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Chronic Idiopathic ConstipationPhase 3NCT01982240

12-Week Study of Plecanatide for CIC (The CIC3 Study)

A Phase 3 study testing Plecanatide and Bisacodyl in people with Chronic Idiopathic Constipation, run by Bausch Health Americas, Inc. at 189 sites in 2 countries.

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
Search all trials

Trial summary

The purpose of this study is to confirm that the investigational medication, plecanatide, is safe and effective in treating chronic idiopathic constipation. Read more about this study

Who is it for?
Ages 18 to 80 years
Conditions the study is for
Chronic Idiopathic Constipation
What is being tested?
Plecanatide and Bisacodyl
Type of treatment
Pill or oral medicine
Could I receive a placebo?
Yes, some participants may receive a placebo
How many people
1,394 participants
Where
189 sitesin 2 countries
Study dates
Nov 2013to Jun 2015
Phase
Phase 3
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 to 80 years
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • Male or female aged 18-80, inclusive
  • Meets modified Rome III criteria for functional chronic idiopathic constipation for at least 3 months with symptom onset for at least 6 months
  • Completed a colonoscopy in accordance with AGA colon cancer screening guidelines (5 years), with no clinically significant findings
  • Willing to maintain a stable diet during the study

Who cannot join

  • Loose stool (mushy) or watery (Bristol score 6 or 7) stool in the absence of any laxative or prohibited medicine for > 25% of BMs during the 3 months prior to screening visit OR during the 14 day pre-treatment assessment
  • Active peptic ulcer disease, diabetes or hypertension not adequately treated or not stable
  • History of cathartic colon, laxative, enema abuse, or ischemic colitis
  • Fecal impaction within 3 months of screening
  • Patient has had /has any: diseases or conditions associated with constipation (GI or CNS), structural abnormality of the GI tract or gastric bypass surgery, pelvic floor dysfunction, pseudo-obstruction, active infectious gastritis, diverticulitis, anal fissures or any disease or condition that can affect GI motility or defecation or can be associated with abdominal pain
  • Unexplained and clinically significant "alarm symptoms" including lower GI bleeding, iron-deficiency anemia, weight loss or systemic signs of infection or colitis
  • Major surgery, stroke or MI within 60 days of screening
  • Participated in a previous plecanatide clinical trial

Trial locations and contacts

189 sites in 2 countries.

