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| Name | Class |
|---|---|
| Merck Ltd. | INDUSTRY |
This is a 24-week, prospective, multicenter, open-label, single-arm study to assess the effect of bisoprolol on glycemic level in Type 2 diabetes mellitus (T2DM) controlled subjects with hypertension. The hypothesis of study is that there is no change in glycemic level and lipid metabolism as determined by glycosylated hemoglobin (HbA1c) using bisoprolol in T2DM subjects with suboptimal blood pressure (BP) control.
Diabetes mellitus and hypertension are two of the most common chronic conditions, and each predisposes to accelerated atherosclerosis, cardiovascular disease, and death. There has been a concern that beta-blocker might have adverse effects in subjects with diabetes on glucose metabolism, but some data shows that highly beta-1 selective agents such as bisoprolol are essentially free of metabolic disturbances involving blood sugar, insulin sensitivity and lipids.
This is a prospective, multicenter, single-arm, open-label study to assess the glycemic effect of bisoprolol in T2DM subjects with suboptimal BP control.
After pre-screening period, each enrolled subject with T2DM and suboptimal BP control will undergo laboratory test for efficacy and safety measurement. After that, subject will continue his/her usual dosage of antihypertensive medication and bisoprolol will be added.
Subjects will be instructed to continue their diet and level of physical activity and to attempt to maintain current body weight until completion of the study.
Bisoprolol will be titrated upward until a dosage that lowers BP to less than 130/80 millimeter of mercury (mmHg) during the first 2 months of treatment. The maximum dosage of bisoprolol will be 10 mg once daily. Following 6 month of added bisoprolol therapy, all efficacy and safety measurements will be repeated.
The duration of study will be up to 24 weeks for each subject.
Objectives
Primary objective:
Secondary objectives:
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Bisoprolol | Experimental |
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| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Bisoprolol | Drug | Bisoprolol tablet will be administered orally at dose of 5 milligram (mg) once daily for 24 weeks. If the blood pressure is not less than 130/80 millimeter of mercury (mmHg) during the first 8 weeks of treatment (up-titration), then the dose will be adjusted to 10 mg daily. In cases of hypotensive effect, symptomatic bradycardia or arrhythmia, the daily dose will be reduced to 2.5 mg. |
| Measure | Description | Time Frame |
|---|---|---|
| Change From Baseline in Glycosylated Hemoglobin (HbA1c) at Month 6 | HbA1c represents the percentage of glycosylated hemoglobin. The change in HbA1c at Month 6 was calculated as HbA1c at Month 6 minus HbA1c at baseline. | Baseline, Month 6 |
| Measure | Description | Time Frame |
|---|---|---|
| Change From Baseline in Glycosylated Hemoglobin (HbA1c) at Month 3 | HbA1c represents the percentage of glycosylated hemoglobin. The change in HbA1c at Month 3 was calculated as HbA1c at Month 3 minus HbA1c at baseline. | Baseline, Month 3 |
| Change From Baseline in Systolic Blood Pressure (SBP), Diastolic Blood Pressure (DBP) and Mean Blood Pressure (BP) at Month 6 |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Medical Responsible | Merck Ltd. | Study Director |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Seoul St. Mary´s Hospital | Seoul | South Korea |
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| ID | Title | Description |
|---|---|---|
