informed consent obtained for PGx research
date
C2347500 (UMLS CUI [1,1])
C0021430 (UMLS CUI [1,2])
C0011008 (UMLS CUI [1,3])
Pharmacogenetic Test, Collection of blood specimen for laboratory procedure
Item
Yes, record: Has Blood been collected for PGx research?
boolean
C2347500 (UMLS CUI [1,1])
C0005834 (UMLS CUI [1,2])
Item
No (informed consent obtained), check reason
text
C2347500 (UMLS CUI [1,1])
C0021430 (UMLS CUI [1,2])
C0566251 (UMLS CUI [1,3])
Code List
No (informed consent obtained), check reason
CL Item
Subject declined (1)
CL Item
Subject not asked by Investigator (2)
CL Item
Other, specify (3)
Pharmacogenetic Test, Informed Consent, Reason and justification
Item
Specify
text
C2347500 (UMLS CUI [1,1])
C0021430 (UMLS CUI [1,2])
C0566251 (UMLS CUI [1,3])
Item Group
Pharmacogenetic (PGx) Research Withdrawal of Consent
C2347500 (UMLS CUI-1)
C0021430 (UMLS CUI-2)
C2349954 (UMLS CUI-3)
Pharmacogenetic Test, Informed Consent, Withdraw
Item
Has subject withdrawn consent for PGx research?
boolean
C2347500 (UMLS CUI [1,1])
C0021430 (UMLS CUI [1,2])
C2349954 (UMLS CUI [1,3])
Pharmacogenetic Test, Informed Consent, Withdraw, Date in time
Item
Yes, date informed consent withdrawn
date
C2347500 (UMLS CUI [1,1])
C0021430 (UMLS CUI [1,2])
C2349954 (UMLS CUI [1,3])
C0011008 (UMLS CUI [1,4])
Pharmacogenetic Test, Blood specimen, Destruction, Request
Item
Has a request been made for blood sample destruction?
boolean
C2347500 (UMLS CUI [1,1])
C0178913 (UMLS CUI [1,2])
C1948029 (UMLS CUI [1,3])
C1272683 (UMLS CUI [1,4])
Item
Yes, check reason
text
C2347500 (UMLS CUI [1,1])
C0178913 (UMLS CUI [1,2])
C1948029 (UMLS CUI [1,3])
C1272683 (UMLS CUI [1,4])
C0566251 (UMLS CUI [1,5])
CL Item
Subject withdrew consent for PGx  (1)
CL Item
Screen failure (2)
CL Item
Other, specify (3)
Item
Specify
text
C2347500 (UMLS CUI [1,1])
C0178913 (UMLS CUI [1,2])
C1948029 (UMLS CUI [1,3])
C1272683 (UMLS CUI [1,4])
C0566251 (UMLS CUI [1,5])
Item Group
Screen Failure
C1710476 (UMLS CUI-1)
Trial Screen Failure
Item
Was this subject a screen failure?
boolean
C1710476 (UMLS CUI [1])
Item
Yes, check all that apply
text
C1710476 (UMLS CUI [1,1])
C0566251 (UMLS CUI [1,2])
Code List
Yes, check all that apply
CL Item
Did not meet inclusion/exclusion criteria  (1)
CL Item
Adverse Event (unspecified) (2)
CL Item
Study closed/terminated (unspecified)  (3)
CL Item
Lost to follow up (unspecified) (4)
CL Item
Investigator discretion, specify  (5)
CL Item
Withdrew consent, specify (6)
Item
Specify
text
C1710476 (UMLS CUI [1,1])
C0566251 (UMLS CUI [1,2])
Trial Screen Failure, Clinical Study Case, Investigator Signature
Item
For Data Managers or Monitors only: Tick or untick this box to require the investigator to re- sign the case book
boolean
C1710476 (UMLS CUI [1,1])
C0566251 (UMLS CUI [1,2])
C1706256 (UMLS CUI [1,3])
C2346576 (UMLS CUI [1,4])
Item Group
Eligibility Question
C0013893 (UMLS CUI-1)
Eligibility Determination
Item
Did the subject meet all the entry criteria?
