Apnea of PrematurityBabyCCINONCT06972849
Caffeine Citrate to Improve Neonatal Outcomes.
A study testing Caffeine citrate in people with Apnea of Prematurity, run by University of Melbourne.
Trial summary
The goal of this clinical trial to learn what dose/s of caffeine citrate works to treat preterm born babies who have episodes where they stop breathing. It will also learn about the safety of different doses of caffeine citrate for the variety of preterm-born babies that are prescribed this. Read more about this study
- Who is it for?
- Ages Up to 32 weeks
- Conditions the study is for
- Apnea of Prematurity
- What is being tested?
- Caffeine citrate
- Type of treatment
- Injection or infusion
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 3,900 participants
- Where
- No sites listed yet
- Study dates
- Oct 2025to Dec 2050
- Phase
- Interventional
- Are there results?
- Not yet: the study is under way
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 Up to 32 weeks
- All sexes
- No healthy volunteers
- Child
PLATFORM ELIGIBILITY
Participants must meet all core PLATIPUS platform inclusion criteria:
- Born before 37 weeks gestation
- Receiving pregnancy care at a participating site (hospital) at the time of eligibility assessment and
- Meet eligibility criteria for one or more platform domains.
Participants will be excluded from participation if they meet any core PLATIPUS platform exclusion criteria:
- (Parent) Inability to consent for their infant, unless a domain-level waiver of consent is deemed appropriate.
- Perinatal death is deemed to be imminent and inevitable during the next 24 hours (at time of screening), including if neonatal intensive care is not being provided to the infant.
Infants who meet ALL of the core platform inclusion criteria and none of the exclusion criteria will be considered for BabyCCINO-specific eligibility.
BabyCCINO-SPECIFIC ELIGIBILITY
Platform-eligible participants must meet all BabyCCINO-specific inclusion criteria:
- Very preterm infants born <32 weeks' gestation
- <72 hours old
- Very preterm infants born at <32 weeks' gestation, <72 hours of age, with any clinical indication for commencing caffeine, as determined by the treating clinician, including:
- Prevention or treatment of apnoea
- Facilitating extubation from mechanical ventilation
- Prevention of BPD
- For longer-term benefit.
Participants will be excluded from participation if they meet any BabyCCINO-specific exclusion criteria:
- Prior treatment with caffeine, other methylxanthines, or doxapram
- Major congenital anomalies: major congenital cardiac disease (not including patent ductus arteriosus or isolated atrial/ventricular septal defects), major gastrointestinal malformations, congenital diaphragmatic hernia, known genetic syndromes, known brain malformations
- Death considered to be imminent in the next 24 hours, or intensive care not going to be offered or continued
- Pre-existing tachyarrhythmia (e.g., antenatal or postnatal supraventricular tachycardia)
- Pre-existing seizures
- No parental/caregiver consent or not satisfying the principles and criteria for waiver with consent to continue, as approved in the relevant jurisdiction
Platform-eligible participants who meet all BabyCCINO-specific inclusion criteria and none of the BabyCCINO-specific exclusion criteria will be eligible to participate in BabyCCINO.
Trial locations and contacts
No sites are listed yet. Contact the study team or a site near you to ask about taking part.
Kelly Fredell contact
About this study
Official title: BabyCCINO: Caffeine Citrate to Improve Neonatal Outcomes. A Neonatal Domain Within PLATIPUS.
The goal of this clinical trial to learn what dose/s of caffeine citrate works to treat preterm born babies who have episodes where they stop breathing. It will also learn about the safety of different doses of caffeine citrate for the variety of preterm-born babies that are prescribed this.
The main question it aims to answer is: Which dose is the optimal dose of caffeine citrate for very preterm babies to prevent short-term death and disease?
Read more
Researchers will compare three different doses of caffeine citrate, which are already used in clinical practice to treat breathing stoppages in preterm babies, to see which dose works best. No placebo will be used.
