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AzTrials

Rheumatoid ArthritisPhase 2OSKIRA -4NCT01264770

Evaluation of Efficacy and Safety of Fostamatinib Monotherapy Compared With Adalimumab Monotherapy in Patients With Rheumatoid Arthritis (RA)

A Phase 2 study of Rheumatoid Arthritis, run by AstraZeneca at 105 sites in 13 countries.

Terminated

Stopped early. The study ended before it was planned to and will not resume.

Official record
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Trial summary

The purpose of the study is to evaluate the improvements in signs and symptoms of rheumatoid arthritis (RA) for fostamatinib compared to placebo or adalimumab in patients who are Disease-Modifying anti-rheumatic drug (DMARD) naïve, DMARD intolerant or have had an inadequate response to DMARDs. Read more about this study

Who is it for?
Ages 18 years and older
Conditions the study is for
Rheumatoid Arthritis
Could I receive a placebo?
Yes, some participants may receive a placebo
How many people
644 participants
Where
105 sitesin 13 countries
Study dates
Jan 2011to Aug 2013
Phase
Phase 2
Are there results?
Yes, posted in the registrySummary in the doctors' view

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 years and older
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • Male or female aged 18 and over
  • Active rheumatoid arthritis (RA) diagnosed after the age of 16 and diagnosis within 5 years prior to study visit 1 and inadequate response to treatment with a maximum 2 Disease-Modifying anti-rheumatic drug (DMARD) therapies, or diagnosis within 5 years prior to study visit 1 and intolerance to DMARD therapy, or diagnosis within 2 years prior to study visit 1 and no previous use of DMARDs
  • 4 or more swollen joints and 4 or more tender/painful joints (from 28 joint count) and either Erythrocyte Sedimentation Rate (ESR) blood result of 28mm/h or more, or C-Reactive Protein (CRP) blood result of 10mg/L or more
  • At least 2 of the following: documented history or current presence of positive rheumatoid factor (blood test), radiographic erosion within 12 months prior to study enrolment, presence of serum anti-cyclic citrullinated peptide antibodies (blood test)

Who cannot join

  • Females who are pregnant or breast feeding
  • Poorly controlled hypertension
  • Liver disease or significant liver function test abnormalities
  • Certain inflammatory conditions (other than rheumatoid arthritis), connective tissue diseases or chronic pain disorders
  • Recent or significant cardiovascular disease
  • Significant active or recent infection including tuberculosis
Show all 10Show fewer
  • Previously received treatment with a TNF alpha antagonist (including etanercept, certolizumab, adalimumab, infliximab, golimumab) or anakinra or previous treatment with other biological agent including rituximab, abatacept and tocilizumab
  • Use of any DMARDs within 6 weeks before first study visit
  • Severe renal impairment
  • Neutropenia

Trial locations and contacts

105 sites in 13 countries.