boolean
C0013893 (UMLS CUI [1])
Item
No, please select all boxes corresponding to violations of any inclusion/ exclusion criteria - Inclusion Criteria
text
C1512693 (UMLS CUI [1])
Code List
No, please select all boxes corresponding to violations of any inclusion/ exclusion criteria - Inclusion Criteria
CL Item
Male or female between the ages of 18 and 64 years inclusive. (1)
CL Item
Male subjects, if female partner not using an acceptable method of contraception, must agree to use one of the contraception methods listed in Section 8.1.2. This criterion must be followed from the time of the first dose of study medication until one month post-last dose. (3)
CL Item
BMI within the range 18.8 – 35.0 kg/m2 (inclusive). (4)
CL Item
Capable of giving written informed consent, which includes compliance with the requirements and restrictions listed in the consent form. (5)
CL Item
Subject currently meets the diagnosis for MDD (without psychotic features), single episode or recurrent, as defined in the DSM-IV-TR, diagnosed with SCID-CT (Structural Clinical Interview for DSM-IV Axis I disorders – Clinical Trials Version) as assessed* by a physician with adequate training in psychiatry. (6)
CL Item
Subject must, in the investigator’s opinion based on clinical history, have met DSM IV-TR criteria for their current major depressive episode for at least 4 weeks but for no greater than 24 months. (7)
CL Item
Subject has an independent rater HAMD17 total score ≥24, that is within 10% of the computerised HAMD17 total score, at the baseline assessment. If scores are not within 10% the independent rater or principal investigator, physician from CRS and GSK medical monitor must agree that subject is suitable for inclusion in the study. (8)
CL Item
Non-smoker or smokers (< 20 cigarettes per day). (9)
CL Item
A female subject is eligible to participate if she is of: Non-childbearing potential defined as pre-menopausal females with a hysterectomy; or postmenopausal defined as 12 months of spontaneous amenorrhea [in questionable cases a blood sample with simultaneous follicle stimulating hormone (FSH) > 40 MlU/ml and estradiol < 40 pg/ml (<140 pmol/L) is confirmatory]. [Females on hormone replacement therapy (HRT) and whose menopausal status is in doubt will be required to use one of the contraception methods in Section 8.1.1 if they wish to continue their HRT during the study. Otherwise, they must discontinue HRT to allow confirmation of post-menopausal status prior to study enrollment. For most forms of HRT, at least 2-4 weeks will elapse between the cessation of therapy and the blood draw; this interval depends on the type and dosage of HRT. Following confirmation of their post-menopausal status, they can resume use of HRT during the study without use of a contraceptive method.]; Child-bearing potential and agrees to use one of the contraception methods listed in Section 8.1.1 for an appropriate period of time (as determined by the product label or investigator) prior to the start of dosing to sufficiently minimize the risk of pregnancy at that point. Female subjects must agree to use contraception until one month post-last dose = 2. A female subject is eligible to participate if she is of: Non-childbearing potential defined as pre-menopausal females with a hysterectomy; or postmenopausal defined as 12 months of spontaneous amenorrhea [in questionable cases a blood sample with simultaneous follicle stimulating hormone (FSH) > 40 MlU/ml and estradiol < 40 pg/ml (<140 pmol/L) is confirmatory]. [Females on hormone replacement therapy (HRT) and whose menopausal status is in doubt will be required to use one of the contraception methods in Section 8.1.1 if they wish to continue their HRT during the study. Otherwise, they must discontinue HRT to allow confirmation of post-menopausal status prior to study enrollment. For most forms of HRT, at least 2-4 weeks will elapse between the cessation of therapy and the blood draw; this interval depends on the type and dosage of HRT. Following confirmation of their post-menopausal status, they can resume use of HRT during the study without use of a contraceptive method.]; Child-bearing potential and agrees to use one of the contraception methods listed in Section 8.1.1 for an appropriate period of time (as determined by the product label or investigator) prior to the start of dosing to sufficiently minimize the risk of pregnancy at that point. Female subjects must agree to use contraception until one month post-last dose (2)
