HealthyNCT07247513
Glycaemic Responses to a Food Intake Sequence Intervention in Free-living Elite Female Athletes
A study testing Carbohydrate-last meal pattern and Carbohydrate-first meal pattern in people with Healthy and Nutrition, run by Universidade do Porto at 1 site in Portugal.
Trial summary
The goal of this clinical trial is to investigate the impact of a food intake sequence intervention under free-living conditions on glycaemic responses in elite female athletes. Specifically, the main questions it aims to answer are: 1. Read more about this study
- Who is it for?
- Ages 18 to 64 years, women onlyHealthy volunteers can take part
- Conditions the study is for
- Healthy, Nutrition, Glycemic Variability
- What is being tested?
- Carbohydrate-last meal pattern and Carbohydrate-first meal pattern
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 22 participants
- Where
- 1 sitePortugal
- Study dates
- 24 Nov 2025to 29 Nov 2025
- Phase
- Interventional
- 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 to 64 years
- Women only
- Healthy volunteers accepted
- Adult
Who may be able to join
- Adult (18-64 years old)
- Women
- Elite athletes (meeting training and performance caliber criteria ≥Tier 4; McKay et al., 2022)
- Healthy (meeting the exclusion criteria for medical conditions)
- Normal glucose tolerant according to the latest review standards of the American Diabetes Association (ElSayed et al., 2024): HbA1c <5.7%, fasting plasma glucose <5.6 mmol/L (100 mg/dL), or 2-h plasma glucose <7.8 mmol/L (140 mg/dL) during a 75-g OGTT
- Able and willing to provide informed consent and safely comply with study procedures
Who cannot join
- Any medical condition or behaviour deemed either to pose undue personal risk to the participant or introduce bias into the experiment (e.g. pregnancy, alcohol or substance abuse; any condition affecting the glucose and lipid metabolism or appetite, reviewed on a case by case basis)
- Any reported medication or supplementation that may interfere with the glucose metabolism (e.g., acarbose, aspirin, berberine, insulin, metformin, semaglutide, sulfonylureas, thiazide diuretics, thiazolidinediones, vitamin C). Other medication and supplementation will be reviewed on a case by case basis.
- Recent change in body mass (± 2 kg in the last 2 months)
- Smoking
Trial locations and contacts
1 site in 1 country.
About this study
Official title: Glycaemic Responses to a Food Intake Sequence Intervention Under Free-living Conditions in Elite Female Athletes
The goal of this clinical trial is to investigate the impact of a food intake sequence intervention under free-living conditions on glycaemic responses in elite female athletes. Specifically, the main questions it aims to answer are:
- Does consuming breakfast in different food intake sequences alter postprandial interstitial glucose responses?
- Does consuming a pre-exercise meal in different food intake sequences alter interstitial glucose responses during exercise?
- Does consuming the last meal of the day in different food intake sequences alter nocturnal interstitial glucose responses?
Read more
To address these questions, researchers will compare eating the dietary sources of rapidly absorbed carbohydrate (CHO) at the end (CHO-last meal pattern) or at the start (CHO-first meal pattern) of standardised mixed meals, at different times of day, in a randomised, counterbalanced, crossover design.
Participants will wear a blinded continuous glucose monitor (CGM) for 6 consecutive days during a training camp. Throughout the study, they will be provided with buffet meals, at the same time and location each day. Dietary intake will be ad libitum, except for breakfast and supper, for which participants will select a preferred composition (ingredients, preparation methods, portion sizes) to replicate across study days. In all ad libitum meals (i.e., lunch, snacks, and dinner), they will be asked to maintain their assigned food intake sequence.
- On day 1, athletes will eat freely. An educational session on the study protocol and food sequence manipulation will be delivered, and informed consent, questionnaires, screening assessments, and CGM fitting will be completed. Data collected by the CGM during the first 24 hours will be disregarded due to sensor stabilisation. Hence, this period will serve for familiarisation only.
- On days 2 and 3, one group will eat the last meal of the day (i.e., supper) in a CHO-last meal pattern, while the other will follow a CHO-first meal pattern; on days 3 and 4 one group will eat breakfast in a CHO-last meal pattern while the other will follow a CHO-first meal pattern.