189 sites in 2 countries

United States177 sites

  • Synergy Research Site

    Albuquerque, New Mexico, 87109

  • Synergy Research Site

    Anaheim, California, 92801

  • Synergy Research Site

    Anaheim, California, 92804

  • Synergy Research Site

    Anderson, South Carolina, 29621

  • Synergy Research Site

    Athens, Georgia, 30606

  • Synergy Research Site

    Augusta, Georgia, 30912

  • Synergy Research Site

    Augusta, Kansas, 67010

  • Synergy Research Site

    Austin, Texas, 78745

  • Synergy Research Site

    Bastrop, Louisiana, 71220

  • Synergy Research Site

    Beavercreek, Ohio, 45432

  • Synergy Research Site

    Biloxi, Mississippi, 39531

  • Synergy Research Site

    Birmingham, Alabama, 35242

  • Synergy Research Site

    Boston, Massachusetts, 02131

  • Synergy Research Site

    Boynton Beach, Florida, 33426

  • Synergy Research Site

    Bristol, Connecticut, 06010

  • Synergy Research Site

    Brockton, Massachusetts, 02302

  • Synergy Research Site

    Brooklyn, New York, 11206

  • Synergy Research Site

    Carlsbad, California, 92008

  • Synergy Research Site

    Cary, North Carolina, 27518

  • Synergy Research Site

    Centerville, Ohio, 45459

  • Synergy Research Site

    Cerritos, California, 90703

  • Synergy Research Site

    Chapel Hill, North Carolina, 27599

  • Synergy Research Site

    Charleston, South Carolina, 28406

  • Synergy Research Site

    Charlotte, North Carolina, 28210

  • Synergy Research Site

    Charlotte, North Carolina, 28277

  • Synergy Research Site

    Chattanooga, Tennessee, 37421

  • Synergy Research Site

    Chesterfield, Michigan, 48047

  • Synergy Research Site

    Chevy Chase, Maryland, 20815

  • Synergy Research Site

    Christiansburg, Virginia, 24073

  • Synergy Research Site

    Chula Vista, California, 91910

  • Synergy Research Site

    Cincinnati, Ohio, 45246

  • Synergy Research Site

    Clearwater, Florida, 33759

  • Synergy Research Site

    Clive, Iowa, 50325

  • Synergy Research Site

    Colorado Springs, Colorado, 80907

  • Synergy Research Site

    Colorado Springs, Colorado, 80909

  • Synergy Research Site

    Columbia, South Carolina, 29204

  • Synergy Research Site

    Dallas, Texas, 75230

  • Synergy Research Site

    Dallas, Texas, 75234

  • Synergy Research Site

    Danbury, Connecticut, 06810

  • Synergy Research Site

    Decatur, Georgia, 30032

  • Synergy Research Site

    Decatur, Georgia, 30033

  • Synergy Research Site

    DeLand, Florida, 32720

  • Synergy Research Site

    Denver, Colorado, 80218

  • Synergy Research Site

    Denver, Colorado, 80220

  • Synergy Research Site

    Denver, Colorado, 80246

  • Synergy Research Site

    Dothan, Alabama, 36305

  • Synergy Research Site

    El Cajon, California, 92020

  • Synergy Research Site

    Encinitas, California, 92024

  • Synergy Research Site

    Encino, California, 91436

  • Synergy Research Site

    Evanston, Illinois, 60201

  • Synergy Research Site

    Fargo, North Dakota, 58103

  • Synergy Research Site

    Flint, Michigan, 48504

  • Synergy Research Site

    Fort Lauderdale, Florida, 33306

  • Synergy Research Site

    Fort Lauderdale, Florida, 33308

  • Synergy Research Site

    Fountain Valley, California, 92708

  • Synergy Research Site

    Fresno, California, 93726

  • Synergy Research Site

    Great Neck, New York, 11023

  • Synergy Research Site

    Greensboro, North Carolina, 27403

  • Synergy Research Site

    Gulf Shores, Alabama, 36542

  • Synergy Research Site

    Hawaiian Gardens, California, 90716

  • Synergy Research Site

    Henderson, Nevada, 89014

  • Synergy Research Site

    Henrico, Virginia, 23233

  • Synergy Research Site

    Hialeah, Florida, 33012

  • Synergy Research Site

    Hilliard, Ohio, 43026

  • Synergy Research Site