| FG000 | Bisoprolol | Bisoprolol tablet was administered orally at dose of 5 milligram (mg) once daily for 24 weeks. If the blood pressure was not less than 130/80 millimeter of mercury (mmHg) during the first 8 weeks of treatment (up-titration), then the dose was adjusted to 10 mg daily. In cases of hypotensive effect, symptomatic bradycardia or arrhythmia, the daily dose was reduced to 2.5 mg. |
| Title | Milestones | Reasons Not Completed | |||||
|---|---|---|---|---|---|---|---|
| Overall Study |
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The change in SBP, DBP, and mean BP at Month 6 were calculated as SBP, DBP, and mean BP at Month 6 minus SBP, DBP, and mean BP at baseline, respectively. Mean BP was calculated using the formula: (DBP plus [{SBP minus DBP} divided by 3]). |
| Baseline, Month 6 |
| Change From Baseline in Homeostasis Model Assessment of Insulin Resistance (HOMA-IR) at Months 3 and 6 | HOMA-IR is as an indicator of insulin resistance in participants with Type 2 diabetes mellitus and comorbid hypertension. HOMA-IR was derived from fasting plasma glucose (FPG) and fasting insulin (FI) using the formula: (FI [micro international units per milliliter {mcIU/mL}] * FPG [millimole per liter {mmol/L}]) divided by 22.5. The change in HOMA-IR at Months 3 and 6 was calculated as HOMA-IR at Months 3 and 6 minus HOMA-IR at baseline. | Baseline, Months 3 and 6 |
| Change From Baseline in Insulin Level at Months 3 and 6 | The change in insulin level at Months 3 and 6 was calculated as insulin level at Months 3 and 6 minus insulin level at baseline. | Baseline, Months 3 and 6 |
| Change From Baseline in C-Peptide Level at Months 3 and 6 | The change in C-peptide level at Months 3 and 6 was calculated as C-peptide level at Months 3 and 6 minus C-peptide level at baseline. | Baseline, Months 3 and 6 |
| Change From Baseline in Total Cholesterol, Low Density Lipoprotein (LDL) Cholesterol, High Density Lipoprotein (HDL) Cholesterol and Triglyceride Level at Month 6 | The change in total cholesterol, low density lipoprotein (LDL) cholesterol, high density lipoprotein (HDL) cholesterol, and triglyceride levels at Month 6 was calculated as total cholesterol, LDL cholesterol, HDL cholesterol, and triglyceride levels at Month 6 minus total cholesterol, LDL cholesterol, HDL cholesterol, and triglyceride levels at baseline, respectively. | Baseline, Month 6 |
| Change From Baseline in Albumin/Creatinine Ratio at Month 6 | The change in albumin/creatinine ratio at Month 6 was calculated as albumin/creatinine ratio at Month 6 minus albumin/creatinine ratio at baseline. | Baseline, Month 6 |
| Change From Baseline in Microalbumin Level at Month 6 | The change in microalbumin level at Month 6 was calculated as microalbumin level at Month 6 minus microalbumin level at baseline. | Baseline, Month 6 |
| Number of Participants With Adverse Events (AEs) and Serious Adverse Events (SAEs) | An Adverse Event (AE) was defined as any new untoward medical occurrences/worsening of pre-existing medical condition without regard to possibility of causal relationship. A Serious Adverse Event (SAE) was an AE that resulted in any of the following outcomes: death; life threatening; persistent/significant disability/incapacity; initial or prolonged inpatient hospitalization; congenital anomaly/birth defect. | Baseline up to Month 6 |
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| COMPLETED |
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| NOT COMPLETED |
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Analysis population included all the participants who were enrolled in this study.