- On days 4 and 5 (supper) and 5 and 6 (breakfast), participants in each group will adhere to the alternate condition.
Concurrent data on potential confounding factors (e.g., dietary intake, physical activity, internal and external load during training sessions/competition, sleep quantity and quality, menstrual cycle phase/status) will be collected.
Due to the short camp duration, implementing a one-day washout period will not be feasible. Therefore, repeated measurements over two consecutive days per condition will be obtained to minimise carryover effects of the food intake sequence from prior meals on end-of-intervention data (the final 24 hours per condition), and to assess intraindividual consistency of outcomes at matched-times and standardised settings.
Glycaemic responses will be compared within-participant between food intake sequences using linear mixed models with random intercepts, to account for repeated measures, interindividual variability, and potential missing data.
- Conditions
- Healthy, Nutrition, Glycemic Variability, Dietary Intervention, Sleep, Exercise
- Being tested
- Carbohydrate-last meal pattern, Carbohydrate-first meal pattern
- Keywords
- food order, meal sequence, glycaemia, sport nutrition
- Medical subject headings
- Motor Activity
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
Carbohydrate-last meal patternOther
Also called CL, CHO-last
Participants will consume the main dietary sources of protein, fat, fibre and/or polyphenols before the main dietary sources of simple carbohydrate in the standardised test-meals (breakfast and supper) and will be encouraged to maintain this food intake sequence in the remaining meals of the day.
Participants will be instructed to consume lunch and dinner within 30 min, and breakfast and supper within 15 min at a comfortable pace, without intervals between the carbohydrate and non-carbohydrate-rich meal components.
Carbohydrate-first meal patternOther
Also called CF, CHO-first
Participants will consume the main dietary sources of protein, fat, fibre and/or polyphenols after the main dietary sources of simple carbohydrate in the standardised test-meals (breakfast and supper) and will be encouraged to maintain this food intake sequence in the remaining meals of the day.
Participants will be instructed to consume lunch and dinner within 30 min, and breakfast and supper within 15 min at a comfortable pace, without intervals between the carbohydrate and non-carbohydrate-rich meal components.
| Study group | Role | What they receive |
|---|---|---|
| CL - CF | Experimental | The interventions (carbohydrate-last meal pattern (CL) or carbohydrate-first meal pattern (CF)) will be delivered in random order. If participants are allocated to this study arm, they will receive the CL on the first 2 days and the CF on the next 2 days of the study period. Receives: Other: Carbohydrate-last meal pattern; Other: Carbohydrate-first meal pattern |
| CF - CL | Active comparator | The interventions (carbohydrate-last meal pattern (CL) or carbohydrate-first meal pattern (CF)) will be delivered in random order. If participants are allocated to this study arm, they will receive the CF on the first 2 days and the CL on the next 2 days of the study period. Receives: Other: Carbohydrate-last meal pattern; Other: Carbohydrate-first meal pattern |
What is being measured
The primary outcome is the main question the study is designed to answer.
Incremental interstitial glucose peak after a standardised test meal
Difference between CHO-last and CHO-first meal patterns in the incremental interstitial glucose peak (mmol/L) adjusted for baseline, following standardised breakfasts (independent of and coinciding with subsequent exercise) and the end-of-intervention (days 3 and 5) standardised supper, assessed using a blinded continuous glucose monitoring system (Freestyle Libre Pro IQ).
Measured: 0-120 minutes following a standardised test meal
Secondary outcomes (11)
Incremental area under the interstitial glucose curve after a standardised test meal
Difference between CHO-last and CHO-first meal patterns in the incremental area under the interstitial glucose curve (mmol/L x min) adjusted for baseline, following standardised breakfasts (independent of and coinciding with subsequent exercise) and the end-of-intervention (days 3 and 5) standardised supper, assessed using a blinded continuous glucose monitoring system (Freestyle Libre Pro IQ).
Measured: 0-120 minutes following a standardised test meal
Time-to-peak interstitial glucose after a standardised test meal
Difference between CHO-last and CHO-first meal patterns in the time-to-peak interstitial glucose (minutes), following standardised breakfasts (independent of and coinciding with subsequent exercise) and the end-of-intervention (days 3 and 5) standardised supper, assessed using a blinded continuous glucose monitoring system (Freestyle Libre Pro IQ).