105 sites in 13 countries

United States40 sites
  • Research Site

    Albuquerque, New Mexico

  • Research Site

    Austin, Texas

  • Research Site

    Birmingham, Alabama

  • Research Site

    Bowling Green, Kentucky

  • Research Site

    Bridgeport, Connecticut

  • Research Site

    Brooklyn, New York

  • Research Site

    Charlotte, North Carolina

  • Research Site

    Chicago, Illinois

  • Research Site

    Colorado Springs, Colorado

  • Research Site

    Daytona Beach, Florida

  • Research Site

    Duncansville, Pennsylvania

  • Research Site

    Elizabethtown, Kentucky

  • Research Site

    Glendale, Arizona

  • Research Site

    Greenville, South Carolina

  • Research Site

    Houston, Texas

  • Research Site

    Huntington Beach, California

  • Research Site

    Jackson, Tennessee

  • Research Site

    Jacksonville, Florida

  • Research Site

    Kalamazoo, Michigan

  • Research Site

    Kalispell, Montana

  • Research Site

    Knoxville, Tennessee

  • Research Site

    Las Cruces, New Mexico

  • Research Site

    Long Beach, California

  • Research Site

    Memphis, Tennessee

  • Research Site

    Mesa, Arizona

  • Research Site

    Mesquite, Texas

  • Research Site

    Miami, Florida

  • Research Site

    Nashua, New Hampshire

  • Research Site

    Ocala, Florida

  • Research Site

    Oxon Hill, Maryland

  • Research Site

    Palm Harbor, Florida

  • Research Site

    Perrysburg, Ohio

  • Research Site

    Phoenix, Arizona

  • Research Site

    Pinellas Park, Florida

  • Research Site

    Plano, Texas

  • Research Site

    Richmond Heights, Missouri

  • Research Site

    San Antonio, Texas

  • Research Site

    Scottsdale, Arizona

  • Research Site

    South Bend, Indiana

  • Research Site

    Venice, Florida

Other trials in United States

Czechia9 sites
  • Research Site

    Brno

  • Research Site

    Bruntál

  • Research Site

    Hlučín

  • Research Site

    Liberec

  • Research Site

    Ostrava

  • Research Site

    Ostrava - Poruba

  • Research Site

    Ostrava - Trebovice

  • Research Site

    Prague

  • Research Site

    Zlín

Other trials in Czechia

Ukraine9 sites
  • Research Site

    Donetsk

  • Research Site

    Ivano-Frankivsk

  • Research Site

    Kharkiv

  • Research Site

    Kyiv

  • Research Site

    Lutsk

  • Research Site

    Lviv

  • Research Site

    Odesa

  • Research Site

    Simferopol

  • Research Site

    Zaporyzhzhya

Other trials in Ukraine

Poland8 sites
  • Research Site

    Bytom

  • Research Site

    Chełm Śląski

  • Research Site

    Grodzisk Mazowiecki

  • Research Site

    Lodz

  • Research Site

    Środa Wielkopolska

  • Research Site

    Warsaw

  • Research Site

    Wroclaw

  • Research Site

    Żyrardów

Other trials in Poland

United Kingdom8 sites
  • Research Site

    Basingstoke

  • Research Site

    Eastbourne, Sussex

  • Research Site

    Eastbourne

  • Research Site

    London, Greater London

  • Research Site

    London

  • Research Site

    Manchester

  • Research Site

    Reading, Berkshire

  • Research Site

    Wolverhampton

Other trials in United Kingdom

Russia7 sites
  • Research Site

    Moscow

  • Research Site

    Nizhny Novgorod

  • Research Site

    Petrozavodsk

  • Research Site

    Ryazan

  • Research Site

    Saint Petersburg

  • Research Site

    Voronezh

  • Research Site

    Yaroslavl

Other trials in Russia

South Africa7 sites
  • Research Site

    Cape Town, Western Cape

  • Research Site

    Cape Town

  • Research Site

    Durban, KwaZulu-Natal

  • Research Site

    Durban

  • Research Site

    Pretoria, Gauteng

  • Research Site

    Pretoria

  • Research Site

    Stellenbosch

Other trials in South Africa

Bulgaria6 sites
  • Research Site

    Pleven

  • Research Site

    Plovdiv

  • Research Site

    Rousse

  • Research Site

    Sevlievo

  • Research Site

    Sofia

  • Research Site

    Veliko Tarnovo

Other trials in Bulgaria

Hungary4 sites
  • Research Site

    Balatonfüred

  • Research Site

    Budapest

  • Research Site

    Debrecen

  • Research Site

    Zalaegerszeg

Other trials in Hungary

Germany3 sites
  • Research Site

    Dresden

  • Research Site

    Hamburg

  • Research Site

    München

Other trials in Germany

Slovakia2 sites
  • Research Site

    Trebišov

  • Research Site

    Trnava

Other trials in Slovakia

Canada1 site
  • Research Site

    Mississauga, Ontario

Other trials in Canada

Netherlands1 site
  • Research Site

    Amsterdam

Other trials in Netherlands

About this study

Official title: (OSKIRA-4): A Phase IIB, Multi-Centre, Randomised, Double-Blind, Placebo-Controlled, Parallel Group Study of the Efficacy and Safety of Fostamatinib Disodium Monotherapy Compared With Adalimumab Monotherapy in Patients With Active Rheumatoid Arthritis

