ndbcimzia.org

Cimzia® Safety Registry | National Data Bank for Rheumatic Diseases

Welcome to the Cimzia. In the pages that follow, we have included the necessary information and documents you will need for the study. You can either click the button at the bottom to go onto the next page or click on the headers above to go to a specific page. If you have any questions or need more forms, please contact us by phone, 1-800-323-5871 ext. 119. Or via email: rebecca@arthritis-research.org. National Data Bank for Rheumatic Diseases. Arthritis Research Center Foundation, Inc. Wichita, KS 67214.

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Arthritis Research Center Foundation Inc.

Mir, Hassan

1035 N. ●●●●●●●● Ste 288

Wi●●ta , KS, 67214

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Arthritis Research Center Foundation Inc.

Mir, Hassan

1035 N. ●●●●●●●● Ste 288

Wi●●ta , KS, 67214

US

1.31●●●●2125

1.31●●●●0761

ha●●●●@ARTHRITIS-RESEARCH.ORG

View this contact

Arthritis Research Center Foundation Inc.

Mir, Hassan

1035 N. ●●●●●●●● Ste 288

Wi●●ta , KS, 67214

US

1.31●●●●2125

1.31●●●●0761

ha●●●●@ARTHRITIS-RESEARCH.ORG

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Cimzia® Safety Registry | National Data Bank for Rheumatic Diseases | ndbcimzia.org Reviews

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Welcome to the Cimzia. In the pages that follow, we have included the necessary information and documents you will need for the study. You can either click the button at the bottom to go onto the next page or click on the headers above to go to a specific page. If you have any questions or need more forms, please contact us by phone, 1-800-323-5871 ext. 119. Or via email: rebecca@arthritis-research.org. National Data Bank for Rheumatic Diseases. Arthritis Research Center Foundation, Inc. Wichita, KS 67214.

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2 study overview

3 irb documents

4 enrollment

5 payment

6 use of data

7 safety registry

8 coupons

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Cimzia® Safety Registry | National Data Bank for Rheumatic Diseases | ndbcimzia.org Reviews

https://ndbcimzia.org

Welcome to the Cimzia. In the pages that follow, we have included the necessary information and documents you will need for the study. You can either click the button at the bottom to go onto the next page or click on the headers above to go to a specific page. If you have any questions or need more forms, please contact us by phone, 1-800-323-5871 ext. 119. Or via email: rebecca@arthritis-research.org. National Data Bank for Rheumatic Diseases. Arthritis Research Center Foundation, Inc. Wichita, KS 67214.

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ndbcimzia.org

1

Cimzia® Safety Registry | National Data Bank for Rheumatic Diseases

http://www.ndbcimzia.org/enroll_forms.html

It's simple to enroll a patient in the NDB-Cimzia. Here's all you have to do. Identify a RA patient who has started Cimzia. Or a nonbiologic DMARD within the last 6 months- -whether or not the patient is still receiving that treatment. Explain the study to the patient and obtain a signed informed consent. Make sure the patient completes the brief questionnaire. Give the patient a copy of the consent form. Completely fill out the physician form on the other side of this instruction form. Wichita, KS 67214.

2

Cimzia® Safety Registry | National Data Bank for Rheumatic Diseases

http://www.ndbcimzia.org/forms.html

Safety Registry is a part of the overall NDB Study and listed below are the documents you may need for IRB submission. Amendment to NDB Protocol. IRB request" href="mailto:rebecca@arthritis-research.org" Click here to request any of the documents above. Because this study does not involve any treatment and patients cannot be identified in any manner, you should be able to utilize your IRB expedited review process. National Data Bank for Rheumatic Diseases. Arthritis Research Center Foundation, Inc.

3

Cimzia® Safety Registry | National Data Bank for Rheumatic Diseases

http://www.ndbcimzia.org/data.html

National Data Bank for Rheumatic Diseases. Arthritis Research Center Foundation, Inc. 1035 N Emporia Suite 230. Wichita, KS 67214.

4

Cimzia® Safety Registry | National Data Bank for Rheumatic Diseases

http://www.ndbcimzia.org/training.html

The purpose of the study is to obtain safety and outcome data on rheumatoid arthritis (RA) patients receiving certolizumab pegol (Cimzia. And other RA treatments. Please note that this purpose is broader than just the evaluation of certolizumab pegol. What you agree to do. What the patient will do. The patients will complete an RA outcomes questionnaire every 6 months. Enrollment and how to enroll patient. A certolizumab pegol patient eligible for enrollment is a patient in your practice who will start c...

5

Cimzia® Safety Registry | National Data Bank for Rheumatic Diseases

http://www.ndbcimzia.org/payment.html

We will pay you $200 for every certolizumab pegol patient and $50 for each control patient who enrolls in the study. An enrolled patient is one who signs the informed consent and completes the follow-up NDB enrollment interview satisfactorily. If the patient decides at the time of the interview that he or she does not want to participate, we will pay you 1/4th of the above amounts ($50/$15) in compensation for your work. A non-enrolling patient may be replaced. Please complete this IRS W9 Form.

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Other Projects - National Data Bank for Rheumatic Diseases

http://webquest.arthritis-research.org/projects.asp

Dr Wolfe's C.V. RAlly: The National Data Bank for Rheumatic Diseases (NDB). For more information: www.ndbrally.org. Certolizumab pegol (Cimzia ) Safety Registry. For more information: www.ndbcimzia.org. Lupus in the Community (SLEC Study). Behind this project is the idea that we can understand lupus and its care and outcomes better if we study it in the community rather than in tertiary centers. ClinHAQ Faxback REPORT Project. This project utilizes a simple assessment questionnaire. Patients receive ...

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ndbcimzia.org

Cimzia® Safety Registry | National Data Bank for Rheumatic Diseases

Welcome to the Cimzia. In the pages that follow, we have included the necessary information and documents you will need for the study. You can either click the button at the bottom to go onto the next page or click on the headers above to go to a specific page. If you have any questions or need more forms, please contact us by phone, 1-800-323-5871 ext. 119. Or via email: rebecca@arthritis-research.org. National Data Bank for Rheumatic Diseases. Arthritis Research Center Foundation, Inc. Wichita, KS 67214.

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