CL Item
Subject must read and write at a level sufficient to complete study-related assessments. (10)
Item
No, please select all boxes corresponding to violations of any inclusion/ exclusion criteria - Exclusion Criteria
text
C0680251 (UMLS CUI [1])
Code List
No, please select all boxes corresponding to violations of any inclusion/ exclusion criteria - Exclusion Criteria
CL Item
Subjects has: Symptoms of the presenting illness which are better accounted for by another diagnosis*; or A current DSM-IV-TR Axis I diagnosis of Dementia; or Antisocial or Borderline Personality Disorder or other current DSM-IV-TR Axis II diagnosis that would suggest non-responsiveness to pharmacotherapy or non- compliance with the protocol; or A current (or within six months prior to the Screening visit) diagnosis of anorexia nervosa or bulimia; or A lifetime history of Schizophrenia, Schizoaffective Disorder, or a Bipolar Disorder. (1)
CL Item
Subjects who, in the investigator’s judgement, pose a homicidal or serious suicidal risk, have made a suicide attempt within 6 months preceding screening or who have ever been homicidal. (2)
CL Item
Subject has initiated psychotherapy within one month prior to the Screening visit, or plans to initiate psychotherapy during the trial. Subjects who present with their current MDD diagnosis despite longer term psychotherapy (i.e., greater than three months prior to the Screening visit) and who agree to maintain the same therapy schedule during the trial may be included. (3)
CL Item
Subject has received vagus nerve stimulation, electroconvulsive therapy, or transcranial magnetic stimulation within the six months prior to the Screening visit. (4)
CL Item
Subject has previously failed an adequate therapeutic course of pharmacotherapy for MDD (e.g., for ≥ 4 weeks) from two different classes of antidepressants. (5)
CL Item
Subject has an unstable medical disorder or a disorder that would interfere with the action, absorption, distribution, metabolism, or excretion of GSK163090 or may pose a safety concern, or interfere with the accurate assessment of safety or efficacy. (6)
CL Item
The subject has a past history of drug abuse or dependence according to DSM-IV TR criteria within the past 12 months or has tested positive for urine drugs of abuse at pre-study screening except as detailed in Section 9.1.1. (7)
CL Item
Abuse of alcohol. To determine if a subject is abusing alcohol investigator will consider: average weekly intake of alcohol, score achieved on Alcohol Use Disorders Identification Test (AUDIT –C, Appendix 8 ) and results from laboratory assessments (in particular any abnormalities to AST: ALT ratio, GGT and MCV). (8)
CL Item
The subject has a past history of serotonin syndrome or in the investigator’s judgement, a history of clinical significant intolerance of SSRIs. (9)
CL Item
Subjects with a history of migraine headaches that respond to treatment with triptan medication. (10)
CL Item
The subject has a history of a clinically significant abnormality of the neurological system (including dementia and other cognitive disorders or significant head injury) or any history of seizure (excluding febrile seizure). (11)
CL Item
A positive pre-study HIV, Hepatitis B surface antigen or positive Hepatitis C antibody result within 3 months of screening. (12)
CL Item
The subject is currently participating in another clinical study in which the subject is or will be exposed to an investigational or non-investigational drug or device, or has done so within the preceding month for studies unrelated to the current illness, or six months for studies related to MDD. (13)
CL Item
