Eosinophilic Granulomatosis With Polyangiitis (EGPA)Phase 3REOVASNCT02807103
Rituximab in Eosinophilic Granulomatosis With Polyangiitis
A Phase 3 study testing Rituximab and Cyclophosphamide in people with Eosinophilic Granulomatosis With Polyangiitis (EGPA), run by Assistance Publique - Hôpitaux de Paris at 1 site in France.
Trial summary
Phase III, comparative, multicenter, randomized, controlled, double-blind and superiority research, comparing rituximab-based regimen with conventional therapeutic strategy for the induction of remission in patients with eosinophilic granulomatosis with polyangiitis (EGPA). Read more about this study
- Who is it for?
- Ages 18 years and older
- Conditions the study is for
- Eosinophilic Granulomatosis With Polyangiitis (EGPA)
- What is being tested?
- Rituximab and Cyclophosphamide
- Type of treatment
- Injection or infusion
- Could I receive a placebo?
- Yes, some participants may receive a placebo
- How many people
- 107 participants
- Where
- 1 siteFrance
- Study dates
- 5 Dec 2016to 21 Oct 2020
- Phase
- Phase 3
- Are there results?
- None posted in the registry
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
- Patients with a diagnosis of EGPA independently of ANCA status,
- Patient aged of 18 years or older,
- Patients with newly-diagnosed disease or relapsing disease at the time of screening, with an active disease defined as a Birmingham Vasculitis Activity Score (BVAS) ≥3,
- Patients within the first 21 days following initiation/increase of corticosteroids at a dose ≤ 1 mg/kg/day (pulses of methylprednisolone before oral corticosteroid therapy are authorized) ,
- Patient able to give written informed consent prior to participation in the study.
Who cannot join
- Patients with GPA, MPA, or other vasculitides, defined by the ACR criteria and/or the Chapel Hill Consensus Conference,
- Patients with vasculitis in remission of the disease defined as a BVAS <3,
- Patients with severe cardiac failure defined as class IV in New York Heart Assocation
- Patients with acute infections or chronic active infections (including HIV, HBV or HCV),
- Patients with active cancer or recent cancer (<5 years), except basocellular carcinoma and prostatic cancer of low activity controlled by hormonal treatment,
- Pregnant women and lactation. Patients with childbearing potential should have reliable contraception for the 12 months duration of the study,
Show all 16Show fewer
- Patients with EGPA who have already been treated with rituximab within the previous 12 months,
- Patients with hypersensitivity to a monoclonal antibody or biologic agent,
- Patients with contraindication to use rituximab, cyclophosphamide, mesna or azathioprine,
- Patients with other uncontrolled diseases, including drug or alcohol abuse, severe psychiatric diseases, that could interfere with participation in the trial according to the protocol,
- Patients included in other investigational therapeutic study within the previous 3 months,
- Patients suspected not to be observant to the proposed treatments,
- Patients who have white blood cell count ≤4,000/mm3,
- Patients who have platelet count ≤100,000/mm3,
- Patients who have ALT or AST level greater that 3 times the upper limit of normal that cannot be attributed to underlying EGPA disease,
- Patients unable to give written informed consent prior to participation in the study.
Trial locations and contacts
1 site in 1 country.
About this study
Official title: Evaluation of Rituximab-based Regimen Compared to Conventional Therapeutic Strategy For Remission Induction In Patients With Newly-Diagnosed or Relapsing Eosinophilic Granulomatosis With Polyangiitis. Prospective, Randomized, Controlled, Double-blind Study
Phase III, comparative, multicenter, randomized, controlled, double-blind and superiority research, comparing rituximab-based regimen with conventional therapeutic strategy for the induction of remission in patients with eosinophilic granulomatosis with polyangiitis (EGPA).
Patients with newly diagnosed or relapsing EGPA will be randomized in a 1:1 ratio to receive:
- Experimental therapeutic strategy based on the use of rituximab (experimental group)
- Conventional therapeutic strategy based on Five-Factor Score (FFS)-assessed disease severity (comparative group)
Read the detailed description
Systemic vasculitides are inflammatory diseases of blood vessels, among which anti-neutrophil cytoplasmic antibody (ANCA)-associated vasculitides (AAV) are often severe with life-threatening manifestations or complications. AAV include granulomatosis with polyangiitis (GPA), microscopic polyangiitis (MPA) and eosinophilic granulomatosis with polyangiitis (EGPA, formerly Churg-Strauss syndrome).