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| ID | Title | Description |
|---|---|---|
| BG000 | Bisoprolol | Bisoprolol tablet was administered orally at dose of 5 mg once daily for 24 weeks. If the blood pressure was not less than 130/80 mmHg during the first 8 weeks of treatment (up-titration), then the dose was adjusted to 10 mg daily. In cases of hypotensive effect, symptomatic bradycardia or arrhythmia, the daily dose was reduced to 2.5 mg. |
| Units | Counts |
|---|---|
| Participants |
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| Title | Description | Population Description | Parameter Type | Dispersion Type | Unit of Measure | Calculate Percentage | Denominator Units Selected | Denominators | Classes | ||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Age, Continuous | Mean | Standard Deviation | years |
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| Sex: Female, Male | Count of Participants | Participants |
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| Type | Title | Description | Population Description | Reporting Status | Anticipated Posting Date | Parameter Type | Dispersion Type | Unit of Measure | Calculate Percentage | Time Frame | Units Analyzed | Denominator Units Selected | Arm/Group Information | Denominators | Classes | Analyses | |||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Primary | Change From Baseline in Glycosylated Hemoglobin (HbA1c) at Month 6 | HbA1c represents the percentage of glycosylated hemoglobin. The change in HbA1c at Month 6 was calculated as HbA1c at Month 6 minus HbA1c at baseline. | Full analysis set (FAS) included all participants who received at least one dose of investigational product and for whom the primary efficacy endpoint (HbA1c) was measured. | Posted | Mean | Standard Deviation | Percent HbA1c | Baseline, Month 6 |
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| Secondary | Change From Baseline in Glycosylated Hemoglobin (HbA1c) at Month 3 | HbA1c represents the percentage of glycosylated hemoglobin. The change in HbA1c at Month 3 was calculated as HbA1c at Month 3 minus HbA1c at baseline. | FAS included all participants who received at least one dose of investigational product and for whom the primary efficacy endpoint (HbA1c) was measured. | Posted | Mean | Standard Deviation | Percent HbA1c | Baseline, Month 3 |
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| Secondary | Change From Baseline in Systolic Blood Pressure (SBP), Diastolic Blood Pressure (DBP) and Mean Blood Pressure (BP) at Month 6 | The change in SBP, DBP, and mean BP at Month 6 were calculated as SBP, DBP, and mean BP at Month 6 minus SBP, DBP, and mean BP at baseline, respectively. Mean BP was calculated using the formula: (DBP plus [{SBP minus DBP} divided by 3]). | FAS included all participants who received at least one dose of investigational product and for whom the primary efficacy endpoint (HbA1c) was measured. | Posted | Mean | Standard Deviation | mmHg | Baseline, Month 6 |
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| Secondary | Change From Baseline in Homeostasis Model Assessment of Insulin Resistance (HOMA-IR) at Months 3 and 6 | HOMA-IR is as an indicator of insulin resistance in participants with Type 2 diabetes mellitus and comorbid hypertension. HOMA-IR was derived from fasting plasma glucose (FPG) and fasting insulin (FI) using the formula: (FI [micro international units per milliliter {mcIU/mL}] * FPG [millimole per liter {mmol/L}]) divided by 22.5. The change in HOMA-IR at Months 3 and 6 was calculated as HOMA-IR at Months 3 and 6 minus HOMA-IR at baseline. | FAS included all participants who received at least one dose of investigational product and for whom the primary efficacy endpoint (HbA1c) was measured. | Posted | Mean | Standard Deviation | mcIU/mL * mmol/L | Baseline, Months 3 and 6 |
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| Secondary | Change From Baseline in Insulin Level at Months 3 and 6 | The change in insulin level at Months 3 and 6 was calculated as insulin level at Months 3 and 6 minus insulin level at baseline. | FAS included all participants who took the investigational product at least once and for whom the primary efficacy endpoint (HbA1c) was measured. | Posted | Mean | Standard Deviation | mcIU/mL | Baseline, Months 3 and 6 |
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| Secondary | Change From Baseline in C-Peptide Level at Months 3 and 6 | The change in C-peptide level at Months 3 and 6 was calculated as C-peptide level at Months 3 and 6 minus C-peptide level at baseline. | FAS included all participants who took the investigational product at least once and for whom the primary efficacy endpoint (HbA1c) was measured. | Posted | Mean | Standard Deviation | nanogram per milliliter (ng/mL) | Baseline, Months 3 and 6 |
