EpilepsyPhase 2NCT02351115
Staccato Alprazolam and Photoparoxysmal Response
A Phase 2 study testing B=Inhaled Alprazolam 0.5 mg, C=Inhaled Alprazolam 1 m and D= Inhaled Alprazolam 2 mg in people with Epilepsy, run by Nova Pneuma Inc. at 3 sites in United States.
Trial summary
The purpose of this study is to determine whether people who usually have photosensitive epilepsy will show a reduction in epileptic activity when they take a single dose of Staccato Alprazolam as compared to placebo. Read more about this study
- Who is it for?
- Ages 18 to 60 years
- Conditions the study is for
- Epilepsy
- What is being tested?
- B=Inhaled Alprazolam 0.5 mg, C=Inhaled Alprazolam 1 m and D= Inhaled Alprazolam 2 mg
- Could I receive a placebo?
- Yes, some participants may receive a placebo
- How many people
- 5 participants
- Where
- 3 sitesUnited States
- Study dates
- Jan 2015to Jul 2016
- 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 to 60 years
- All sexes
- No healthy volunteers
- Adult
Who may be able to join
- Male and female subjects between the ages of 18 to 60 years, inclusive
- Body mass index (BMI) ≥18 and ≤35 kg/m2
- Able to speak, read, and understand English and willing and able to provide written informed consent on an IRB-approved form before the initiation of any study procedures
- A diagnosis and history of a photoparoxysmal response on EEG with or without a diagnosis of epilepsy for which patients are on 0-2 concomitant antiepileptic drugs
- At least 3 of the EEGs performed during the screen visit must have a reproducible IPS-induced photoparoxysmal response (PPR) on EEG of at least 3 points on a frequency assessment scale in at least one eye condition
- In otherwise good general health as determined by a complete medical history, physical examination, 12-lead ECG, blood chemistry profile, hematology, and urinalysis
- Female participants (if of child-bearing potential and sexually active) and male participants (if sexually active with a partner of child-bearing potential) who agree to use a medically acceptable and effective birth control method throughout the study and for 1 week following the end of the study. Medically acceptable methods of contraception that may be used by the participant and/or his/her partner include abstinence, birth control pills or patches, diaphragm with spermicide, intrauterine device (IUD), surgical sterilization, and progestin implant or injection. Prohibited methods include: the rhythm method, withdrawal, condoms alone, or diaphragm alone
Who cannot join
- History of non-epileptic seizures (e.g. metabolic, structural, or pseudo-seizures)
- History of seizure worsening in response to narrow spectrum drugs
- An active CNS infection, demyelinating disease, degenerative neurological disease or any CNS disease deemed to be progressive during the course of the study that may confound the interpretation of the study results
- Use of more than 2 concomitant AEDs for epilepsy treatment
- Subjects taking known inhibitors or inducers of CYP3A , including carbamazepine
- Subjects with a history of allergic reactions to alprazolam or other benzodiazepines
Show all 19Show fewer
- Treatment with an investigational drug within 30 days (or within 5 half-lives of the investigational drug, if >30 days) before Visit 2
- A history within the past 1 year of drug or alcohol dependence or abuse
- Positive urine screen for drugs of abuse at Visit 1 - Screening
- A history of HIV-positivity
- Female subjects who have a positive pregnancy test at screening or prior to test sessions or are breastfeeding
- History of acute narrow angle glaucoma, Parkinson's disease, hydrocephalus, or history of significant head trauma
- Subjects who have a current history of asthma, chronic obstructive lung disease (COPD), or any lung disease associated with bronchospasm
- Subjects who use medications to treat airways disease, such as asthma or COPD
- Subjects who have any acute respiratory signs/symptoms (e.g., wheezing)
- Clinically significant ECG abnormality including (but not limited to) any of the following conduction abnormalities or dysrhythmias: atrial fibrillation, mean QTcF (QT interval corrected for heart rate using Fridericia's method) interval >450 msec, ventricular rate <45 beats/min, second or third degree AV block, left bundle branch block, or evidence of prior myocardial infarction (MI) or acute ischemia
- Hypotension (systolic blood pressure ≤90 mm Hg, diastolic blood pressure ≤50 mm Hg), or hypertension (systolic blood pressure ≥140 mm Hg, diastolic blood pressure ≥100 mm Hg) measured while seated at screening or baseline
- Significant hepatic, renal, gastroenterologic, cardiovascular (including ischemic heart disease and congestive heart failure), endocrine, neurologic (including history of seizures or stroke), or hematologic disease
- Any other disease or condition, by history, physical examination, or laboratory abnormalities that in the investigator's opinion, would present undue risk to the subject, or may confound the interpretation of study results
Trial locations and contacts
3 sites in 1 country.