Cytotoxic drugs and glucocorticoids have been the standard of care for remission induction for nearly five decades. This regimen improved the outcome of severe AAV from death to a strong likelihood of disease control and temporary remission. However, a remission is not obtained in all patients with this combination of drugs, and most patients experience disease flares requiring repeated treatment with associated significant morbidity and mortality.
In 2 prospective controlled trials, rituximab, an anti-CD20 monoclonal antibody, was shown to be non inferior to cyclophosphamide to induce remission with an acceptable safety profile in patients with systemic GPA and MPA. However, patients with EGPA were not included in these trials and rituximab has not been evaluated prospectively to induce remission in this disease which pathogenesis is complex and not only restricted to ANCA responsibility.
In patients with EGPA, overall survival is good when treatment is stratified according to prognostic factors (Five Factor Score) but long-term outcome is not so good since relapses occur in more than 40% of patients, leading to high cumulative morbidity and damage. In small retrospective studies, rituximab seems promising as a remission-induction agent in patients with EGPA, independently from the ANCA status.
The trial detailed here is the first prospective trial evaluating rituximab as induction-remission treatment for EGPA.
- Being tested
- Rituximab, Placebo-rituximab, Cyclophosphamide, Placebo-cyclophosphamide
- Keywords
- Rituximab, remission induction, eosinophilic granulomatosis with polyangiitis
- Medical subject headings
- Churg-Strauss Syndrome
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
RituximabDrug
Also called Mabthera
1 g intravenous pulse at day1 and day15
Placebo-rituximabDrug
Also called nacl
intravenous pulses at day1 and day15
CyclophosphamideDrug
Also called endoxan
intravenous 9 pulses : 600 mg/m2 at days 1, 15 and 29, and then 500 mg-fixed dose at days 50, 71, 92, 113, 134 and 155.
Placebo-cyclophosphamideDrug
Also called Nacl
intravenous 7 pulses : at days 29, 50, 71, 92, 113, 134 and 155.
| Study group | Role | What they receive |
|---|---|---|
| Rituximab with FFS=0 | Experimental | All patients in the rituximab group will receive corticosteroids with a predefined tapering schedule similar to the conventional therapy group.
Patients with FFS=0 will receive 1 gram of rituximab at day 1 and day 15 as induction treatment Receives: Drug: Rituximab |
| Conventional therapy with FFS=0 | Placebo comparator | All patients will receive corticosteroids with a predefined tapering schedule similar to the experimental group.
Patients with FFS=0 will receive placebo-rituximab at day 1 and day 15. Receives: Drug: Placebo-rituximab |
| Rituximab with FFS≥1 | Experimental | All patients in the rituximab group will receive corticosteroids with a predefined tapering schedule similar to the conventional therapy group.
Patients with FFS≥1 will receive a total of 9 pulses :
* 1 gram of rituximab at day 1 and day 15 as induction treatment
* placebo-cyclophosphamide at days 1, 15, 29, 50, 71, 92, 113, 134 and 155.
Maintenance therapy by azathioprine will be started at day 180 according to the standard of care of these patients, as recommended by the French Vasculitis Study Group. Receives: Drug: Rituximab; Drug: Placebo-cyclophosphamide |
| Conventional therapy with FFS≥1 | Active comparator | All patients will receive corticosteroids with a predefined tapering schedule similar to the experimental group.
Patients with FFS≥1 will receive intravenous pulses of cyclophosphamide for a total of 9 pulses: 600 mg/m2 at days 1, 15 and 29, and then 500 mg-fixed dose at days 50, 71, 92, 113, 134 and 155.
Maintenance therapy by azathioprine will be started at day 180 according to the standard of care of these patients, as recommended by the French Vasculitis Study Group. Receives: Drug: Cyclophosphamide |
What is being measured
The primary outcome is the main question the study is designed to answer.
The percentage of patients who obtained a BVAS=0 and prednisone dose ≤7.5 mg/day at day 180.