Participants will be given a 'loading' dose of caffeine citrate <72 hours of life, and a smaller 'maintenance' dose once a day, for as long as the baby needs this.
This trial will be undertaken as part of the PLATIPUS trial (NCT06461429).
Read the detailed description
The BabyCCINO trial will compare the efficacy and safety of a higher, medium or lower-dose caffeine regimen in very preterm infants. It is a neonatal domain within the PLATIPUS adaptive platform trial (NCT06461429).
Apnoea of prematurity, which causes repeated episodes of low oxygen saturation, affects virtually all extremely preterm infants born <28 weeks' gestation and more than half of those born 28-31 weeks' gestation. Apnoeic events are associated with poorer neurodevelopmental outcomes in infancy. Some very preterm infants also require mechanical ventilation due to apnoea, with an associated risk of bronchopulmonary dysplasia (BPD), the chronic lung disease of prematurity diagnosed at 36 weeks' post-menstrual age (PMA).
Caffeine is one of the most commonly prescribed drugs in neonatal medicine and reduces apnoea of prematurity. The largest trial of caffeine in very preterm infants, the Caffeine for Apnea of Prematurity (CAP) trial, found that caffeine improves important short-term respiratory outcomes and longer-term brain development compared with placebo. There is evidence from small clinical trials of more benefit from higher dose caffeine than that used in the CAP trial, however, potential side effects include jitteriness, tachycardia and feed intolerance. A higher rate of cerebellar haemorrhage was also reported in one small trial in infants who received a higher loading dose of 80 mg/kg, along with a trend to higher seizure burden however, a Cochrane review did not identify any adverse effects of higher-dose caffeine.
BabyCCINO will compare three dosing regimens routinely prescribed in Australia and Aotearoa New Zealand and assess health outcomes for infants who receive these.
Very preterm infants born <32 weeks' gestation will be randomly assigned to receive either
- 40mg/kg loading dose and 20mg/kg daily maintenance
- 30 mg/kg loading dose and 15mg/kg daily maintenance, or
- 20mg/kg loading dose and 10mg/kg daily maintenance.
Health outcomes will be assessed using the PLATIPUS Ordinal Outcome Scale, at 42 weeks' postmenstrual age or discharge home, whichever is earliest.
- Conditions
- Apnea of Prematurity
- Being tested
- Caffeine citrate
- Keywords
- Preterm infant, Apnea of Prematurity, Apnoea of Prematurity, Caffeine citrate
- Medical subject headings
- Apnea, Premature Birth
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
Caffeine citrateDrug
Also called Cafcit
Clinically indicated for apnea of prematurity.
| Study group | Role | What they receive |
|---|---|---|
| Caffeine citrate 40mg | Active comparator | Dose and frequency 40mg/kg load and 20mg/kg maintenance daily, as long as clinically indicated.
Administration Loading dose: 2mL/kg loading dose of study drug, either IV or enterally, administered at <72 hours of life, followed by Maintenance dose: 1mL/kg maintenance dose given daily, either IV or enterally, commenced 24 hours after loading dose. Receives: Drug: Caffeine citrate |
| Caffeine citrate 30mg | Active comparator | Dose and frequency 30 mg/kg load and 15mg/kg maintenance daily, as long as clinically indicated.
Administration Loading dose: 2mL/kg loading dose of study drug, either IV or enterally, administered at <72 hours of life, followed by Maintenance dose: 1mL/kg maintenance dose given daily, either IV or enterally, commenced 24 hours after loading dose. Receives: Drug: Caffeine citrate |
| Caffeine citrate 20mg | Active comparator | Dose and frequency 20mg/kg load and 10mg/kg maintenance daily, as long as clinically indicated.
Administration Loading dose: 2mL/kg loading dose of study drug, either IV or enterally, administered at <72 hours of life, followed by Maintenance dose: 1mL/kg maintenance dose given daily, either IV or enterally, commenced 24 hours after loading dose. Receives: Drug: Caffeine citrate |
What is being measured
The primary outcome is the main question the study is designed to answer.