The purpose of the study is to evaluate the improvements in signs and symptoms of rheumatoid arthritis (RA) for fostamatinib compared to placebo or adalimumab in patients who are Disease-Modifying anti-rheumatic drug (DMARD) naïve, DMARD intolerant or have had an inadequate response to DMARDs. The study will last for approximately six months

Read the detailed description

Sub-study:

Full title: Optional Genetic Research

Date: 10 September 2010

Version: 1

Objectives: To collect and store, with appropriate consent , DNA samples for future exploratory research into genes/genetic variation that may influence response (ie, absorption, distribution, metabolism and excretion, safety, tolerability and efficacy) to fostamatinib disodium and/or adalimumab; and/or susceptibility to, progression of and prognosis of RA

The main study recruitment is complete, and sub study recruitment will continue until the target is reached, estimated to be June 2013

Sub-study:

Full title: (Sub-study to OSKIRA-4): A Phase IIB, Multi-Centre, Randomised, Double-Blind, Placebo-Controlled, Parallel Group Study of the Efficacy and Safety of Fostamatinib Disodium Monotherapy Compared with Placebo or Adalimumab Monotherapy in Patients with Active Rheumatoid Arthritis: Magnetic Resonance Imaging Sub-Study

Date: 21 March 2011

Version: 1

Primary objective: Assess the efficacy of fostamatinib in reducing joint synovial disease activity as measured by:

  • Change from baseline to Week 6 (versus placebo) in OMERACT RAMRIS synovitis score.
Being tested
Fostamatinib and placebo injections, Adalimumab and placebo of fostamatinib, Placebo of fostamatinib, fostamatinib, and placebo injections
Keywords
Rheumatoid Arthritis, OSKIRA, fostamatinib
Medical subject headings
Arthritis, Rheumatoid

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Fostamatinib and placebo injectionsDrug

    Fostamatinib 100mg twice daily and placebo injection once every two weeks

  • Fostamatinib and placebo injectionsDrug

    Fostamatinib 100mg twice daily / fostamatinib 150mg once daily and placebo injection once every two weeks

  • Fostamatinib and placebo injectionsDrug

    Fostamatinib 100mg twice daily / fostamatinib 100mg once daily and placebo injection once every two weeks.

  • Adalimumab and placebo of fostamatinibDrug

    Also called Humira®

    Adalimumab 40mg injection once every two weeks and placebo to fostamatinib twice daily.

  • Placebo of fostamatinib, fostamatinib, and placebo injectionsDrug

    Placebo injection once every two weeks. Placebo to fostamatinib for six weeks, followed by fostamatinib 100mg twice daily (Group F) / fostamatinib 100mg twice daily then 150mg once daily (Group G).

Study groups in NCT01264770
Study groupRoleWhat they receive
Dosing Group AExperimentalOral treatment and subcutaneous injection
Receives: Drug: Fostamatinib and placebo injections
Dosing Group BExperimentalOral treatment and subcutaneous injection
Receives: Drug: Fostamatinib and placebo injections
Dosing Group CExperimentalOral treatment and subcutaneous injection
Receives: Drug: Fostamatinib and placebo injections
Dosing Group DActive comparatorOral treatment and subcutaneous injection
Receives: Drug: Adalimumab and placebo of fostamatinib
Dosing Group EPlacebo comparatorOral treatment and subcutaneous injection
Receives: Drug: Placebo of fostamatinib, fostamatinib, and placebo injections

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. DAS28-CRP Score - Change From Baseline to Week 6 Compared to Placebo

    DAS28-CRP: Disease Activity Score based on a count of swollen and tender joints (out of 28 joints), blood test measures of inflammation (CRP) and the patient's own assessment. Scores can take any positive value with a lower value indicating a better clinical condition. Mean changes from baseline in DAS28-CRP score are shown at each visit and are presented as decreases from baseline (defined as baseline minus post-baseline) with larger changes indicative of a better clinical condition. ANCOVA = analysis of covariance, BID = twice daily, CRP = C-reactive protein, DMARD = disease-modifying anti-rheumatic drug, IR = inadequate response, LS = least squares, n/a = not applicable, PO = orally, QD = once a day, SC = subcutaneous.