Measured: 180 days
Secondary outcomes (11)
Number of adverse events
expressed as adverse events according to the CTCAE toxicity grading system per patient-year for the following adverse events combined: death (all causes), grade 2 or higher leukopenia or thrombocytopenia, grade 3 or higher infections, hemorrhagic cystitis, malignancies, venous thromboembolic events, hospitalization resulting either from the disease or from a complication due to the study treatment, infusion reactions (within 24 hours of infusion) that result in the cessation of further infusions
Measured: 180 days
Number of adverse events
expressed as adverse events according to the CTCAE toxicity grading system per patient-year for the following adverse events combined: death (all causes), grade 2 or higher leukopenia or thrombocytopenia, grade 3 or higher infections, hemorrhagic cystitis, malignancies, venous thromboembolic events, hospitalization resulting either from the disease or from a complication due to the study treatment, infusion reactions (within 24 hours of infusion) that result in the cessation of further infusions
Measured: 360 days
Area under the curve for corticosteroids
To measure the corticosteroid dose and to compare the corticosteroid sparing effect of rituximab versus conventional therapy
Measured: 180 days
Area under the curve for corticosteroids
To measure the corticosteroid dose and to compare the corticosteroid sparing effect of rituximab versus conventional therapy
Measured: 360 days
Number of sequelae assessed by the Vasculitis Damage Index
Measured: 180 days
Number of sequelae assessed by the Vasculitis Damage Index
Measured: day 180 and day 360
ANCA titers and CD19+cells
Measured: day 180 and day 360
Health Assessment Questionnaire (HAQ) score
to evaluate functional disability
Measured: 180 days
Health Assessment Questionnaire (HAQ) score
to evaluate functional disability
Measured: 360 days
Short Form-36 score
to evaluate quality of life
Measured: 180 days
Short Form-36 score
to evaluate quality of life
Measured: 360 days
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted21 Jun 2016 (estimated)
- Study start5 Dec 2016
- Primary completion21 Oct 2020
- Study completion21 Oct 2020
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Publications (1)Papers the sponsor has linked to this study.
- Other trials for Eosinophilic Granulomatosis With Polyangiitis (EGPA)Studies of the same condition, open and under way.
- More trials run by Assistance Publique - Hôpitaux de ParisThe sponsor's other registered studies.
- 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 3
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Quadruple blind
- Who is masked
- Participant, Care provider, Investigator, Outcomes assessor
- Enrolment
- 107 participants (actual)
Sponsor and investigators
- Lead sponsor
- Assistance Publique - Hôpitaux de Paris
- Sponsor type
- University, hospital or other
- Collaborators
- French Vasculitis Study Group, URC-CIC Paris Descartes Necker Cochin
- Responsible party
- Sponsor
- Investigators
- Xavier PUECHAL, MD, PhD, Study chair, Centre de référence " Maladies systémiques et autoimmunes rares, en particulier Vascularites nécrosantes et Sclérodermies systémiques "
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT02807103
- Sponsor's protocol ID
- P140915
- Other IDs
- 2016-000275-25, 2016
- Acronym
- REOVAS
- Status last verified
- Jan 2026
- First submitted
- 20 May 2016
- Last updated
- 15 Jan 2026
- Results posted
- No
- Data monitoring committee
- No
- Individual data sharing
- No
Publications
Terrier B, Pugnet G, de Moreuil C, Bonnotte B, Benhamou Y, Chauveau D, Besse MC, Duffau P, Limal N, Neel A, Urbanski G, Jourde-Chiche N, Martin-Silva N, Campagne J, Mekinian A, Schleinitz N, Ackermann F, Fauchais AL, Froissart A, Le Gallou T, Uzunhan Y, Viallard JF, Berezne A, Chiche L, Taille C, Direz G, Durel CA, Godmer P, Trad S, Lambert M, de Menthon M, Quemeneur T, Cadranel J, Charles P, Dossier A, Jilet L, Guillevin L, Abdoul H, Puechal X; French Vasculitis Study Group. Rituximab Versus Conventional Therapy for Remission Induction in Eosinophilic Granulomatosis With Polyangiitis : A Randomized Controlled Trial. Ann Intern Med. 2025 Sep;178(9):1249-1257. doi: 10.7326/ANNALS-24-03947. Epub 2025 Jul 29.
PubMed 40720835
Study at a glance
From the registry record, last updated by the sponsor on 15 Jan 2026. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Evaluation of Rituximab-based Regimen Compared to Conventional Therapeutic Strategy For Remission Induction In Patients With Newly-Diagnosed or Relapsing Eosinophilic Granulomatosis With Polyangiitis. Prospective, Randomized, Controlled, Double-blind Study
- ClinicalTrials.gov ID
- NCT02807103
- Acronym / sponsor ID
- REOVAS / P140915
- Keywords
- Rituximab, remission induction, eosinophilic granulomatosis with polyangiitis
- Phase
- Phase 3
- Study type
- Interventional
- Recruitment status
- Completed
- Enrolment
- 107 participants (actual)
- Lead sponsor
- Assistance Publique - Hôpitaux de ParisUniversity, hospital or other
- Collaborators
- French Vasculitis Study Group, URC-CIC Paris Descartes Necker Cochin
- Study start
- 5 Dec 2016 (actual)
- Primary completion
- 21 Oct 2020 (actual)
- Study completion
- 21 Oct 2020 (actual)
- First posted
- 21 Jun 2016 (estimated)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
Phase III, comparative, multicenter, randomized, controlled, double-blind and superiority research, comparing rituximab-based regimen with conventional therapeutic strategy for the induction of remission in patients with eosinophilic granulomatosis with polyangiitis (EGPA).