Number of participants who progress by at least one level higher on the PLATIPUS Ordinal Outcome Scale
The PLATIPUS-Ordinal Outcome Scale ranks the most severe core short-term infant health outcome in the specified time frame.
Levels 1-15: 1= Well, liveborn infant; 2= Neonatal unit admission for <48 hours; 3= Neonatal unit admission for >/= 48 hours; 4= Non-invasive respiratory support or oxygen therapy for ≥ 4 hours \& < 5 days; 5= Non-invasive respiratory support or oxygen therapy >/= 5 days; 6= Mechanical ventilation via endotracheal tube for ≥ 4 hours \& <7 days; 7= Mechanical ventilation via endotracheal tube for >/=7 days; 8= Moderate respiratory morbidity; 9=Necrotising enterocolitis AND/OR Sepsis; 10= Severe Respiratory Morbidity; 11= Major Surgery; 12= Brain Injury; 13= TWO of severe respiratory morbidity OR major surgery OR brain injury; 14= Severe respiratory morbidity \& major surgery \& brain injury; 15 = Death.
Measured: At any time prior to 42 weeks' postmenstrual age or first discharge home from hospital (whichever is earlier)
Secondary outcomes (8)
Number of infants with moderate respiratory morbidity (as per the primary outcome)
Number of infants meeting the PLATIPUS-Ordinal Outcome Scale definition of 'moderate respiratory morbidity'.
Measured: At any time prior to 42 weeks' postmenstrual age or first discharge home from hospital (whichever is earlier).
Number of infants with severe respiratory morbidity (as per the primary outcome)
Number of infants meeting the PLATIPUS-Ordinal Outcome Scale definition of 'severe respiratory morbidity'.
Measured: At any time prior to 42 weeks' postmenstrual age or first discharge home from hospital (whichever is earlier).
Duration of any positive pressure ventilation, in days
Any positive pressure ventilation (mechanical ventilation, non-invasive positive pressure ventilation, continuous positive airway pressure or nasal high-flow therapy), in days (in survivors to 42 weeks' PMA or first discharge home from hospital, whichever is sooner).
Measured: From first date and time (any mode), to final date and time (any mode), up to 42 weeks' postmenstrual age or first discharge home from hospital (whichever is earlier)
Duration of mechanical ventilation, in days
Mechanical ventilation, in days (in survivors to 42 weeks' PMA or first discharge home from hospital, whichever is sooner).
Measured: From start date and time, to end date and time, up to 42 weeks' postmenstrual age or first discharge home from hospital (whichever is earlier)
Number of infants with patent ductus arteriosus treated with medication or surgery
Number of infants with patent ductus arteriosus treated with medication or surgery.
Measured: At any time prior to 42 weeks' postmenstrual age or first discharge home from hospital (whichever is earlier)
Number of infants with retinopathy of prematurity receiving intraocular or laser treatment
Number of infants with retinopathy of prematurity receiving intraocular or laser treatment.
Measured: At any time prior to 42 weeks' postmenstrual age or first discharge home from hospital (whichever is earlier)
Number of infants treated with postnatal systemic corticosteroids for preterm lung disease
Number of infants treated with postnatal systemic corticosteroids for preterm lung disease.
Measured: At any time prior to 42 weeks' postmenstrual age or first discharge home from hospital (whichever is earlier)
Number of infants with presumed caffeine side-effects
Number of infants with presumed caffeine side-effects, where the treating clinician has reduced the dose or ceased caffeine.
Measured: At any time prior to 42 weeks' postmenstrual age or first discharge home from hospital (whichever is earlier)
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted15 May 2025
- Study startOct 2025 (estimated)
- Primary completionDec 2029 (estimated)
- Study completionDec 2050 (estimated)
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Other trials for Apnea of PrematurityStudies 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 N/A
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Model description
- BabyCCINO is a domain within the PLATIPUS adaptive platform trial (NCT06461429).