Measured: 0-120 minutes following a standardised test meal
Time out of interstitial glucose range after a standardised test meal
Difference between CHO-last and CHO-first meal patterns in the time spent >7.8 mmol/L and time <3.9 mmol/L (%), following standardised breakfasts (independent of and coinciding with subsequent exercise) and the end-of-intervention (days 3 and 5) standardised supper, assessed using a blinded continuous glucose monitoring system (Freestyle Libre Pro IQ).
Measured: 0-180 minutes following a standardised test meal
Interstitial glucose dip after a standardised test meal
Difference between CHO-last and CHO-first meal patterns in the 2-3-hour interstitial glucose dip (mmol/L), following standardised breakfasts not coinciding with subsequent exercise, and the end-of-intervention (days 3 and 5) standardised supper, assessed using a blinded continuous glucose monitoring system (Freestyle Libre Pro IQ).
Measured: 0-180 minutes following a standardised test meal
Interstitial glucose concentrations during specific activities
Difference between CHO-last and CHO-first meal patterns in the mean interstitial glucose concentrations (mmol/L) across 15-minute averages and adjusted for baseline where relevant, during the following periods: after standardised breakfasts (independent of and coinciding with exercise); after the end-of-intervention (days 3 and 5) standardised supper, during exercise not coinciding with postprandial periods, during evening sleep, and during daytime rest, assessed using a blinded continuous glucose monitoring system (Freestyle Libre Pro IQ).
Measured: 24 hours
Within-day standard deviation of interstitial glucose
Difference between CHO-last and CHO-first meal patterns in the 24-hour standard deviation (SD) of interstitial glucose concentrations during the end-of-intervention monitoring period (days 3 and 5), assessed using a blinded continuous glucose monitoring system (Freestyle Libre Pro IQ sensor).
Measured: 24 hours
Within-day coefficient of variation of interstitial glucose
Difference between CHO-last and CHO-first meal patterns in the 24-hour coefficient of variation (%) of interstitial glucose concentrations during the end-of-intervention monitoring period (days 3 and 5), assessed using a blinded continuous glucose monitoring system (Freestyle Libre Pro IQ sensor).
Measured: 24 hours
Mean amplitude of glycaemic excursions (MAGE)
Difference between CHO-last and CHO-first meal patterns in the mean amplitude of glycaemic excursions (MAGE) during the end-of-intervention monitoring period (days 3 and 5), assessed using a blinded continuous glucose monitoring system (Freestyle Libre Pro IQ sensor).
Measured: 24 hours
Large amplitude of glycaemic excursions (LAGE)
Difference between CHO-last and CHO-first meal patterns in the large amplitude of glycaemic excursions (LAGE) during the end-of-intervention monitoring period (days 3 and 5), assessed using a blinded continuous glucose monitoring system (Freestyle Libre Pro IQ sensor).
Measured: 24 hours
Within-day time out of interstitial glucose range
Difference between CHO-last and CHO-first meal patterns in the time spent >7.8 mmol/L and <3.9 mmol/L (%) over 24 hours during the end-of-intervention monitoring period (days 3 and 5), assessed using a blinded continuous glucose monitoring system (Freestyle Libre Pro IQ sensor).
Measured: 24 hours
Between-day glycaemic variability
Difference between CHO-last and CHO-first meal patterns in the mean of daily differences (MODD) of interstitial glucose responses at matched clock times, assessed using a blinded continuous glucose monitoring system (Freestyle Libre Pro IQ).
Measured: 24 hours
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted25 Nov 2025
- Study start24 Nov 2025
- Primary completion29 Nov 2025
- Study completion29 Nov 2025
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Other trials for HealthyStudies 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
- Basic science
- Allocation
- Randomised
- Intervention model
- Crossover
- Model description
- This trial is designed as a randomised, counterbalanced, crossover, open label, superiority trial with two groups. Block randomization will be performed by an external researcher with a 1:1 allocation ratio, and allocation concealment will be ensured through the use of sequentially numbered, opaque, sealed envelopes.