United States3 sites
Consultants in Epilepsy & Neurology, PLLC
Boise, Idaho
New York University Epilepsy Center
New York, New York
University of Pennsylvania - Penn Epilepsy Center
Philadelphia, Pennsylvania
About this study
Official title: Assessment of Staccato® Alprazolam on the EEG Photoparoxysmal Response in Patients With Epilepsy
The purpose of this study is to determine whether people who usually have photosensitive epilepsy will show a reduction in epileptic activity when they take a single dose of Staccato Alprazolam as compared to placebo.
Read the detailed description
The purpose of this study is to determine whether people who usually have photosensitive epilepsy will show a reduction in epileptic activity when they take a single dose of Staccato Alprazolam as compared to placebo. People with photosensitive epilepsy have changes on their electroencephalogram (EEG) when shown flashing lights. Three dose levels of Staccato Alprazolam will be compared to placebo.
This study will also assess the level of sedation of Staccato Alprazolam compared to placebo.
- Conditions
- Epilepsy
- Being tested
- A=Placebo, B=Inhaled Alprazolam 0.5 mg, C=Inhaled Alprazolam 1 m, D= Inhaled Alprazolam 2 mg, E=Placebo
- Medical subject headings
- Epilepsy
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
A=PlaceboDrug
B=Inhaled Alprazolam 0.5 mgDrug
C=Inhaled Alprazolam 1 mDrug
D= Inhaled Alprazolam 2 mgDrug
E=PlaceboDrug
| Study group | Role | What they receive |
|---|---|---|
| Sequence BEADC | Experimental | A=Placebo, B=Inhaled Alprazolam 0.5 mg, C=Inhaled Alprazolam 1 mg, D= Inhaled Alprazolam 2 mg, E=Placebo Receives: Drug: A=Placebo; Drug: B=Inhaled Alprazolam 0.5 mg; Drug: C=Inhaled Alprazolam 1 m; Drug: D= Inhaled Alprazolam 2 mg; Drug: E=Placebo |
| Sequence CDAEB | Experimental | A=Placebo, B=Inhaled Alprazolam 0.5 mg, C=Inhaled Alprazolam 1 mg, D= Inhaled Alprazolam 2 mg, E=Placebo Receives: Drug: A=Placebo; Drug: B=Inhaled Alprazolam 0.5 mg; Drug: C=Inhaled Alprazolam 1 m; Drug: D= Inhaled Alprazolam 2 mg; Drug: E=Placebo |
| Sequence DEBAC | Experimental | A=Placebo, B=Inhaled Alprazolam 0.5 mg, C=Inhaled Alprazolam 1 mg, D= Inhaled Alprazolam 2 mg, E=Placebo Receives: Drug: A=Placebo; Drug: B=Inhaled Alprazolam 0.5 mg; Drug: C=Inhaled Alprazolam 1 m; Drug: D= Inhaled Alprazolam 2 mg; Drug: E=Placebo |
| Sequence EDBAC | Experimental | A=Placebo, B=Inhaled Alprazolam 0.5 mg, C=Inhaled Alprazolam 1 mg, D= Inhaled Alprazolam 2 mg, E=Placebo Receives: Drug: A=Placebo; Drug: B=Inhaled Alprazolam 0.5 mg; Drug: C=Inhaled Alprazolam 1 m; Drug: D= Inhaled Alprazolam 2 mg; Drug: E=Placebo |
| Sequence CABED | Experimental | A=Placebo, B=Inhaled Alprazolam 0.5 mg, C=Inhaled Alprazolam 1 mg, D= Inhaled Alprazolam 2 mg, E=Placebo Receives: Drug: A=Placebo; Drug: B=Inhaled Alprazolam 0.5 mg; Drug: C=Inhaled Alprazolam 1 m; Drug: D= Inhaled Alprazolam 2 mg; Drug: E=Placebo |
What is being measured
The primary outcome is the main question the study is designed to answer.
