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  1. 1. Clinical Trial
  2. 2. Routine Documentation
  3. 3. Registry/Cohort Study
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DEMOGRAPHY Ropinirole Case Report Form GSK RRL100013 - DEMOGRAPHY Ropinirole Case Report Form GSK

- 8/27/17 - 1 form, 8 itemgroups, 67 items, 2 languages
Itemgroups: DEMOGRAPHY, VITAL SIGNS, RLS DIAGNOSTIC CLINICAL INTERVIEW - WORKSHEET, ALCOHOL INTAKE, CAFFEINE INTAKE INVEST/GA TOR INSTRUCTIONS, RLS SCREEN HISTORY, INTERNATIONAL RESTLESS LEG SYNDROME STUDY GROUP (IRLSSG) DIAGNOSTIC CRITERIA, CARDIOVASCULAR MEDICAL HISTORY
DEMOGRAPHY Ropinirole Case Report Form GSK Study ID: 100013 Clinical Study ID: RRL100013 A 12-Week, Double-Blind, Placebo-Controlled, Twice-Daily Dosing Study to Assess the Efficacy and Safety of Ropinirole in Patients Suffering from Restless Legs Syndrome (RLS) Requiring Extended Treatment Coverage

RLS Symptoms on the first day of the patient RLS Symptoms Diary prior to the Week 48 Visit Ropinirole Restless Legs Syndrom NCT00355641 - RLS Symptoms on the first day of the patient RLS Symptoms Diary prior to the Week 48 Visit

- 8/13/17 - 1 form, 2 itemgroups, 30 items, 1 language
Itemgroups: General Information, Symptoms RLS
Study part: RLS Symptoms on the first day of the patient RLS Symptoms Diary prior to the Week 48 Visit. A 52-Week, Open-Label Study to Assess the Long-Term Safety of Ropinirole Extended Release (XR) in Patients with Restless Legs Syndrome (RLS). Patient Level Data: Study Listed on ClinicalStudyDataRequest.com. Clinicaltrials.gov Identifier: NCT00355641. Phase: phase 3. Study Recruitment Status: Completed. Generic Name: ropinirole. Trade Name Modutab, ZIPEREVE, ZEPREVE, REPREVE, ADARTREL, REQUIP, Zygara; Zygara, ZIPEREVE, ZEPREVE, Requip Depot, REQUIP, REPREVE, Modutab, ADARTREL. Study Indication : Restless Legs Syndrome. Study ID: 101468/206. Clinical Study ID: 101468/206.

RLS Symptoms on the first day of the patient RLS Symptoms Diary prior to the Week 24 Visit Ropinirole Restless Legs Syndrom NCT00355641 - RLS Symptoms on the first day of the patient RLS Symptoms Diary prior to the Week 24 Visit

- 8/13/17 - 1 form, 2 itemgroups, 30 items, 1 language
Itemgroups: General Information, Symptoms RLS
Study part: RLS Symptoms on the first day of the patient RLS Symptoms Diary prior to the Week 24 Visit. A 52-Week, Open-Label Study to Assess the Long-Term Safety of Ropinirole Extended Release (XR) in Patients with Restless Legs Syndrome (RLS). Patient Level Data: Study Listed on ClinicalStudyDataRequest.com. Clinicaltrials.gov Identifier: NCT00355641. Phase: phase 3. Study Recruitment Status: Completed. Generic Name: ropinirole. Trade Name Modutab, ZIPEREVE, ZEPREVE, REPREVE, ADARTREL, REQUIP, Zygara; Zygara, ZIPEREVE, ZEPREVE, Requip Depot, REQUIP, REPREVE, Modutab, ADARTREL. Study Indication : Restless Legs Syndrome. Study ID: 101468/206. Clinical Study ID: 101468/206.

RLS Symptoms on the first day of the patient RLS Symptoms Diary prior to the Week 52 Visit Ropinirole Restless Legs Syndrom NCT00355641 - RLS Symptoms on the first day of the patient RLS Symptoms Diary prior to the Week 52 Visit

- 8/13/17 - 1 form, 2 itemgroups, 30 items, 1 language
Itemgroups: General Information, Symptoms RLS
Study part: RLS Symptoms on the first day of the patient RLS Symptoms Diary prior to the Week 52 Visit. A 52-Week, Open-Label Study to Assess the Long-Term Safety of Ropinirole Extended Release (XR) in Patients with Restless Legs Syndrome (RLS). Patient Level Data: Study Listed on ClinicalStudyDataRequest.com. Clinicaltrials.gov Identifier: NCT00355641. Phase: phase 3. Study Recruitment Status: Completed. Generic Name: ropinirole. Trade Name Modutab, ZIPEREVE, ZEPREVE, REPREVE, ADARTREL, REQUIP, Zygara; Zygara, ZIPEREVE, ZEPREVE, Requip Depot, REQUIP, REPREVE, Modutab, ADARTREL. Study Indication : Restless Legs Syndrome. Study ID: 101468/206. Clinical Study ID: 101468/206.