The subject has a screening ECG with a QTc value of >450msec and or a PR interval outside the range 110 to 220msec or an ECG that is not suitable for QT measurements (e.g poorly defined termination of the T-wave). (14)
CL Item
Any cardiac condition or ECG evidence that the investigator feels may predispose the subject to ischemia or arrhythmia or any ECG abnormality that, in the investigator’s judgment, may pose a potential safety concern. (15)
CL Item
The subject has a systolic blood pressure (SBP) ≥160mmHg or a diastolic blood pressure (DBP) ≥ 100 mmHg verified by repeated measurement at the Screening or Randomization visit. (16)
CL Item
The subject has any liver function enzyme (ALT, AST, ALP or GGT) elevated > 2 times, or total or direct bilirubin>1.5 times (unless consistent with presumed or diagnosed Gilbert’s disease), above the reference range at pre-study screening that remains elevated with a repeat LFT. (17)
CL Item
Subjects who are not euthyroid based on lab results at the screening visit. Subjects maintained on thyroid medication must be euthyroid for a period of at least six months prior to the screen visit. (18)
CL Item
Subject has any laboratory abnormality that in the investigator’s judgement is considered to be clinically significant and could potentially affect subject safety or study outcome. (19)
CL Item
Subject is female and has a positive Human Chorionic Gonadotropin (HCG) pregnancy test at screen visit, a positive urine dipstick test at randomization, or who is lactating or planning to become pregnant within 4 weeks following the last dose of study medication. (20)
CL Item
Subject has received depot antipsychotics within the 12 weeks before screening. (21)
CL Item
Subject has taken a regular course of other psychoactive drugs within the two weeks (22)
CL Item
Subject has taken other (non-psychoactive) prescription, non-prescription, dietary, or herbal products that are potent or moderate inducers and/or inhibitors of the cytochrome P450 3A4 pathway for 2 weeks (or 5 half lives, whichever is longer) prior to the Randomization visit. (23)
CL Item
Subject has taken other (non-psychoactive) prescription, non-prescription, dietary, or herbal products metabolized via the cytochrome P450 3A4 pathway with a narrow therapeutic index within 2 weeks (or 5 half-lives, whichever is longer) prior to the Randomization visit. (24)
CL Item
Subject has taken other (non-psychoactive) prescription, non-prescription that are inhibitors of the P-glycoprotein for 2 weeks (or 5 half lives, whichever is longer) prior to the Randomization visit. (25)
CL Item
Use of monoamine oxidase inhibitors (MAOI) and linezolid (antibiotic) for 1 month prior to first dose of study medication. (26)
CL Item
History of sensitivity to any of the study medications, or components thereof or a history of drug or other allergy that, in the opinion of the investigator or GSK Medical Monitor, contraindicates their participation. (27)
CL Item
prior to the Screening Visit (except as discussed and permitted in section 9.1.1): All antidepressants including SSRIs (with the exception of fluoxetine, which requires 5 weeks), Long acting benzodiazepines, other psychoactive medications (including psychoactive herbal treatments, e.g., St. John’s Wort, SAM-E), Lithium, other mood stabilizers (including anticonvulsants) and oral antipsychotics, Opiates (including tramadol), hypnotics, and all other sedatives (including sedating antihistamines if they are used for their sedating and/or hypnotic properties) (prior to the Screening Visit (except as discussed and permitted in section 9.1.1): All antidepressants including SSRIs (with the exception of fluoxetine, which requires 5 weeks), Long acting benzodiazepines, other psychoactive medications (including psychoactive herbal treatments, e.g., St. John’s Wort, SAM-E), Lithium, other mood stabilizers (including anticonvulsants) and oral antipsychotics, Opiates (including tramadol), hypnotics, and all other sedatives (including sedating antihistamines if they are used for their sedating and/or hypnotic properties))