- Masking
- None (open label)
- Enrolment
- 22 participants (actual)
Sponsor and investigators
- Lead sponsor
- Universidade do Porto
- Sponsor type
- University, hospital or other
- Collaborators
- Portuguese Football Federation, Fundação para a Ciência e a Tecnologia
- Responsible party
- Sponsor
- Investigators
- Rita Giro, Principal investigator, Faculty of Nutrition and Food Sciences of the University of Porto (FCNAUP); FPF Academy, Federação Portuguesa de Futebol
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT07247513
- Sponsor's protocol ID
- FOODSEQ-GRFA
- Other IDs
- 2022.12954.BD
- Status last verified
- Dec 2025
- First submitted
- 14 Nov 2025
- Last updated
- 5 Dec 2025
- Results posted
- No
- Data monitoring committee
- No
- FDA-regulated drug
- No
- FDA-regulated device
- No
- Individual data sharing
- Yes: Anonymised IPD will be made available upon reasonable request directed to the corresponding author.
Study at a glance
From the registry record, last updated by the sponsor on 5 Dec 2025. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Glycaemic Responses to a Food Intake Sequence Intervention Under Free-living Conditions in Elite Female Athletes
- ClinicalTrials.gov ID
- NCT07247513
- Acronym / sponsor ID
- FOODSEQ-GRFA
- Conditions
- Healthy, Nutrition, Glycemic Variability, Dietary Intervention, Sleep, Exercise
- Keywords
- food order, meal sequence, glycaemia, sport nutrition
- Study type
- Interventional
- Recruitment status
- Completed
- Enrolment
- 22 participants (actual)
- Lead sponsor
- Universidade do PortoUniversity, hospital or other
- Collaborators
- Portuguese Football Federation, Fundação para a Ciência e a Tecnologia
- Study start
- 24 Nov 2025 (actual)
- Primary completion
- 29 Nov 2025 (actual)
- Study completion
- 29 Nov 2025 (actual)
- First posted
- 25 Nov 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 is to investigate the impact of a food intake sequence intervention under free-living conditions on glycaemic responses in elite female athletes. Specifically, the main questions it aims to answer are:
- Does consuming breakfast in different food intake sequences alter postprandial interstitial glucose responses?
- Does consuming a pre-exercise meal in different food intake sequences alter interstitial glucose responses during exercise?
- Does consuming the last meal of the day in different food intake sequences alter nocturnal interstitial glucose responses?
To address these questions, researchers will compare eating the dietary sources of rapidly absorbed carbohydrate (CHO) at the end (CHO-last meal pattern) or at the start (CHO-first meal pattern) of standardised mixed meals, at different times of day, in a randomised, counterbalanced, crossover design.
Participants will wear a blinded continuous glucose monitor (CGM) for 6 consecutive days during a training camp. Throughout the study, they will be provided with buffet meals, at the same time and location each day. Dietary intake will be ad libitum, except for breakfast and supper, for which participants will select a preferred composition (ingredients, preparation methods, portion sizes) to replicate across study days. In all ad libitum meals (i.e., lunch, snacks, and dinner), they will be asked to maintain their assigned food intake sequence.
- On day 1, athletes will eat freely. An educational session on the study protocol and food sequence manipulation will be delivered, and informed consent, questionnaires, screening assessments, and CGM fitting will be completed. Data collected by the CGM during the first 24 hours will be disregarded due to sensor stabilisation. Hence, this period will serve for familiarisation only.
- On days 2 and 3, one group will eat the last meal of the day (i.e., supper) in a CHO-last meal pattern, while the other will follow a CHO-first meal pattern; on days 3 and 4 one group will eat breakfast in a CHO-last meal pattern while the other will follow a CHO-first meal pattern.
- On days 4 and 5 (supper) and 5 and 6 (breakfast), participants in each group will adhere to the alternate condition.
Concurrent data on potential confounding factors (e.g., dietary intake, physical activity, internal and external load during training sessions/competition, sleep quantity and quality, menstrual cycle phase/status) will be collected.
Due to the short camp duration, implementing a one-day washout period will not be feasible. Therefore, repeated measurements over two consecutive days per condition will be obtained to minimise carryover effects of the food intake sequence from prior meals on end-of-intervention data (the final 24 hours per condition), and to assess intraindividual consistency of outcomes at matched-times and standardised settings.