RLS Symptoms on the first day of the patient RLS Symptoms Diary prior to the Week 36 Visit Ropinirole Restless Legs Syndrom NCT00355641 - RLS Symptoms on the first day of the patient RLS Symptoms Diary prior to the Week 36 Visit

- 8/13/17 - 1 form, 2 itemgroups, 30 items, 1 language
Itemgroups: General Information, Symptoms RLS
Study part: RLS Symptoms on the first day of the patient RLS Symptoms Diary prior to the Week 36 Visit . A 52-Week, Open-Label Study to Assess the Long-Term Safety of Ropinirole Extended Release (XR) in Patients with Restless Legs Syndrome (RLS). Patient Level Data: Study Listed on ClinicalStudyDataRequest.com. Clinicaltrials.gov Identifier: NCT00355641. Phase: phase 3. Study Recruitment Status: Completed. Generic Name: ropinirole. Trade Name Modutab, ZIPEREVE, ZEPREVE, REPREVE, ADARTREL, REQUIP, Zygara; Zygara, ZIPEREVE, ZEPREVE, Requip Depot, REQUIP, REPREVE, Modutab, ADARTREL. Study Indication : Restless Legs Syndrome. Study ID: 101468/206. Clinical Study ID: 101468/206.

RLS Symptoms on the first day of the patient RLS Symptoms Diary prior to the Week 36 Visit Ropinirole Restless Legs Syndrom NCT00355641 - RLS Symptoms on the first day of the patient RLS Symptoms Diary prior to the Week 36 Visit

- 8/13/17 - 1 form, 2 itemgroups, 30 items, 1 language
Itemgroups: General Information, Symptoms RLS
Study part: RLS Symptoms on the first day of the patient RLS Symptoms Diary prior to the Week 36 Visit. A 52-Week, Open-Label Study to Assess the Long-Term Safety of Ropinirole Extended Release (XR) in Patients with Restless Legs Syndrome (RLS). Patient Level Data: Study Listed on ClinicalStudyDataRequest.com. Clinicaltrials.gov Identifier: NCT00355641. Phase: phase 3. Study Recruitment Status: Completed. Generic Name: ropinirole. Trade Name Modutab, ZIPEREVE, ZEPREVE, REPREVE, ADARTREL, REQUIP, Zygara; Zygara, ZIPEREVE, ZEPREVE, Requip Depot, REQUIP, REPREVE, Modutab, ADARTREL. Study Indication : Restless Legs Syndrome. Study ID: 101468/206. Clinical Study ID: 101468/206.

RLS Symptoms on the first day of the patient RLS Symptoms Diary prior to the Week 12 Visit Ropinirole Restless Legs Syndrom NCT00355641 - RLS Symptoms on the first day of the patient RLS Symptoms Diary prior to the Week 12 Visit

- 8/13/17 - 1 form, 2 itemgroups, 30 items, 1 language
Itemgroups: General Information, Symptoms RLS
Study part: RLS Symptoms on the first day of the patient RLS Symptoms Diary prior to the Week 12 Visit. A 52-Week, Open-Label Study to Assess the Long-Term Safety of Ropinirole Extended Release (XR) in Patients with Restless Legs Syndrome (RLS). Patient Level Data: Study Listed on ClinicalStudyDataRequest.com. Clinicaltrials.gov Identifier: NCT00355641. Phase: phase 3. Study Recruitment Status: Completed. Generic Name: ropinirole. Trade Name Modutab, ZIPEREVE, ZEPREVE, REPREVE, ADARTREL, REQUIP, Zygara; Zygara, ZIPEREVE, ZEPREVE, Requip Depot, REQUIP, REPREVE, Modutab, ADARTREL. Study Indication : Restless Legs Syndrome. Study ID: 101468/206. Clinical Study ID: 101468/206.

RLS Symptoms on the first day of the patient RLS Symptoms diary prior to the Baseline Visit Ropinirole Restless Legs Syndrom NCT00355641 - RLS Symptoms on the first day of the patient RLS Symptoms diary prior to the Baseline Visit

- 8/13/17 - 1 form, 2 itemgroups, 28 items, 1 language
Itemgroups: General Information, Symptoms RLS
Study part: RLS Symptoms on the first day of the patient RLS Symptoms diary prior to the Baseline Visit. A 52-Week, Open-Label Study to Assess the Long-Term Safety of Ropinirole Extended Release (XR) in Patients with Restless Legs Syndrome (RLS). Patient Level Data: Study Listed on ClinicalStudyDataRequest.com. Clinicaltrials.gov Identifier: NCT00355641. Phase: phase 3. Study Recruitment Status: Completed. Generic Name: ropinirole. Trade Name Modutab, ZIPEREVE, ZEPREVE, REPREVE, ADARTREL, REQUIP, Zygara; Zygara, ZIPEREVE, ZEPREVE, Requip Depot, REQUIP, REPREVE, Modutab, ADARTREL. Study Indication : Restless Legs Syndrome. Study ID: 101468/206. Clinical Study ID: 101468/206.