Maximum Observed Change From Pretreatment Baseline in the Standardized Photosensitivity Range (SPR)
Photosensitivity describes the presentation of an epileptiform EEG response (photoparoxysmal response) from exposure to intermittent photic stimulation (IPS). SPR is the number of frequency steps (2, 5, 8, 10, 13, 15, 18, 20, 23, 25, 30, 40, 50 and 60 Hz). between the upper and lower limits of sensitivity to IPS for that patient at that time, in order not to evoke seizures. Thus a reduction (-change) means the intervention is working (desired effect on sensitivity)
Measured: SPR was recorded pretreatment, 2, 10, 30 min, 1, 2, 4, and 6 hr post each study drug administration The maximum change from baseline occurred at: 10 min for alprazolam 2 mg, 1 hour for alprazolam 0.5 and 1 mg and placebo
Secondary outcomes (5)
Maximum Sedation Using Visual Analog Scale (Sedated-Alert)
Maximum change (in mm) from pretreatment baseline in level of sedation reported by the patient on a 100 mm line anchored by Sedated (0) and Alert (100)
Measured: Sedation was recorded pretreatment, 2, 10, 30 min, 1, 2, 4, and 6 hr post each study drug administration The maximum change from baseline occurred at:: 30 min for alprazolam 1 mg, 1 hour for alprazolam 0.5 and 2 mg, and 4 hours for placebo
Maximum Sedation Using Visual Analog Scale (Sleepy-Awake)
Maximum change (in mm) from pretreatment baseline in level of sedation reported by each subject on a 100 mm line anchored by Sleepy (0) and Awake (100)
Measured: Sleepiness was recorded pretreatment, 2, 10, 30 min, 1, 2, 4, and 6 hr post each study drug administration The maximum change from baseline occurred: at: 30 min for alprazolam 1 mg, 1 hour for alprazolam 0.5 and 2 mg and placebo
Correlation of Plasma Concentrations of Alprazolam With Pharmacodynamic Effects on Standardized Photosensitivity Range (SPR)
Pearson correlation of all paired plasma concentrations of alprazolam (PK) with pharmacodynamic effect on SPR (PD) for each alprazolam dose
Measured: Pretreatment, 2, 10, 30 min, 1, 2, 4, and 6 hr post each study drug administration
Correlation of Plasma Concentrations of Alprazolam With Pharmacodynamic Effects on Visual Analog Scale (Sedated-Alert)
Pearson correlation of all paired plasma concentrations of alprazolam (PK) with pharmacodynamic effect on Sedation (PD) for each alprazolam dose
Measured: Pretreatment, 2, 10, 30 min, 1, 2, 4, and 6 hr post each study drug administration
Correlation of Plasma Concentrations of Alprazolam With Pharmacodynamic Effects on Visual Analog Scale (Sleepy-Awake)
Pearson correlation of all paired plasma concentrations of alprazolam (PK) with pharmacodynamic effect on Sleepiness (PD) for each alprazolam dose
Measured: Pretreatment, 2, 10, 30 min, 1, 2, 4, and 6 hr post each study drug administration
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted30 Jan 2015 (estimated)
- Study startJan 2015
- Primary completionJul 2016
- Study completionJul 2016
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Posted resultsParticipant flow, outcome measures and adverse events reported by the sponsor.
- Other trials for EpilepsyStudies of the same condition, open and under way.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
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
- Crossover
- Masking
- Quadruple blind
- Who is masked
- Participant, Care provider, Investigator, Outcomes assessor
- Enrolment
- 5 participants (actual)
Sponsor and investigators
- Lead sponsor
- Nova Pneuma Inc.
- Sponsor type
- Industry (pharma, biotech, devices)
- Collaborators
- The Epilepsy Study Consortium
- Responsible party
- Sponsor
- Investigators
- J Isojarvi, MD, Study chair, Engage Therapeutics, Inc.
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT02351115
- Sponsor's protocol ID
- AMDC-002-202
- Status last verified
- Apr 2026
- First submitted
- 19 Jan 2015
- Last updated
- 20 Apr 2026
- Results posted
- Yes, on ClinicalTrials.gov
- Data monitoring committee
- No
- FDA-regulated drug
- Yes
- FDA-regulated device
- No
- Individual data sharing
- Yes: IPD submitted to regulatory authorities. Others may contact Alexza Pharmaceuticals, Inc. Please send your request to ClinicalTrialsInfo@alexza.com
Study at a glance
From the registry record, last updated by the sponsor on 20 Apr 2026. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Assessment of Staccato® Alprazolam on the EEG Photoparoxysmal Response in Patients With Epilepsy
- ClinicalTrials.gov ID
- NCT02351115
- Acronym / sponsor ID
- AMDC-002-202
- Conditions
- Epilepsy
- Phase
- Phase 2
- Study type
- Interventional
- Recruitment status
- Completed
- Enrolment
- 5 participants (actual)
- Lead sponsor
- Nova Pneuma Inc.Industry (pharma, biotech, devices)
- Collaborators
- The Epilepsy Study Consortium
- Study start
- Jan 2015
- Primary completion
- Jul 2016 (actual)
- Study completion
- Jul 2016 (actual)
- First posted
- 30 Jan 2015 (estimated)
- Results
- Posted 10 Aug 2021
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
The purpose of this study is to determine whether people who usually have photosensitive epilepsy will show a reduction in epileptic activity when they take a single dose of Staccato Alprazolam as compared to placebo.
