Trial Documentation

PEXIVAS Study Visit Forms

Contact Details and Assessment Schedule 

Baseline

Download and Complete Form 1.1: Randomisation Notepad
Download and Complete Form 1.2: Entry

Baseline

Other forms to be completed at this visit

Required Samples to be collected at this visit Required (for patients that have consented to sample collection)
BVAS/WG Yes DNA Pax Tube Yes
CDA  Yes RNA Pax Tube Yes
SF-36 Yes Serum Tube Yes
EQ-5D Yes Plasma Tube Yes
    Renal Biopsy Yes

Week 2

 Download and Complete Form 2.1: Week 2 Follow-up

Other forms to be completed at this visit

Required Samples to be collected at this visit Required (for patients that have consented to sample collection)
BVAS/WG Yes DNA Pax Tube No
CDA  No RNA Pax Tube No
SF-36 No Serum Tube Yes
EQ-5D No Plasma Tube Yes

Week 4

Download and Complete Form 3.1: Week 4 Follow-up

Other forms to be completed at this visit

Required Samples to be collected at this visit Required (for patients that have consented to sample collection)
BVAS/WG Yes DNA Pax Tube No
CDA  No RNA Pax Tube No
SF-36 No Serum Tube No
EQ-5D No Plasma Tube No

Week 8

Download and Complete Form 4.1: Week 8 Follow-up

Other forms to be completed at this visit

Required Samples to be collected at this visit Required (for patients that have consented to sample collection)
BVAS/WG Yes DNA Pax Tube No
CDA  No RNA Pax Tube No
SF-36 No Serum Tube No
EQ-5D No Plasma Tube No

Week 12

Download and Complete Form 5.1: Week 12 Follow-up

Other forms to be completed at this visit

Required Samples to be collected at this visit Required (for patients that have consented to sample collection)
BVAS/WG Yes DNA Pax Tube No
CDA  Yes RNA Pax Tube Yes
SF-36 Yes Serum Tube Yes
EQ-5D Yes Plasma Tube Yes

Week 26

Download and Complete Form 6.1: Week 26 Follow-up

Other forms to be completed at this visit

Required Samples to be collected at this visit Required (for patients that have consented to sample collection)
BVAS/WG Yes DNA Pax Tube No
CDA  Yes RNA Pax Tube No
SF-36 Yes Serum Tube No
EQ-5D Yes Plasma Tube No

Week 39

Download and Complete Form 7.1: Week 39 Follow-up 

Other forms to be completed at this visit

Required Samples to be collected at this visit Required (for patients that have consented to sample collection)
BVAS/WG Yes DNA Pax Tube No
CDA  No RNA Pax Tube No
SF-36 No Serum Tube No
EQ-5D No Plasma Tube No

Week 52

Download and Complete Form 8.1: Week 52 Follow-up 

Other forms to be completed at this visit

Required Samples to be collected at this visit Required (for patients that have consented to sample collection)
BVAS/WG Yes DNA Pax Tube No
CDA  Yes RNA Pax Tube Yes
SF-36 Yes Serum Tube Yes
EQ-5D Yes Plasma Tube Yes

6 Monthly

Download and Complete Form 9.1: 6 Monthly Follow-up 

Other forms to be completed at this visit

Required Samples to be collected at this visit Required (for patients that have consented to sample collection)
BVAS/WG Yes DNA Pax Tube No
CDA  Yes RNA Pax Tube No
SF-36 Yes Serum Tube No
EQ-5D Yes Plasma Tube No

PEXIVAS Protocol

Centres should contact the PEXIVAS Study Office in Cambridge for the full protocol - please email Elizabeth Broadhurst at elizabeth.broadhurst@addenbrookes.nhs.uk