Item Group
Status of Medications
C2347852 (UMLS CUI-1)
Concomitant Agent
Item
Were any medications recorded on the In-Clinic Medications Taken Diary?
boolean
C2347852 (UMLS CUI [1])
Concomitant Agent, Sequence Number
Item
Sequence Number
integer
C2347852 (UMLS CUI [1,1])
C2348184 (UMLS CUI [1,2])
Concomitant Agent, Medication name
Item
Drug Name (Trade Name preferred)
text
C2347852 (UMLS CUI [1,1])
C2360065 (UMLS CUI [1,2])
Concomitant Agent, Medication name, Reported Term
Item
Modified reported term
text
C2347852 (UMLS CUI [1,1])
C2360065 (UMLS CUI [1,2])
C2826302 (UMLS CUI [1,3])
Concomitant Agent, Pharmaceutical Preparations, Synonym
Item
GSK Drug synonym
text
C2347852 (UMLS CUI [1,1])
C0013227 (UMLS CUI [1,2])
C0871468 (UMLS CUI [1,3])
Concomitant Agent, Code
Item
GSK Drug Collection code
text
C2347852 (UMLS CUI [1,1])
C0805701 (UMLS CUI [1,2])
Concomitant Agent, Code, Failed
Item
Failed coding
text
C2347852 (UMLS CUI [1,1])
C0805701 (UMLS CUI [1,2])
C0231175 (UMLS CUI [1,3])
Concomitant Agent, Date in time
Item
Date Taken
date
C2347852 (UMLS CUI [1,1])
C0011008 (UMLS CUI [1,2])
Concomitant Agent, Time
Item
Time Taken
time
C2347852 (UMLS CUI [1,1])
C0040223 (UMLS CUI [1,2])
Item Group
Vital Signs
C0518766 (UMLS CUI-1)
Body Height
Item
Height
integer
C0005890 (UMLS CUI [1])
Body Weight
Item
Weight
float
C0005910 (UMLS CUI [1])
Body mass index
Item
Body mass index
float
C1305855 (UMLS CUI [1])
Systolic Pressure
Item
Blood pressure(1st Reading) - Systolic
integer
C0871470 (UMLS CUI [1])
Diastolic blood pressure
Item
Blood pressure(1st Reading) - Diastolic
integer
C0428883 (UMLS CUI [1])
Systolic Pressure
Item
Blood pressure(2nd Reading) - Systolic
integer
C0871470 (UMLS CUI [1])
Diastolic blood pressure
Item
Blood pressure(2nd Reading) - Diastolic
integer
C0428883 (UMLS CUI [1])
Systolic Pressure
Item
Blood pressure(3rd Reading) - Systolic
integer
C0871470 (UMLS CUI [1])
Diastolic blood pressure
Item
Blood pressure(3rd Reading) - Diastolic
integer
C0428883 (UMLS CUI [1])
Heart rate
Item
Heart rate
integer
C0018810 (UMLS CUI [1])
Systolic Pressure, Low, Average
Item
Average of the lowest two blood pressure readings - Systolic
integer
C0871470 (UMLS CUI [1,1])
C0205251 (UMLS CUI [1,2])
C1510992 (UMLS CUI [1,3])
Diastolic blood pressure, Low, Average
Item
Average of the lowest two blood pressure readings - Diastolic
integer
C0428883 (UMLS CUI [1,1])
C0205251 (UMLS CUI [1,2])
C1510992 (UMLS CUI [1,3])
Item Group
12-Lead ECG
C0430456 (UMLS CUI-1)
12 lead ECG, Date in time
Item
Date of ECG
date
C0430456 (UMLS CUI [1,1])
C0011008 (UMLS CUI [1,2])
12 lead ECG, Heart rate
Item
Heart rate
integer
C0430456 (UMLS CUI [1,1])
C0018810 (UMLS CUI [1,2])
12 lead ECG, P-R Interval
Item
PR Interval
integer
C0430456 (UMLS CUI [1,1])
C0429087 (UMLS CUI [1,2])
12 lead ECG, QRS complex duration
Item
QRS Duration
integer
C0430456 (UMLS CUI [1,1])
C0429025 (UMLS CUI [1,2])
12 lead ECG, QT Interval
Item
Uncorrected QT Interval
integer
C0430456 (UMLS CUI [1,1])
C1287082 (UMLS CUI [1,2])
12 lead ECG, Electrocardiogram QT corrected interval
Item
QTc Interval
integer
C0430456 (UMLS CUI [1,1])
C0855331 (UMLS CUI [1,2])
Item
Result of the ECG
text
C0430456 (UMLS CUI [1,1])
C1274040 (UMLS CUI [1,2])
Code List
Result of the ECG
CL Item
Normal (1)
CL Item
Abnormal - Not clinically significant (2)
CL Item
Abnormal, clinically significant  (3)
CL Item
No result (not available) (4)
12 lead ECG, QRS Axis
Item
QRS Axis
text
C0430456 (UMLS CUI [1,1])
C0429012 (UMLS CUI [1,2])
12 lead ECG, RR interval
Item
RR interval
integer
C0430456 (UMLS CUI [1,1])
C0489636 (UMLS CUI [1,2])
Item Group
Investigator Signature
C2346576 (UMLS CUI-1)
Clinical Study Case, Investigator Signature
Item
Is this casebook ready to sign?
boolean
C1706256 (UMLS CUI [1,1])
C2346576 (UMLS CUI [1,2])
Clinical Study Case, Investigator Signature
Item
For Data Managers or Monitors only: Tick or untick this box to require the investigator to re- sign the case book
boolean
C1706256 (UMLS CUI [1,1])
C2346576 (UMLS CUI [1,2])

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