- Masking
- Quadruple blind
- Who is masked
- Participant, Care provider, Investigator, Outcomes assessor
- Enrolment
- 3,900 participants (estimated)
Sponsor and investigators
- Lead sponsor
- University of Melbourne
- Sponsor type
- University, hospital or other
- Responsible party
- Sponsor
- Investigators
- Brett Manley, MBChB PhD, Principal investigator, University of Melbourne
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT06972849
- Sponsor's protocol ID
- P-N01-BabyCCINO
- Acronym
- BabyCCINO
- Status last verified
- Apr 2025
- First submitted
- 27 Apr 2025
- Last updated
- 15 May 2025
- Results posted
- No
- Data monitoring committee
- Yes
- FDA-regulated drug
- No
- FDA-regulated device
- No
- Individual data sharing
- Yes: Data sharing will align with PLATIPUS (NCT06461429) policy. Version 1, Apr-2024 Once data unblinding no longer compromises the integrity of the trial, a de-identified data set collected for the analysis of domains within PLATIPUS will be made available. Conditions: 1. All domains in which the participant is co-enrolled are closed to recruitment\* (\*Where one or more domains in which a participant is co-enrolled are not yet closed to recruitment, the participant's data may be provided, without the treatment code, to prevent unblinding in unfinished domains). 2. Primary domain conclusions/analyses have been published, AND 3. The 2-year follow-up of participants within the domain/s of interest is/are complete. Supporting materials (Core Protocol, Domain-Specific Appendices, Data Dictionaries and Domain-Specific Statistical Analysis Plans) will be available. Contact: University of Melbourne - info@platipustrial.org.
Study at a glance
From the registry record, last updated by the sponsor on 15 May 2025. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- BabyCCINO: Caffeine Citrate to Improve Neonatal Outcomes. A Neonatal Domain Within PLATIPUS.
- ClinicalTrials.gov ID
- NCT06972849
- Acronym / sponsor ID
- BabyCCINO / P-N01-BabyCCINO
- Conditions
- Apnea of Prematurity
- Keywords
- Preterm infant, Apnea of Prematurity, Apnoea of Prematurity, Caffeine citrate
- Study type
- Interventional
- Recruitment status
- Not yet recruiting
- Enrolment
- 3,900 participants (estimated)
- Lead sponsor
- University of MelbourneUniversity, hospital or other
- Study start
- Oct 2025 (estimated)
- Primary completion
- Dec 2029 (estimated)
- Study completion
- Dec 2050 (estimated)
- First posted
- 15 May 2025 (actual)
- 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.
The goal of this clinical trial to learn what dose/s of caffeine citrate works to treat preterm born babies who have episodes where they stop breathing. It will also learn about the safety of different doses of caffeine citrate for the variety of preterm-born babies that are prescribed this.
The main question it aims to answer is: Which dose is the optimal dose of caffeine citrate for very preterm babies to prevent short-term death and disease?
Researchers will compare three different doses of caffeine citrate, which are already used in clinical practice to treat breathing stoppages in preterm babies, to see which dose works best. No placebo will be used.
Participants will be given a 'loading' dose of caffeine citrate <72 hours of life, and a smaller 'maintenance' dose once a day, for as long as the baby needs this.
This trial will be undertaken as part of the PLATIPUS trial (NCT06461429).
Detailed description
The BabyCCINO trial will compare the efficacy and safety of a higher, medium or lower-dose caffeine regimen in very preterm infants. It is a neonatal domain within the PLATIPUS adaptive platform trial (NCT06461429).
Apnoea of prematurity, which causes repeated episodes of low oxygen saturation, affects virtually all extremely preterm infants born <28 weeks' gestation and more than half of those born 28-31 weeks' gestation. Apnoeic events are associated with poorer neurodevelopmental outcomes in infancy. Some very preterm infants also require mechanical ventilation due to apnoea, with an associated risk of bronchopulmonary dysplasia (BPD), the chronic lung disease of prematurity diagnosed at 36 weeks' post-menstrual age (PMA).