    Measured: Baseline and 6 weeks

  2. DAS28-CRP Score - Change From Baseline to Week 24 Compared to Adalimumab

    DAS28-CRP: Disease Activity Score based on a count of swollen and tender joints (out of 28 joints), blood test measures of inflammation (CRP) and the patient's own assessment. Scores can take any positive value with a lower value indicating a better clinical condition. Mean changes from baseline in DAS28-CRP score are shown at each visit and are presented as decreases from baseline (defined as baseline minus post-baseline) with larger changes indicative of a better clinical condition. Non-responder imputation has been applied by carrying the baseline observation forward. ANCOVA = analysis of covariance, BID = twice daily, CRP = C-reactive protein, DMARD = disease-modifying anti-rheumatic drug, IR = inadequate response, LS = least squares, n/a = not applicable, PO = orally, QD = once a day, SC = subcutaneous.

    Measured: Baseline and 24 weeks

Secondary outcomes (11)
  1. DAS28 EULAR Response at Week 6

    Change in DAS28 was derived for each post baseline scheduled assessment and categorised using the European League Against Rheumatism (EULAR) response criteria. Non-responder imputation has been applied by carrying the baseline observation forward. bid = twice daily, DAS28 = Disease Activity Score based on a 28-joint count, DMARD = disease-modifying anti-rheumatic drug, OR = odds ratio, PO = orally, qd = once a day, SC = subcutaneous.

    Measured: 6 weeks

  2. DAS28 EULAR Response at Week 24

    Change in DAS28 was derived for each post baseline scheduled assessment and categorised using the European League Against Rheumatism (EULAR) response criteria. Non-responder imputation has been applied by carrying the baseline observation forward. bid = twice daily, DAS28 = Disease Activity Score based on a 28-joint count, DMARD = disease-modifying anti-rheumatic drug, OR = odds ratio, PO = orally, qd = once a day, SC = subcutaneous.

    Measured: 24 weeks

  3. Proportion of Patients Achieving ACR20 up to Week 24

    ACR20: American College of Rheumatology 20% response criteria, based on count of swollen and tender joints (out of 28 joints), blood test measures of inflammation (such as CRP) and the physician and patient's own assessments of disease activity, pain and physical function. Non-responder imputation has been applied by carrying the baseline observation forward. BID = twice daily, CRP = C-reactive protein, DMARD = disease-modifying anti-rheumatic drug, IR = inadequate response, n/a = not applicable, PO = orally, qd = once a day, SC = subcutaneous.

    Measured: 6 and 24 weeks

  4. Proportion of Patients Achieving ACR50 up to Week 24

    ACR50: American College of Rheumatology 50% response criteria, based on count of swollen and tender joints (out of 28 joints), blood test measures of inflammation (such as CRP) and the physician and patient's own assessments of disease activity, pain and physical function. Non-responder imputation has been applied by carrying the baseline observation forward. BID = twice daily, CRP = C-reactive protein, DMARD = disease-modifying anti-rheumatic drug, IR = inadequate response, n/a = not applicable, PO = orally, qd = once a day, SC = subcutaneous.

    Measured: 6 and 24 weeks

  5. Proportion of Patients Achieving ACR70 up to Week 24

    ACR70: American College of Rheumatology 70% response criteria, based on count of swollen and tender joints (out of 28 joints), blood test measures of inflammation (such as CRP) and the physician and patient's own assessments of disease activity, pain and physical function. Non-responder imputation has been applied by carrying the baseline observation forward. BID = twice daily, CRP = C-reactive protein, DMARD = disease-modifying anti-rheumatic drug, IR = inadequate response, n/a = not applicable, PO = orally, qd = once a day, SC = subcutaneous.