    Hot Springs, Arkansas, 71913

  • Synergy Research Site

    Houston, Texas, 77043

  • Synergy Research Site

    Houston, Texas, 77062

  • Synergy Research Site

    Houston, Texas, 77070

  • Synergy Research Site

    Houston, Texas, 77090

  • Synergy Research Site

    Huber Heights, Ohio, 45424

  • Synergy Research Site

    Huntsville, Alabama, 35801

  • Synergy Research Site

    Jackson, Mississippi, 39202

  • Synergy Research Site

    Jackson, Tennessee, 38305

  • Synergy Research Site

    Johns Creek, Georgia, 30097

  • Synergy Research Site

    Jupiter, Florida, 33458

  • Synergy Research Site

    Killeen, Texas, 76543

  • Synergy Research Site

    Kinston, North Carolina, 28501

  • Synergy Research Site

    Lakeland, Florida, 33805

  • Synergy Research Site

    Lancaster, California, 93534

  • Synergy Research Site

    Las Vegas, Nevada, 89119

  • Synergy Research Site

    Las Vegas, Nevada, 89121

  • Synergy Research Site

    Lebanon, New Hampshire, 03756

  • Synergy Research Site

    Lexington, Kentucky, 40503

  • Synergy Research Site

    Lexington, Kentucky, 40504

  • Synergy Research Site

    Limerick, Pennsylvania, 19468

  • Synergy Research Site

    Little Rock, Arkansas, 72211

  • Synergy Research Site

    Littleton, Colorado, 80120

  • Synergy Research Site

    Lodi, New Jersey, 07644

  • Synergy Research Site

    Logan, Utah, 84341

  • Synergy Research Site

    Long Beach, California, 90806

  • Synergy Research Site

    Los Angeles, California, 90015

  • Synergy Research Site

    Los Angeles, California, 90045

  • Synergy Research Site

    Los Angeles, California, 90067

  • Synergy Research Site

    Lynchburg, Virginia, 24502

  • Synergy Research Site

    Lynn Haven, Florida, 32444

  • Synergy Research Site

    Marrero, Louisiana, 70072

  • Synergy Research Site

    Maumee, Ohio, 43537

  • Synergy Research Site

    Mentor, Ohio, 44060

  • Synergy Research Site

    Mesa, Arizona, 85206

  • Synergy Research Site

    Metairie, Louisiana, 70006

  • Synergy Research Site

    Miami, Florida, 33130

  • Synergy Research Site

    Miami, Florida, 33165

  • Synergy Research Site

    Miami, Florida, 33173

  • Synergy Research Site

    Miami, Florida, 33174

  • Synergy Research Site

    Miami, Florida, 33185

  • Synergy Research Site

    Miami, Florida, 33186

  • Synergy Research Site

    Mission Hills, California, 91345

  • Synergy Research Site

    Mobile, Alabama, 36695

  • Synergy Research Site

    Murrieta, California, 92562

  • Synergy Research Site

    Nashville, Tennessee, 37205

  • Synergy Research Site

    New Bedford, Massachusetts, 02740

  • Synergy Research Site

    New Orleans, Louisiana, 70115

  • Synergy Research Site

    New Orleans, Louisiana, 70119

  • Synergy Research Site

    New Tazewell, Tennessee, 37825

  • Synergy Research Site

    Newton, Kansas, 67114

  • Synergy Research Site

    Norfolk, Virginia, 23502

  • Synergy Research Site

    Norfolk, Virginia, 23507

  • Synergy Research Site

    Norman, Oklahoma, 73071

  • Synergy Research Site

    North Hollywood, California, 91606

  • Synergy Research Site

    North Little Rock, Arkansas, 72117

  • Synergy Research Site

    North Massapequa, New York, 11758

  • Synergy Research Site

    Oakwood, Georgia, 30566

  • Synergy Research Site

    Oakwood, Ohio, 45419

  • Synergy Research Site

    Ocean City, New Jersey, 07712

  • Synergy Research Site

    Oceanside, California, 92054

  • Synergy Research Site

    Oklahoma City, Oklahoma, 73102

  • Synergy Research Site

    Omaha, Nebraska, 68114

  • Synergy Research Site

    Orlando, Florida, 32803

  • Synergy Research Site

    Orlando, Florida, 32806

  • Synergy Research Site

    Oxnard, California, 93030

  • Synergy Research Site

    Pasadena, California, 91105