Detailed description
The purpose of this study is to determine whether people who usually have photosensitive epilepsy will show a reduction in epileptic activity when they take a single dose of Staccato Alprazolam as compared to placebo. People with photosensitive epilepsy have changes on their electroencephalogram (EEG) when shown flashing lights. Three dose levels of Staccato Alprazolam will be compared to placebo.
This study will also assess the level of sedation of Staccato Alprazolam compared to placebo.
Study design
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Crossover
- Masking
- Quadruple blind (participant, care provider, investigator, outcomes assessor)
- Number of arms
- 5
| Arm | Type | Receives |
|---|---|---|
| Sequence BEADC | Experimental | Drug: A=Placebo, Drug: B=Inhaled Alprazolam 0.5 mg, Drug: C=Inhaled Alprazolam 1 m, Drug: D= Inhaled Alprazolam 2 mg, Drug: E=PlaceboA=Placebo, B=Inhaled Alprazolam 0.5 mg, C=Inhaled Alprazolam 1 mg, D= Inhaled Alprazolam 2 mg, E=Placebo |
| Sequence CDAEB | Experimental | Drug: A=Placebo, Drug: B=Inhaled Alprazolam 0.5 mg, Drug: C=Inhaled Alprazolam 1 m, Drug: D= Inhaled Alprazolam 2 mg, Drug: E=PlaceboA=Placebo, B=Inhaled Alprazolam 0.5 mg, C=Inhaled Alprazolam 1 mg, D= Inhaled Alprazolam 2 mg, E=Placebo |
| Sequence DEBAC | Experimental | Drug: A=Placebo, Drug: B=Inhaled Alprazolam 0.5 mg, Drug: C=Inhaled Alprazolam 1 m, Drug: D= Inhaled Alprazolam 2 mg, Drug: E=PlaceboA=Placebo, B=Inhaled Alprazolam 0.5 mg, C=Inhaled Alprazolam 1 mg, D= Inhaled Alprazolam 2 mg, E=Placebo |
| Sequence EDBAC | Experimental | Drug: A=Placebo, Drug: B=Inhaled Alprazolam 0.5 mg, Drug: C=Inhaled Alprazolam 1 m, Drug: D= Inhaled Alprazolam 2 mg, Drug: E=PlaceboA=Placebo, B=Inhaled Alprazolam 0.5 mg, C=Inhaled Alprazolam 1 mg, D= Inhaled Alprazolam 2 mg, E=Placebo |
| Sequence CABED | Experimental | Drug: A=Placebo, Drug: B=Inhaled Alprazolam 0.5 mg, Drug: C=Inhaled Alprazolam 1 m, Drug: D= Inhaled Alprazolam 2 mg, Drug: E=PlaceboA=Placebo, B=Inhaled Alprazolam 0.5 mg, C=Inhaled Alprazolam 1 mg, D= Inhaled Alprazolam 2 mg, E=Placebo |
Who may qualify
- Ages
- 18 to 60 years
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult
Key inclusion criteria (7 listed)
- Male and female subjects between the ages of 18 to 60 years, inclusive
- Body mass index (BMI) ≥18 and ≤35 kg/m2
- Able to speak, read, and understand English and willing and able to provide written informed consent on an IRB-approved form before the initiation of any study procedures
- A diagnosis and history of a photoparoxysmal response on EEG with or without a diagnosis of epilepsy for which patients are on 0-2 concomitant antiepileptic drugs
- At least 3 of the EEGs performed during the screen visit must have a reproducible IPS-induced photoparoxysmal response (PPR) on EEG of at least 3 points on a frequency assessment scale in at least one eye condition
Key exclusion criteria (19 listed)
- History of non-epileptic seizures (e.g. metabolic, structural, or pseudo-seizures)
- History of seizure worsening in response to narrow spectrum drugs
- An active CNS infection, demyelinating disease, degenerative neurological disease or any CNS disease deemed to be progressive during the course of the study that may confound the interpretation of the study results
- Use of more than 2 concomitant AEDs for epilepsy treatment
- Subjects taking known inhibitors or inducers of CYP3A , including carbamazepine
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| A=Placebo | Drug | Sequence BEADC, Sequence CABED, Sequence CDAEB, Sequence DEBAC, Sequence EDBAC |
| B=Inhaled Alprazolam 0.5 mg | Drug | Sequence BEADC, Sequence CABED, Sequence CDAEB, Sequence DEBAC, Sequence EDBAC |
| C=Inhaled Alprazolam 1 m | Drug | Sequence BEADC, Sequence CABED, Sequence CDAEB, Sequence DEBAC, Sequence EDBAC |
| D= Inhaled Alprazolam 2 mg | Drug | Sequence BEADC, Sequence CABED, Sequence CDAEB, Sequence DEBAC, Sequence EDBAC |