    Measured: 6 and 24 weeks

  6. ACRn - Comparison Between Fostamatinib and Placebo at Week 6

    ACRn: American College of Rheumatology Index of RA improvement, based on smallest percentage improvement in the count of swollen joints (out of 28 joints), count of tender joints (out of 28 joints) or in blood test measures of inflammation (such as CRP) or the physician and patient's own asessment of disease activity, pain and physical function. Scores are reported as a percentage improvement on a scale of -100 to +100, with larger values representing a better clinical outcome. Non-responder imputation has been applied by carrying the baseline observation forward. BID = twice daily, DMARD = disease-modifying anti-rheumatic drug, IR = inadequate response, n/a = not applicable, PO = orally, qd = once a day, SC = subcutaneous. Mean refers to change at Week 6. Treatment difference: difference between fostamatinib and placebo groups.

    Measured: Baseline and 6 weeks

  7. ACRn - Comparison Between Fostamatinib and Adalimumab at Week 24

    ACRn: American College of Rheumatology Index of RA improvement, based on smallest percentage improvement in the count of swollen joints (out of 28 joints), count of tender joints (out of 28 joints) or in blood test measures of inflammation (such as CRP) or the physician and patient's own asessment of disease activity, pain and physical function. Scores are reported as a percentage improvement on a scale of -100 to +100, with larger values representing a better clinical outcome. Non-responder imputation has been applied by carrying the baseline observation forward. BID = twice daily, CRP = C-reactive protein, DMARD = disease-modifying anti-rheumatic drug, IR = inadequate response, n/a = not applicable, PO = orally, qd = once a day, SC = subcutaneous. Mean refers to change at Week 24. Treatment difference: difference between fostamatinib and adalimumab groups.

    Measured: Baseline and 24 weeks

  8. HAQ-DI - Comparison of the Change From Baseline Between Fostamatinib and Placebo at Week 6

    HAQ-DI: Health Assessment Questionnaire - Disability Index, a measure of physical function. The HAQ-DI score is calculated by summing the category scores from 8 sub-categories (ie, scores for patient ability in dressing and grooming, rising, eating, walking, hygiene, reach, grip and common daily activities) and dividing by the number of categories completed. The HAQ-DI score takes values between 0 and 3, with a higher score indicating greater disability. Non-responder imputation has been applied by carrying the baseline observation forward. ANCOVA = analysis of covariance, BID = twice daily, DMARD = disease-modifying anti-rheumatic drug, IR = inadequate response, LS = least squares, n/a = not applicable, PO = orally, qd = once a day, SC = subcutaneous.

    Measured: Baseline and 6 weeks

  9. HAQ-DI - Comparison of the Change From Baseline Between Fostamatinib and Adalimumab at Week 24

    HAQ-DI: Health Assessment Questionnaire - Disability Index, a measure of physical function. The HAQ-DI score is calculated by summing the category scores from 8 sub-categories (ie, scores for patient ability in dressing and grooming, rising, eating, walking, hygiene, reach, grip and common daily activities) and dividing by the number of categories completed. The HAQ-DI score takes values between 0 and 3, with a higher score indicating greater disability. Non-responder imputation has been applied by carrying the baseline observation forward. ANCOVA = analysis of covariance, BID = twice daily, DMARD = disease-modifying anti-rheumatic drug, IR = inadequate response, LS = least squares, n/a = not applicable, PO = orally, qd = once a day, SC = subcutaneous.