  • Synergy Research Site

    Philadelphia, Pennsylvania, 19152

  • Synergy Research Site

    Phoenix, Arizona, 85018

  • Synergy Research Site

    Phoenix, Arizona, 85023

  • Synergy Research Site

    Plano, Texas, 75093

  • Synergy Research Site

    Port Orange, Florida, 32129

  • Synergy Research Site

    Poway, California, 92064

  • Synergy Research Site

    Raleigh, North Carolina, 27612

  • Synergy Research Site

    Reno, Nevada, 89511

  • Synergy Research Site

    Richmond, Virginia, 23294

  • Synergy Research Site

    Rochester, Michigan, 48307

  • Synergy Research Site

    Sacramento, California, 95816

  • Synergy Research Site

    Saginaw, Michigan, 48604

  • Synergy Research Site

    Salt Lake City, Utah, 84124

  • Synergy Research Site

    San Angelo, Texas, 76904

  • Synergy Research Site

    San Antonio, Texas, 78209

  • Synergy Research Site

    San Antonio, Texas, 78258

  • Synergy Research Site

    San Diego, California, 92101

  • Synergy Research Site

    San Diego, California, 92103

  • Synergy Research Site

    San Diego, California, 92108

  • Synergy Research Site

    San Diego, California, 92114

  • Synergy Research Site

    Savannah, Georgia, 31406

  • Synergy Research Site

    Seattle, Washington, 98105

  • Synergy Research Site

    Shawnee Mission, Kansas, 66218

  • Synergy Research Site

    Shreveport, Louisiana, 71103

  • Synergy Research Site

    Smithfield, Pennsylvania, 15478

  • Synergy Research Site

    Smyrna, Georgia, 30082

  • Synergy Research Site

    Southfield, Michigan, 48034

  • Synergy Research Site

    St Louis, Missouri, 63128

  • Synergy Research Site

    St. George, Utah, 84790

  • Synergy Research Site

    Stow, Ohio, 44224

  • Synergy Research Site

    Sugar Land, Texas, 77479

  • Synergy Research Site

    Tacoma, Washington, 98405

  • Synergy Research Site

    Tampa, Florida, 33604

  • Synergy Research Site

    Tampa, Florida, 33606

  • Synergy Research Site

    Tampa, Florida, 33617

  • Synergy Research Site

    Tempe, Arizona, 85283

  • Synergy Research Site

    Thousand Oaks, California, 91360

  • Synergy Research Site

    Tucson, Arizona, 85712

  • Synergy Research Site

    Virginia Beach, Virginia, 23455

  • Synergy Research Site

    Waterbury, Connecticut, 06708

  • Synergy Research Site

    Wauwatosa, Wisconsin, 53226

  • Synergy Research Site

    Wichita, Kansas, 67205

  • Synergy Research Site

    Wichita, Kansas, 67207

  • Synergy Research Site

    Wilmington, North Carolina, 28401

  • Synergy Research Site

    Winston-Salem, North Carolina, 27103

  • Synergy Research Site

    Yardley, Pennsylvania, 19067

Other trials in United States

Canada12 sites

  • Synergy Research Site

    Brampton, Ontario, L6T 0G1

  • Synergy Research Site

    Bridgewater, Nova Scotia, B4V 3N2

  • Synergy Research Site

    Cambridge, Ontario, N1S 2M6

  • Synergy Research Site

    Greater Sudbury, Ontario, P3E 1H5

  • Synergy Research Site

    Kelowna, British Columbia, V1Y 1Z9

  • Synergy Research Site

    London, Ontario, N5Y 5K7

  • Synergy Research Site

    Mirabel, Quebec, J7J 2K8

  • Synergy Research Site

    Oshawa, Ontario, L1H 1B9

  • Synergy Research Site

    Pointe-Claire, Quebec, H9R 4S3

  • Synergy Research Site

    Saint Romuald, Quebec, G6W 5M6

  • Synergy Research Site

    Toronto, Ontario, M3H 5S4

  • Synergy Research Site

    Toronto, Ontario, M9W 4L6

Other trials in Canada

About this study

Official title: A Randomized, 12-Week, Double-Blind, Placebo-Controlled Study to Assess the Safety and Efficacy of Plecanatide (3.0 and 6.0 mg) in Patients With Chronic Idiopathic Constipation (The CIC3 Study)

The purpose of this study is to confirm that the investigational medication, plecanatide, is safe and effective in treating chronic idiopathic constipation.