Patients with newly diagnosed or relapsing EGPA will be randomized in a 1:1 ratio to receive:
- Experimental therapeutic strategy based on the use of rituximab (experimental group)
- Conventional therapeutic strategy based on Five-Factor Score (FFS)-assessed disease severity (comparative group)
Detailed description
Systemic vasculitides are inflammatory diseases of blood vessels, among which anti-neutrophil cytoplasmic antibody (ANCA)-associated vasculitides (AAV) are often severe with life-threatening manifestations or complications. AAV include granulomatosis with polyangiitis (GPA), microscopic polyangiitis (MPA) and eosinophilic granulomatosis with polyangiitis (EGPA, formerly Churg-Strauss syndrome).
Cytotoxic drugs and glucocorticoids have been the standard of care for remission induction for nearly five decades. This regimen improved the outcome of severe AAV from death to a strong likelihood of disease control and temporary remission. However, a remission is not obtained in all patients with this combination of drugs, and most patients experience disease flares requiring repeated treatment with associated significant morbidity and mortality.
In 2 prospective controlled trials, rituximab, an anti-CD20 monoclonal antibody, was shown to be non inferior to cyclophosphamide to induce remission with an acceptable safety profile in patients with systemic GPA and MPA. However, patients with EGPA were not included in these trials and rituximab has not been evaluated prospectively to induce remission in this disease which pathogenesis is complex and not only restricted to ANCA responsibility.
In patients with EGPA, overall survival is good when treatment is stratified according to prognostic factors (Five Factor Score) but long-term outcome is not so good since relapses occur in more than 40% of patients, leading to high cumulative morbidity and damage. In small retrospective studies, rituximab seems promising as a remission-induction agent in patients with EGPA, independently from the ANCA status.
The trial detailed here is the first prospective trial evaluating rituximab as induction-remission treatment for EGPA.
Study design
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Quadruple blind (participant, care provider, investigator, outcomes assessor)
- Number of arms
- 4
| Arm | Type | Receives |
|---|---|---|
| Rituximab with FFS=0 | Experimental | Drug: RituximabAll patients in the rituximab group will receive corticosteroids with a predefined tapering schedule similar to the conventional therapy group. Patients with FFS=0 will receive 1 gram of rituximab at day 1 and day 15 as induction treatment |
| Conventional therapy with FFS=0 | Placebo comparator | Drug: Placebo-rituximabAll patients will receive corticosteroids with a predefined tapering schedule similar to the experimental group. Patients with FFS=0 will receive placebo-rituximab at day 1 and day 15. |
| Rituximab with FFS≥1 | Experimental | Drug: Rituximab, Drug: Placebo-cyclophosphamideAll patients in the rituximab group will receive corticosteroids with a predefined tapering schedule similar to the conventional therapy group. Patients with FFS≥1 will receive a total of 9 pulses : * 1 gram of rituximab at day 1 and day 15 as induction treatment * placebo-cyclophosphamide at days 1, 15, 29, 50, 71, 92, 113, 134 and 155. Maintenance therapy by azathioprine will be started at day 180 according to the standard of care of these patients, as recommended by the French Vasculitis Study Group. |
| Conventional therapy with FFS≥1 | Active comparator | Drug: CyclophosphamideAll patients will receive corticosteroids with a predefined tapering schedule similar to the experimental group. Patients with FFS≥1 will receive intravenous pulses of cyclophosphamide for a total of 9 pulses: 600 mg/m2 at days 1, 15 and 29, and then 500 mg-fixed dose at days 50, 71, 92, 113, 134 and 155. Maintenance therapy by azathioprine will be started at day 180 according to the standard of care of these patients, as recommended by the French Vasculitis Study Group. |
Who may qualify
- Ages
- 18 years and older
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult, Older adult
Key inclusion criteria (5 listed)
- Patients with a diagnosis of EGPA independently of ANCA status,
- Patient aged of 18 years or older,
- Patients with newly-diagnosed disease or relapsing disease at the time of screening, with an active disease defined as a Birmingham Vasculitis Activity Score (BVAS) ≥3,
- Patients within the first 21 days following initiation/increase of corticosteroids at a dose ≤ 1 mg/kg/day (pulses of methylprednisolone before oral corticosteroid therapy are authorized) ,
- Patient able to give written informed consent prior to participation in the study.