Caffeine is one of the most commonly prescribed drugs in neonatal medicine and reduces apnoea of prematurity. The largest trial of caffeine in very preterm infants, the Caffeine for Apnea of Prematurity (CAP) trial, found that caffeine improves important short-term respiratory outcomes and longer-term brain development compared with placebo. There is evidence from small clinical trials of more benefit from higher dose caffeine than that used in the CAP trial, however, potential side effects include jitteriness, tachycardia and feed intolerance. A higher rate of cerebellar haemorrhage was also reported in one small trial in infants who received a higher loading dose of 80 mg/kg, along with a trend to higher seizure burden however, a Cochrane review did not identify any adverse effects of higher-dose caffeine.
BabyCCINO will compare three dosing regimens routinely prescribed in Australia and Aotearoa New Zealand and assess health outcomes for infants who receive these.
Very preterm infants born <32 weeks' gestation will be randomly assigned to receive either
- 40mg/kg loading dose and 20mg/kg daily maintenance
- 30 mg/kg loading dose and 15mg/kg daily maintenance, or
- 20mg/kg loading dose and 10mg/kg daily maintenance.
Health outcomes will be assessed using the PLATIPUS Ordinal Outcome Scale, at 42 weeks' postmenstrual age or discharge home, whichever is earliest.
Study design
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Quadruple blind (participant, care provider, investigator, outcomes assessor)
- Number of arms
- 3
- Model description
- BabyCCINO is a domain within the PLATIPUS adaptive platform trial (NCT06461429).
| Arm | Type | Receives |
|---|---|---|
| Caffeine citrate 40mg | Active comparator | Drug: Caffeine citrateDose and frequency 40mg/kg load and 20mg/kg maintenance daily, as long as clinically indicated. Administration Loading dose: 2mL/kg loading dose of study drug, either IV or enterally, administered at <72 hours of life, followed by Maintenance dose: 1mL/kg maintenance dose given daily, either IV or enterally, commenced 24 hours after loading dose. |
| Caffeine citrate 30mg | Active comparator | Drug: Caffeine citrateDose and frequency 30 mg/kg load and 15mg/kg maintenance daily, as long as clinically indicated. Administration Loading dose: 2mL/kg loading dose of study drug, either IV or enterally, administered at <72 hours of life, followed by Maintenance dose: 1mL/kg maintenance dose given daily, either IV or enterally, commenced 24 hours after loading dose. |
| Caffeine citrate 20mg | Active comparator | Drug: Caffeine citrateDose and frequency 20mg/kg load and 10mg/kg maintenance daily, as long as clinically indicated. Administration Loading dose: 2mL/kg loading dose of study drug, either IV or enterally, administered at <72 hours of life, followed by Maintenance dose: 1mL/kg maintenance dose given daily, either IV or enterally, commenced 24 hours after loading dose. |
Who may qualify
- Ages
- Up to 32 weeks
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Child
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 |
|---|---|---|
| Caffeine citrateAlso: CafcitClinically indicated for apnea of prematurity. | Drug | Caffeine citrate 20mg, Caffeine citrate 30mg, Caffeine citrate 40mg |
Primary outcome
Number of participants who progress by at least one level higher on the PLATIPUS Ordinal Outcome Scale
Time frame: At any time prior to 42 weeks' postmenstrual age or first discharge home from hospital (whichever is earlier)
The PLATIPUS-Ordinal Outcome Scale ranks the most severe core short-term infant health outcome in the specified time frame. Levels 1-15: 1= Well, liveborn infant; 2= Neonatal unit admission for <48 hours; 3= Neonatal unit admission for >/= 48 hours; 4= Non-invasive respiratory support or oxygen therapy for ≥ 4 hours \& < 5 days; 5= Non-invasive respiratory support or oxygen therapy >/= 5 days; 6= Mechanical ventilation via endotracheal tube for ≥ 4 hours \& <7 days; 7= Mechanical ventilation via endotracheal tube for >/=7 days; 8= Moderate respiratory morbidity; 9=Necrotising enterocolitis AND/OR Sepsis; 10= Severe Respiratory Morbidity; 11= Major Surgery; 12= Brain Injury; 13= TWO of severe respiratory morbidity OR major surgery OR brain injury; 14= Severe respiratory morbidity \& major surgery \& brain injury; 15 = Death.