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| Secondary | Change From Baseline in Total Cholesterol, Low Density Lipoprotein (LDL) Cholesterol, High Density Lipoprotein (HDL) Cholesterol and Triglyceride Level at Month 6 | The change in total cholesterol, low density lipoprotein (LDL) cholesterol, high density lipoprotein (HDL) cholesterol, and triglyceride levels at Month 6 was calculated as total cholesterol, LDL cholesterol, HDL cholesterol, and triglyceride levels at Month 6 minus total cholesterol, LDL cholesterol, HDL cholesterol, and triglyceride levels at baseline, respectively. | FAS included all participants who took the investigational product at least once and for whom the primary efficacy endpoint (HbA1c) was measured. Here, "N" (number of participants analyzed) signifies those participants who were evaluable for this outcome measure and "n" signifies those participants who were evaluable for the specified category. | Posted | Mean | Standard Deviation | milligram per deciliter (mg/dL) | Baseline, Month 6 |
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| Secondary | Change From Baseline in Albumin/Creatinine Ratio at Month 6 | The change in albumin/creatinine ratio at Month 6 was calculated as albumin/creatinine ratio at Month 6 minus albumin/creatinine ratio at baseline. | FAS included all participants who took the investigational product at least once and for whom the primary efficacy endpoint (HbA1c) was measured. Here, "N" (number of participants analyzed) signifies those participants who were evaluable for this outcome measure and "n" signifies those participants who were evaluable for the specified category. | Posted | Mean | Standard Deviation | ratio | Baseline, Month 6 |
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| Secondary | Change From Baseline in Microalbumin Level at Month 6 | The change in microalbumin level at Month 6 was calculated as microalbumin level at Month 6 minus microalbumin level at baseline. | FAS included all participants who took the investigational product at least once and for whom the primary efficacy endpoint (HbA1c) was measured. Here, "N" (number of participants analyzed) signifies those participants who were evaluable for this outcome measure and "n" signifies those participants who were evaluable for the specified category. | Posted | Mean | Standard Deviation | mg/dL | Baseline, Month 6 |
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| Secondary | Number of Participants With Adverse Events (AEs) and Serious Adverse Events (SAEs) | An Adverse Event (AE) was defined as any new untoward medical occurrences/worsening of pre-existing medical condition without regard to possibility of causal relationship. A Serious Adverse Event (SAE) was an AE that resulted in any of the following outcomes: death; life threatening; persistent/significant disability/incapacity; initial or prolonged inpatient hospitalization; congenital anomaly/birth defect. | Safety population included all participants who received at least one dose of investigational product. | Posted | Number | participants | Baseline up to Month 6 |
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Baseline up to Month 6
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| ID | Title | Description | Deaths (Affected) | Deaths (At Risk) | Serious Events (Affected) | Serious Events (At Risk) | Other Events (Affected) | Other Events (At Risk) |
|---|---|---|---|---|---|---|---|---|
| EG000 | Bisoprolol | Bisoprolol tablet was administered orally at dose of 5 mg once daily for 24 weeks. If the blood pressure was not less than 130/80 mmHg during the first 8 weeks of treatment (up-titration), then the dose was adjusted to 10 mg daily. In cases of hypotensive effect, symptomatic bradycardia or arrhythmia, the daily dose was reduced to 2.5 mg. | 7 | 200 | 61 | 200 |
| Term | Organ System | Source Vocabulary | Assessment Type | Notes | Statistical Information |
|---|---|---|---|---|---|
| Fracture lower limb | Musculoskeletal and connective tissue disorders | Non-systematic Assessment |
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| Fracture rib | Musculoskeletal and connective tissue disorders | Non-systematic Assessment |
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| Fracture upper limb | Musculoskeletal and connective tissue disorders | Non-systematic Assessment |
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| Musculoskeletal disorder | Musculoskeletal and connective tissue disorders | Non-systematic Assessment |
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| Breast cancer | Neoplasms benign, malignant and unspecified (incl cysts and polyps) | Non-systematic Assessment |
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| Gallbladder carcinoma | Neoplasms benign, malignant and unspecified (incl cysts and polyps) | Non-systematic Assessment |
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| Hepatic neoplasm malignant | Neoplasms benign, malignant and unspecified (incl cysts and polyps) | Non-systematic Assessment |
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| Neoplasm metastatic | Neoplasms benign, malignant and unspecified (incl cysts and polyps) | Non-systematic Assessment |
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| Term | Organ System | Source Vocabulary | Assessment Type | Notes | Statistical Information |
|---|---|---|---|---|---|
| Oedema | General disorders | Non-systematic Assessment |
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| Oedema periorbital | General disorders | Non-systematic Assessment |
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| Pain legs | General disorders | Non-systematic Assessment |