| E=Placebo | Drug | Sequence BEADC, Sequence CABED, Sequence CDAEB, Sequence DEBAC, Sequence EDBAC |
Primary outcome
Maximum Observed Change From Pretreatment Baseline in the Standardized Photosensitivity Range (SPR)
Time frame: SPR was recorded pretreatment, 2, 10, 30 min, 1, 2, 4, and 6 hr post each study drug administration The maximum change from baseline occurred at: 10 min for alprazolam 2 mg, 1 hour for alprazolam 0.5 and 1 mg and placebo
Photosensitivity describes the presentation of an epileptiform EEG response (photoparoxysmal response) from exposure to intermittent photic stimulation (IPS). SPR is the number of frequency steps (2, 5, 8, 10, 13, 15, 18, 20, 23, 25, 30, 40, 50 and 60 Hz). between the upper and lower limits of sensitivity to IPS for that patient at that time, in order not to evoke seizures. Thus a reduction (-change) means the intervention is working (desired effect on sensitivity)
5 secondary outcomes
Maximum Sedation Using Visual Analog Scale (Sedated-Alert)
Time frame: Sedation was recorded pretreatment, 2, 10, 30 min, 1, 2, 4, and 6 hr post each study drug administration The maximum change from baseline occurred at:: 30 min for alprazolam 1 mg, 1 hour for alprazolam 0.5 and 2 mg, and 4 hours for placebo
Maximum Sedation Using Visual Analog Scale (Sleepy-Awake)
Time frame: Sleepiness was recorded pretreatment, 2, 10, 30 min, 1, 2, 4, and 6 hr post each study drug administration The maximum change from baseline occurred: at: 30 min for alprazolam 1 mg, 1 hour for alprazolam 0.5 and 2 mg and placebo
Correlation of Plasma Concentrations of Alprazolam With Pharmacodynamic Effects on Standardized Photosensitivity Range (SPR)
Time frame: Pretreatment, 2, 10, 30 min, 1, 2, 4, and 6 hr post each study drug administration
Correlation of Plasma Concentrations of Alprazolam With Pharmacodynamic Effects on Visual Analog Scale (Sedated-Alert)
Time frame: Pretreatment, 2, 10, 30 min, 1, 2, 4, and 6 hr post each study drug administration
Correlation of Plasma Concentrations of Alprazolam With Pharmacodynamic Effects on Visual Analog Scale (Sleepy-Awake)
Time frame: Pretreatment, 2, 10, 30 min, 1, 2, 4, and 6 hr post each study drug administration
Results and safety
Loading the posted results from ClinicalTrials.gov…
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 20 Apr 2026.
- Posted resultsParticipant flow, baseline, all outcome measures and adverse events.
- Individual participant dataSharing planned: Yes. IPD submitted to regulatory authorities. Others may contact Alexza Pharmaceuticals, Inc. Please send your request to ClinicalTrialsInfo@alexza.com
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part. This study is not recruiting at the moment.
J Isojarvi, MD study chair
Engage Therapeutics, Inc.
3 sites in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A Phase 2 study testing B=Inhaled Alprazolam 0.5 mg, C=Inhaled Alprazolam 1 m and D= Inhaled Alprazolam 2 mg in people with Epilepsy, run by Nova Pneuma Inc. at 3 sites in United States.
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 7 inclusion and 19 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 20 Apr 2026. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 3 sites in United States. 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. 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 10 Aug 2021). 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?
Maximum Observed Change From Pretreatment Baseline in the Standardized Photosensitivity Range (SPR) (time frame: SPR was recorded pretreatment, 2, 10, 30 min, 1, 2, 4, and 6 hr post each study drug administration The maximum change from baseline occurred at: 10 min for alprazolam 2 mg, 1 hour for alprazolam 0.5 and 1 mg and placebo). It is what the study was designed to measure, not a finding.
Where can I read the original study information?
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 20 Apr 2026.