8 secondary outcomes
Number of infants with moderate respiratory morbidity (as per the primary outcome)
Time frame: At any time prior to 42 weeks' postmenstrual age or first discharge home from hospital (whichever is earlier).
Number of infants with severe respiratory morbidity (as per the primary outcome)
Time frame: At any time prior to 42 weeks' postmenstrual age or first discharge home from hospital (whichever is earlier).
Duration of any positive pressure ventilation, in days
Time frame: From first date and time (any mode), to final date and time (any mode), up to 42 weeks' postmenstrual age or first discharge home from hospital (whichever is earlier)
Duration of mechanical ventilation, in days
Time frame: From start date and time, to end date and time, up to 42 weeks' postmenstrual age or first discharge home from hospital (whichever is earlier)
Number of infants with patent ductus arteriosus treated with medication or surgery
Time frame: At any time prior to 42 weeks' postmenstrual age or first discharge home from hospital (whichever is earlier)
Number of infants with retinopathy of prematurity receiving intraocular or laser treatment
Time frame: At any time prior to 42 weeks' postmenstrual age or first discharge home from hospital (whichever is earlier)
Number of infants treated with postnatal systemic corticosteroids for preterm lung disease
Time frame: At any time prior to 42 weeks' postmenstrual age or first discharge home from hospital (whichever is earlier)
Number of infants with presumed caffeine side-effects
Time frame: At any time prior to 42 weeks' postmenstrual age or first discharge home from hospital (whichever is earlier)
Results and safety
This study is still under way. Results are not available in the source record yet.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 15 May 2025.
- Individual participant dataSharing planned: Yes. Data sharing will align with PLATIPUS (NCT06461429) policy. Version 1, Apr-2024 Once data unblinding no longer compromises the integrity of the trial, a de-identified data set collected for the analysis of domains within PLATIPUS will be made available. Conditions: 1. All domains in which the participant is co-enrolled are closed to recruitment* (*Where one or more domains in which a participant is co-enrolled are not yet closed to recruitment, the participant's data may be provided, without the treatment code, to prevent unblinding in unfinished domains). 2. Primary domain conclusions/analyses have been published, AND 3. The 2-year follow-up of participants within the domain/s of interest is/are complete. Supporting materials (Core Protocol, Domain-Specific Appendices, Data Dictionaries and Domain-Specific Statistical Analysis Plans) will be available. Contact: University of Melbourne - info@platipustrial.org.
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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.
Kelly Fredell contact
Brett Manley, MBChB PhD principal investigator
University of Melbourne
Questions about this trial
What is this clinical trial studying?
A study testing Caffeine citrate in people with Apnea of Prematurity, run by University of Melbourne.
The full registered description is in the About this study section and the official record.
Who may be eligible to take part?
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: opening soon, as of the sponsor's last update on 15 May 2025. Status can change between updates, so confirm with the study contact before making plans.
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.
Are results available for this study?
This study is still under way. Results are not available in the source record yet.
How can a doctor refer a patient or contact the research team?
Contact Brett Manley, MB BS, PhD (00610383452000, Brett.Manley@unimelb.edu.au), or a site near the patient. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
Number of participants who progress by at least one level higher on the PLATIPUS Ordinal Outcome Scale (time frame: At any time prior to 42 weeks' postmenstrual age or first discharge home from hospital (whichever is earlier)). 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 15 May 2025.