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| Sensation of warmth | General disorders | Non-systematic Assessment |
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| Weakness generalized | General disorders | Non-systematic Assessment |
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| ECG abnormal | Cardiac disorders | Non-systematic Assessment |
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| AV block first degree | Cardiac disorders | Non-systematic Assessment |
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| Bradyarrhythmia | Cardiac disorders | Non-systematic Assessment |
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| Palpitation | Cardiac disorders | Non-systematic Assessment |
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| Dizziness | Nervous system disorders | Non-systematic Assessment |
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| Dizziness postural | Nervous system disorders | Non-systematic Assessment |
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| Headache | Nervous system disorders | Non-systematic Assessment |
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| Numbness | Nervous system disorders | Non-systematic Assessment |
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| Vocal cord paralysis | Nervous system disorders | Non-systematic Assessment |
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| Abdominal discomfort | Gastrointestinal disorders | Non-systematic Assessment |
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| Abdominal pain | Gastrointestinal disorders | Non-systematic Assessment |
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| Abdominal pain upper | Gastrointestinal disorders | Non-systematic Assessment |
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| Colonic polyp | Gastrointestinal disorders | Non-systematic Assessment |
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| Constipation | Gastrointestinal disorders | Non-systematic Assessment |
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| Diarrhoea | Gastrointestinal disorders | Non-systematic Assessment |
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| Dyspepsia | Gastrointestinal disorders | Non-systematic Assessment |
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| Enteritis | Gastrointestinal disorders | Non-systematic Assessment |
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| Gastritis | Gastrointestinal disorders | Non-systematic Assessment |
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| Gastritis aggravated | Gastrointestinal disorders | Non-systematic Assessment |
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| Gastritis atrophic | Gastrointestinal disorders | Non-systematic Assessment |
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| Gastro-intestinal disorder nos | Gastrointestinal disorders | Non-systematic Assessment |
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| Gastroenteritis | Gastrointestinal disorders | Non-systematic Assessment |
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| Gingivitis | Gastrointestinal disorders | Non-systematic Assessment |
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| Haemorrhoids | Gastrointestinal disorders | Non-systematic Assessment |
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| Irritable bowel syndrome | Gastrointestinal disorders | Non-systematic Assessment |
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| Nausea | Gastrointestinal disorders | Non-systematic Assessment |
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| Periodontitis | Gastrointestinal disorders | Non-systematic Assessment |
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| Reflux oesophagitis | Gastrointestinal disorders | Non-systematic Assessment |
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| Tooth ache | Gastrointestinal disorders | Non-systematic Assessment |
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| Vomiting | Gastrointestinal disorders | Non-systematic Assessment |
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| Biliary stones | Hepatobiliary disorders | Non-systematic Assessment |
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| Liver fatty | Hepatobiliary disorders | Non-systematic Assessment |
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| Liver function tests abnormal nos | Hepatobiliary disorders | Non-systematic Assessment |
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| Hyperglycaemia | Metabolism and nutrition disorders | Non-systematic Assessment |
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| Hyperlipaemia | Metabolism and nutrition disorders | Non-systematic Assessment |
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| Hypertriglyceridaemia | Metabolism and nutrition disorders | Non-systematic Assessment |
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| Polydipsia | Metabolism and nutrition disorders | Non-systematic Assessment |
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| Weight decrease | Metabolism and nutrition disorders | Non-systematic Assessment |
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| Arthralgia | Musculoskeletal and connective tissue disorders | Non-systematic Assessment |