Ambulatory Blood Pressure Monitoring Diary Restless Legs Syndrom NCT00355641 - Ambulatory Blood Pressure Monitoring Diary

- 8/13/17 - 1 form, 2 itemgroups, 19 items, 1 language
Itemgroups: General Information, Ambulatory Blood Pressure Monitoring
Study part: Ambulatory Blood Pressure Monitoring Diary. A 52-Week, Open-Label Study to Assess the Long-Term Safety of Ropinirole Extended Release (XR) in Patients with Restless Legs Syndrome (RLS). Patient Level Data: Study Listed on ClinicalStudyDataRequest.com. Clinicaltrials.gov Identifier: NCT00355641. Phase: phase 3. Study Recruitment Status: Completed. Generic Name: ropinirole. Trade Name Modutab, ZIPEREVE, ZEPREVE, REPREVE, ADARTREL, REQUIP, Zygara; Zygara, ZIPEREVE, ZEPREVE, Requip Depot, REQUIP, REPREVE, Modutab, ADARTREL. Study Indication : Restless Legs Syndrome. Study ID: 101468/206. Clinical Study ID: 101468/206.

Substance Use- Tobacco (SUBUSE) Ropinirole Restless Legs Syndrom NCT00355641 - Substance Use- Tobacco (SUBUSE)

- 8/13/17 - 1 form, 1 itemgroup, 2 items, 1 language
Itemgroup: Substance Use Disorder Tobacco
Study part: Substance Use- Tobacco (SUBUSE). A 52-Week, Open-Label Study to Assess the Long-Term Safety of Ropinirole Extended Release (XR) in Patients with Restless Legs Syndrome (RLS). Patient Level Data: Study Listed on ClinicalStudyDataRequest.com. Clinicaltrials.gov Identifier: NCT00355641. Phase: phase 3. Study Recruitment Status: Completed. Generic Name: ropinirole. Trade Name Modutab, ZIPEREVE, ZEPREVE, REPREVE, ADARTREL, REQUIP, Zygara; Zygara, ZIPEREVE, ZEPREVE, Requip Depot, REQUIP, REPREVE, Modutab, ADARTREL. Study Indication : Restless Legs Syndrome. Study ID: 101468/206. Clinical Study ID: 101468/206.

Investigational Product Compliance (COMP) Ropinirole Restless Legs Syndrom NCT00355641 - Investigational Product Compliance (COMP)

- 8/13/17 - 1 form, 4 itemgroups, 21 items, 1 language
Itemgroups: Total Daily Dose, Pharmaceutical Strength, Pharmaceutical Strength, Pharmaceutical Strength
Study part: Investigational Product Compliance (COMP). A 52-Week, Open-Label Study to Assess the Long-Term Safety of Ropinirole Extended Release (XR) in Patients with Restless Legs Syndrome (RLS). Patient Level Data: Study Listed on ClinicalStudyDataRequest.com. Clinicaltrials.gov Identifier: NCT00355641. Phase: phase 3. Study Recruitment Status: Completed. Generic Name: ropinirole. Trade Name Modutab, ZIPEREVE, ZEPREVE, REPREVE, ADARTREL, REQUIP, Zygara; Zygara, ZIPEREVE, ZEPREVE, Requip Depot, REQUIP, REPREVE, Modutab, ADARTREL. Study Indication : Restless Legs Syndrome. Study ID: 101468/206. Clinical Study ID: 101468/206.

Assessment Of Rebound (RBND) Ropinirole Restless Legs Syndrom NCT00355641 - Assessment Of Rebound (RBND)

- 8/12/17 - 1 form, 1 itemgroup, 2 items, 1 language
Itemgroup: Assessment
Study part: Assessment Of Rebound (RBND). A 52-Week, Open-Label Study to Assess the Long-Term Safety of Ropinirole Extended Release (XR) in Patients with Restless Legs Syndrome (RLS). Patient Level Data: Study Listed on ClinicalStudyDataRequest.com. Clinicaltrials.gov Identifier: NCT00355641. Phase: phase 3. Study Recruitment Status: Completed. Generic Name: ropinirole. Trade Name Modutab, ZIPEREVE, ZEPREVE, REPREVE, ADARTREL, REQUIP, Zygara; Zygara, ZIPEREVE, ZEPREVE, Requip Depot, REQUIP, REPREVE, Modutab, ADARTREL. Study Indication : Restless Legs Syndrome. Study ID: 101468/206. Clinical Study ID: 101468/206.

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