Read the detailed description

This is a randomized, 12-week, double-blind, placebo-controlled, study in approximately 1350 adult male and female patients with CIC comparing 2 doses of plecanatide to placebo. The study will be conducted at approximately 180 clinical study sites in the United States (US) and Canada. The primary objective of the study is to evaluate the efficacy and safety of 3.0 and 6.0 mg of plecanatide administered once daily (QD) for 12 weeks in a population of patients with CIC. The study population will include only patients without other causes of constipation or other chronic conditions that could interfere with study assessments. Patients may not take laxatives (with the exception of the study-provided rescue medication, bisacodyl 5mg tablets), or a number of prohibited drugs that are known to cause constipation or diarrhea, during study participation.

There are 6 scheduled study visits, including the screening and follow-up visits. The planned duration of participation in this study will be 112 days and up to 155 days, with washout and all visit windows considered.

Being tested
Plecanatide, Placebo, Bisacodyl
Keywords
CIC, Constipation, Chronic Constipation, Synergy, Plecanatide
Medical subject headings
Constipation

What participants receive

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

  • PlecanatideDrug

    Also called Trulance

    Plecanatide tablets QD for 12 weeks

  • PlaceboDrug

    Also called Trulance placebo

    Matching placebo tablets QD for 12 weeks

  • BisacodylDrug

    Also called Dulcolax

    Rescue medication

Study groups in NCT01982240
Study groupRoleWhat they receive
Plecanatide 3.0 mgActive comparatorPlecanatide tablets 3.0 mg QD for 12 weeks
Receives: Drug: Plecanatide
Plecanatide 6.0 mgActive comparatorPlecanatide tablets 6.0 mg QD for 12 weeks
Receives: Drug: Plecanatide
PlaceboPlacebo comparatorMatching placebo tablets QD for 12 weeks
Receives: Drug: Placebo
BisacodylOtherRescue medication
Receives: Drug: Bisacodyl

What is being measured

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

  1. Number of Durable Overall CSBM Responders , Mean Replacement Approach

    A durable overall CSBM responder was defined as a weekly CSBM responder for at least 9 of the 12 treatment weeks, included at least 3 of the last 4 weeks. A CSBM weekly responder was defined as a patient who has ≥ 3 Complete Spontaneous Bowel Movements (CSBMs) per week and an increase from baseline of ≥1 CSBM for that week. A CSBM was a bowel movement that occurred in the absence of laxative use within 24 hours and was associated with the feeling of complete evacuation.

    Measured: 12-week Treatment Period

Secondary outcomes (4)

  1. Change From Baseline in CSBMs (CSBMS/Week) Over 12-week Treatment Period, Mean Replacement Approach

    A Complete Spontaneous Bowel Movement (CSBM) was a Bowel Movement (BM) that occurred in the absence of laxative use within 24 hours of the BM and the patient reported a feeling of complete evacuation. A weekly responder had 3 or more CSBMs and an increase of at least one CSBM from baseline in the same week.

    Measured: 12-Week Treatment Period

  2. Change From Baseline in SBM (SBMs/Week) Over 12-week Treatment Period, Mean Replacement Approach

    The change from baseline in the number of Spontaneous Bowel Movement (SBM) over the 12-week Treatment Period was assessed. Baseline was the mean number of SBMs recorded during the 2-week baseline diary assessment period prior to the first dose of study drug. The weekly SBM totals were derived from the daily diary entries reported during the Treatment Period in the BM and Symptom Diary.

    Measured: 12-Week Treatment Period

  3. Change From Baseline in Stool Consistency Score Over the 12-week Treatment Period, Mean Replacement Approach

    The stool consistency of each bowel movement (BM) was assessed by patients using the 7-point Bristol Stool Form Scale [BSFS] from 1 to 7.