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| Back pain | Musculoskeletal and connective tissue disorders | Non-systematic Assessment |
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| Jaw pain | Musculoskeletal and connective tissue disorders | Non-systematic Assessment |
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| Ligament disorder | Musculoskeletal and connective tissue disorders | Non-systematic Assessment |
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| Pain neck/shoulder | Musculoskeletal and connective tissue disorders | Non-systematic Assessment |
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| Larynx neoplasm benign | Neoplasms benign, malignant and unspecified (incl cysts and polyps) | Non-systematic Assessment |
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| Insomnia | Psychiatric disorders | Non-systematic Assessment |
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| Anaemia | Investigations | Non-systematic Assessment |
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| Benign prostatic hyperplasia | Reproductive system and breast disorders | Non-systematic Assessment |
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| Common cold | Infections and infestations | Non-systematic Assessment |
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| Coryza | Infections and infestations | Non-systematic Assessment |
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| Rhinitis | Infections and infestations | Non-systematic Assessment |
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| Tinea pedis | Infections and infestations | Non-systematic Assessment |
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| Upper respiratory tract infection | Infections and infestations | Non-systematic Assessment |
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| Bronchostenosis | Respiratory, thoracic and mediastinal disorders | Non-systematic Assessment |
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| Coughing | Respiratory, thoracic and mediastinal disorders | Non-systematic Assessment |
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| Dry cough | Respiratory, thoracic and mediastinal disorders | Non-systematic Assessment |
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| Pharyngeal disorder | Respiratory, thoracic and mediastinal disorders | Non-systematic Assessment |
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| Sputum disorder | Respiratory, thoracic and mediastinal disorders | Non-systematic Assessment |
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| Throat pain | Respiratory, thoracic and mediastinal disorders | Non-systematic Assessment |
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| Alopecia | Skin and subcutaneous tissue disorders | Non-systematic Assessment |
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| Pruritus | Skin and subcutaneous tissue disorders | Non-systematic Assessment |
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| Pruritus aggravated | Skin and subcutaneous tissue disorders | Non-systematic Assessment |
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| Skin injury | Skin and subcutaneous tissue disorders | Non-systematic Assessment |
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| Albuminuria | Renal and urinary disorders | Non-systematic Assessment |
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| Polyuria | Renal and urinary disorders | Non-systematic Assessment |
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| Renal cyst | Renal and urinary disorders | Non-systematic Assessment |
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| Peripheral coldness | Vascular disorders | Non-systematic Assessment |
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| Allergic conjunctivitis aggravated | Eye disorders | Non-systematic Assessment |
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| Cataract aggravated | Eye disorders | Non-systematic Assessment |
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| Conjunctivitis | Eye disorders | Non-systematic Assessment |
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| Eye abnormality | Eye disorders | Non-systematic Assessment |
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| Title | Organization | Phone | Extension | |
|---|---|---|---|---|
| Merck KGaA Communication Center | Merck Serono, a division of Merck KGaA | +49-6151-72-5200 | service@merckgroup.com |
| ID | Term |
|---|---|
| D006973 | Hypertension |
| D003924 | Diabetes Mellitus, Type 2 |
| ID | Term |
|---|---|
| D014652 | Vascular Diseases |
| D002318 | Cardiovascular Diseases |
| D003920 | Diabetes Mellitus |
| D044882 | Glucose Metabolism Disorders |
| D008659 | Metabolic Diseases |
| D009750 | Nutritional and Metabolic Diseases |
| D004700 | Endocrine System Diseases |
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| ID | Term |
|---|---|
| D017298 | Bisoprolol |
| ID | Term |
|---|---|
| D050198 | Phenoxypropanolamines |
| D011412 | Propanolamines |
| D000605 | Amino Alcohols |
| D000438 | Alcohols |
| D009930 | Organic Chemicals |
| D020005 | Propanols |
| D000588 | Amines |
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