Key exclusion criteria (16 listed)
- Patients with GPA, MPA, or other vasculitides, defined by the ACR criteria and/or the Chapel Hill Consensus Conference,
- Patients with vasculitis in remission of the disease defined as a BVAS <3,
- Patients with severe cardiac failure defined as class IV in New York Heart Assocation
- Patients with acute infections or chronic active infections (including HIV, HBV or HCV),
- Patients with active cancer or recent cancer (<5 years), except basocellular carcinoma and prostatic cancer of low activity controlled by hormonal treatment,
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 |
|---|---|---|
| RituximabAlso: Mabthera1 g intravenous pulse at day1 and day15 | Drug | Rituximab with FFS=0, Rituximab with FFS≥1 |
| Placebo-rituximabAlso: naclintravenous pulses at day1 and day15 | Drug | Conventional therapy with FFS=0 |
| CyclophosphamideAlso: endoxanintravenous 9 pulses : 600 mg/m2 at days 1, 15 and 29, and then 500 mg-fixed dose at days 50, 71, 92, 113, 134 and 155. | Drug | Conventional therapy with FFS≥1 |
| Placebo-cyclophosphamideAlso: Naclintravenous 7 pulses : at days 29, 50, 71, 92, 113, 134 and 155. | Drug | Rituximab with FFS≥1 |
Primary outcome
The percentage of patients who obtained a BVAS=0 and prednisone dose ≤7.5 mg/day at day 180.
Time frame: 180 days
11 secondary outcomes
Number of adverse events
Time frame: 180 days
Number of adverse events
Time frame: 360 days
Area under the curve for corticosteroids
Time frame: 180 days
Area under the curve for corticosteroids
Time frame: 360 days
Number of sequelae assessed by the Vasculitis Damage Index
Time frame: 180 days
Number of sequelae assessed by the Vasculitis Damage Index
Time frame: day 180 and day 360
ANCA titers and CD19+cells
Time frame: day 180 and day 360
Health Assessment Questionnaire (HAQ) score
Time frame: 180 days
Health Assessment Questionnaire (HAQ) score
Time frame: 360 days
Short Form-36 score
Time frame: 180 days
Short Form-36 score
Time frame: 360 days
Results and safety
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 15 Jan 2026.
- Results publication: PubMed 40720835Terrier B, Pugnet G, de Moreuil C, Bonnotte B, Benhamou Y, Chauveau D, Besse MC, Duffau P, Limal N, Neel A, Urbanski G, Jourde-Chiche N, Martin-Silva N, Campagne J, Mekinian A, Schleinitz N, Ackermann F, Fauchais AL, Froissart A, Le Gallou T, Uzunhan Y, Viallard JF, Berezne A, Chiche L, Taille C, Direz G, Durel CA, Godmer P, Trad S, Lambert M, de Menthon M, Quemeneur T, Cadranel J, Charles P, Dossier A, Jilet L, Guillevin L, Abdoul H, Puechal X; French Vasculitis Study Group. Rituximab Versus Conventional Therapy for Remission Induction in Eosinophilic Granulomatosis With Polyangiitis : A Randomized Controlled Trial. Ann Intern Med. 2025 Sep;178(9):1249-1257. doi: 10.7326/ANNALS-24-03947. Epub 2025 Jul 29.
- Related InfoLink provided by the sponsor.
- Individual participant dataSharing planned: No
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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.
Xavier PUECHAL, MD, PhD study chair
Centre de référence " Maladies systémiques et autoimmunes rares, en particulier Vascularites nécrosantes et Sclérodermies systémiques "
1 site in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A Phase 3 study testing Rituximab and Cyclophosphamide in people with Eosinophilic Granulomatosis With Polyangiitis (EGPA), run by Assistance Publique - Hôpitaux de Paris at 1 site in France.
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 5 inclusion and 16 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 15 Jan 2026. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 1 site in France. 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?
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
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?
The percentage of patients who obtained a BVAS=0 and prednisone dose ≤7.5 mg/day at day 180. (time frame: 180 days). 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 NCT02807103, 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 15 Jan 2026.