    1. = separate hard lumps like nuts (difficult to pass)
    2. = sausage shaped but lumpy
    3. = like a sausage but with cracks on its surface
    4. = like a sausage or snake, smooth and soft
    5. = soft blobs with clear-cut edges (passed easily)
    6. = fluffy pieces with ragged edges, a mushy stool
    7. = watery, no solid pieces (entirely liquid)

    Measured: 12-Week Treatment Period

  4. Change From Baseline in Straining Score Over 12-Week Treatment Period, Mean Replacement Approach

    Baseline was the mean of non-missing straining scores recorded during the 2-week baseline diary assessment period prior to the first dose of study drug. The weekly average straining score was derived from the straining scores reported during the Treatment Period in the Daily Symptom Diary. The severity of straining during bowel movements was assessed on a 5-point Likert scale where 0 = none, 1 = mild, 2 = moderate, 3 = severe, and 4 = very severe.

    Measured: 12-Week Treatment Period

Timeline

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

  1. First posted13 Nov 2013 (estimated)
  2. Study startNov 2013
  3. Primary completionApr 2015
  4. Study completionJun 2015

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 3
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Masking
Quadruple blind
Who is masked
Participant, Care provider, Investigator, Outcomes assessor
Enrolment
1,394 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT01982240
Sponsor's protocol ID
SP304203-00
Status last verified
Dec 2019
First submitted
5 Nov 2013
Last updated
26 Dec 2019
Data monitoring committee
No

Publications

  • Cash BD, Sharma A, Walker A, Laitman AP, Chang L. Plecanatide for the treatment of chronic idiopathic constipation and irritable bowel syndrome with constipation: Post hoc analyses of placebo-controlled trials in adults with severe constipation. Neurogastroenterol Motil. 2023 Sep;35(9):e14632. doi: 10.1111/nmo.14632. Epub 2023 Jun 18.

    PubMed 37332239

  • Rao SSC, Laitman AP, Miner PB Jr. Influence of Demographic Factors on Clinical Outcomes in Adults With Chronic Idiopathic Constipation Treated With Plecanatide. Clin Transl Gastroenterol. 2023 Jul 1;14(7):e00598. doi: 10.14309/ctg.0000000000000598.

    PubMed 37162147

  • Moshiree B, Schoenfeld P, Franklin H, Rezaie A. The Effect of Acid Suppression Therapy on the Safety and Efficacy of Plecanatide: Analysis of Randomized Phase III Trials. Clin Ther. 2022 Jan;44(1):98-110.e1. doi: 10.1016/j.clinthera.2021.11.009. Epub 2022 Jan 25.

    PubMed 35086735

  • Menees SB, Franklin H, Chey WD. Evaluation of Plecanatide for the Treatment of Chronic Idiopathic Constipation and Irritable Bowel Syndrome With Constipation in Patients 65 Years or Older. Clin Ther. 2020 Jul;42(7):1406-1414.e4. doi: 10.1016/j.clinthera.2020.05.012. Epub 2020 Jul 10.

    PubMed 32660770

  • Miner PB Jr, Koltun WD, Wiener GJ, De La Portilla M, Prieto B, Shailubhai K, Layton MB, Barrow L, Magnus L, Griffin PH. A Randomized Phase III Clinical Trial of Plecanatide, a Uroguanylin Analog, in Patients With Chronic Idiopathic Constipation. Am J Gastroenterol. 2017 Apr;112(4):613-621. doi: 10.1038/ajg.2016.611. Epub 2017 Feb 7.

    PubMed 28169285

Questions about this trial

What is this clinical trial studying?

A Phase 3 study testing Plecanatide and Bisacodyl in people with Chronic Idiopathic Constipation, run by Bausch Health Americas, Inc. at 189 sites in 2 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 8 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: finished, as of the sponsor's last update on 26 Dec 2019. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 189 sites in United States, Canada. 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 3 studies compare the treatment with the current standard treatment or a placebo in a large group, to confirm how well it works and watch for side effects.

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 21 Mar 2019). 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?

Number of Durable Overall CSBM Responders , Mean Replacement Approach (time frame: 12-week Treatment Period). 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 NCT01982240, which also lists 5 linked publications.

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 26 Dec 2019.

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