    Measured: Baseline and 24 weeks

  10. SF-36 - Comparison of the Change in PCS From Baseline Between Fostamatinib and Adalimumab at Week 24

    SF-36: 36-item Short Form Health Survey, a measure of health-related QoL. Scores for 8 sub-domains (Physical Functioning, Role-Physical, Bodily Pain, General Health, Vitality, Social Function, Role-Emotional \& Mental Health) are derived \& normalised to a scale of 0-100. Physical \& Mental Component Scores (PCS \& MCS) are derived by multiplying each of these 8 scores by a constant, summing them \& standardising against a population with mean of 50, standard deviation of 10. Higher scores represent a better QoL. Mean changes from baseline score are presented at each visit as increases from baseline (defined as post-baseline minus baseline); larger changes indicate a better clinical condition. Non-responder imputation applied by carrying the baseline observation forward. ANCOVA = analysis of covariance, BID = twice daily, DMARD = disease-modifying anti-rheumatic drug, IR = inadequate response, LS = least squares, PO = orally, QD = once a day, QoL = quality of life, SC = subcutaneous.

    Measured: Baseline and 24 weeks

  11. SF-36 - Comparison of the Change in MCS From Baseline Between Fostamatinib and Adalimumab at Week 24

    SF-36: 36-item Short Form Health Survey, a measure of health-related QoL. Scores for 8 sub-domains (Physical Functioning, Role-Physical, Bodily Pain, General Health, Vitality, Social Function, Role-Emotional \& Mental Health) are derived \& normalised to a scale of 0-100. Physical \& Mental Component Scores (PCS \& MCS) are derived by multiplying each of these 8 scores by a constant, summing them \& standardising against a population with mean of 50, standard deviation of 10. Higher scores represent a better QoL. Mean changes from baseline score are presented at each visit as increases from baseline (defined as post-baseline minus baseline); larger changes indicate a better clinical condition. Non-responder imputation applied by carrying the baseline observation forward. ANCOVA = analysis of covariance, BID = twice daily, DMARD = disease-modifying anti-rheumatic drug, IR = inadequate response, LS = least squares, PO = orally, QD = once a day, QoL = quality of life, SC = subcutaneous.

    Measured: Baseline and 24 weeks

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted22 Dec 2010 (estimated)
  2. Study startJan 2011
  3. Primary completionOct 2012
  4. Study completionAug 2013

Why it stopped: AZ decision to discontinue fostamatinib development in RA; rights to fostamatinib returned to Rigel Pharmaceuticals.

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase 2
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Masking
Quadruple blind
Who is masked
Participant, Care provider, Investigator, Outcomes assessor
Enrolment
644 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT01264770
Sponsor's protocol ID
D4300C00004
Other IDs
2010-023692-26
Acronym
OSKIRA -4
Status last verified
Apr 2014
First submitted
17 Dec 2010
Last updated
6 May 2014
Data monitoring committee
Yes

Publications

  • Taylor PC, Genovese MC, Greenwood M, Ho M, Nasonov E, Oemar B, Stoilov R, Vencovsky J, Weinblatt M. OSKIRA-4: a phase IIb randomised, placebo-controlled study of the efficacy and safety of fostamatinib monotherapy. Ann Rheum Dis. 2015 Dec;74(12):2123-9. doi: 10.1136/annrheumdis-2014-205361. Epub 2014 Jul 29.

    PubMed 25074688

Questions about this trial

What is this clinical trial studying?

A Phase 2 study of Rheumatoid Arthritis, run by AstraZeneca at 105 sites in 13 countries.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 4 inclusion and 10 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: stopped early, as of the sponsor's last update on 6 May 2014. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 105 sites in United States, Czechia, Ukraine, Poland, United Kingdom and 8 more countries. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. Some participants in this study may receive a placebo. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

What does this phase mean?

Phase 2 studies give the treatment to a larger group to see whether it has the intended effect and to keep checking safety.

Not every study follows the same path, and some studies (observational studies, device studies) have no phase.

Are results available for this study?

Yes. Results are posted in the registry (first posted 6 May 2014). A summary is in the For doctors view, and the full results are on ClinicalTrials.gov.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

DAS28-CRP Score - Change From Baseline to Week 6 Compared to Placebo (time frame: Baseline and 6 weeks). The study lists 2 primary outcomes in all. It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT01264770, which also lists 1 linked publication.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 6 May 2014.

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