Glycaemic responses will be compared within-participant between food intake sequences using linear mixed models with random intercepts, to account for repeated measures, interindividual variability, and potential missing data.
Study design
- Primary purpose
- Basic science
- Allocation
- Randomised
- Intervention model
- Crossover
- Masking
- None (open label)
- Number of arms
- 2
- Model description
- This trial is designed as a randomised, counterbalanced, crossover, open label, superiority trial with two groups. Block randomization will be performed by an external researcher with a 1:1 allocation ratio, and allocation concealment will be ensured through the use of sequentially numbered, opaque, sealed envelopes.
| Arm | Type | Receives |
|---|---|---|
| CL - CF | Experimental | Other: Carbohydrate-last meal pattern, Other: Carbohydrate-first meal patternThe interventions (carbohydrate-last meal pattern (CL) or carbohydrate-first meal pattern (CF)) will be delivered in random order. If participants are allocated to this study arm, they will receive the CL on the first 2 days and the CF on the next 2 days of the study period. |
| CF - CL | Active comparator | Other: Carbohydrate-last meal pattern, Other: Carbohydrate-first meal patternThe interventions (carbohydrate-last meal pattern (CL) or carbohydrate-first meal pattern (CF)) will be delivered in random order. If participants are allocated to this study arm, they will receive the CF on the first 2 days and the CL on the next 2 days of the study period. |
Who may qualify
- Ages
- 18 to 64 years
- Sex
- Female only
- Healthy volunteers
- Accepted
- Age groups
- Adult
Key inclusion criteria (6 listed)
- Adult (18-64 years old)
- Women
- Elite athletes (meeting training and performance caliber criteria ≥Tier 4; McKay et al., 2022)
- Healthy (meeting the exclusion criteria for medical conditions)
- Normal glucose tolerant according to the latest review standards of the American Diabetes Association (ElSayed et al., 2024): HbA1c <5.7%, fasting plasma glucose <5.6 mmol/L (100 mg/dL), or 2-h plasma glucose <7.8 mmol/L (140 mg/dL) during a 75-g OGTT
Key exclusion criteria (4 listed)
- Any medical condition or behaviour deemed either to pose undue personal risk to the participant or introduce bias into the experiment (e.g. pregnancy, alcohol or substance abuse; any condition affecting the glucose and lipid metabolism or appetite, reviewed on a case by case basis)
- Any reported medication or supplementation that may interfere with the glucose metabolism (e.g., acarbose, aspirin, berberine, insulin, metformin, semaglutide, sulfonylureas, thiazide diuretics, thiazolidinediones, vitamin C). Other medication and supplementation will be reviewed on a case by case basis.
- Recent change in body mass (± 2 kg in the last 2 months)
- Smoking
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 |
|---|---|---|
| Carbohydrate-last meal patternAlso: CL, CHO-lastParticipants will consume the main dietary sources of protein, fat, fibre and/or polyphenols before the main dietary sources of simple carbohydrate in the standardised test-meals (breakfast and supper) and will be encouraged to maintain this food intake sequence in the remaining meals of the day. Participants will be instructed to consume lunch and dinner within 30 min, and breakfast and supper within 15 min at a comfortable pace, without intervals between the carbohydrate and non-carbohydrate-rich meal components. | Other | CF - CL, CL - CF |
| Carbohydrate-first meal patternAlso: CF, CHO-firstParticipants will consume the main dietary sources of protein, fat, fibre and/or polyphenols after the main dietary sources of simple carbohydrate in the standardised test-meals (breakfast and supper) and will be encouraged to maintain this food intake sequence in the remaining meals of the day. Participants will be instructed to consume lunch and dinner within 30 min, and breakfast and supper within 15 min at a comfortable pace, without intervals between the carbohydrate and non-carbohydrate-rich meal components. | Other | CF - CL, CL - CF |
Primary outcome
Incremental interstitial glucose peak after a standardised test meal
Time frame: 0-120 minutes following a standardised test meal
Difference between CHO-last and CHO-first meal patterns in the incremental interstitial glucose peak (mmol/L) adjusted for baseline, following standardised breakfasts (independent of and coinciding with subsequent exercise) and the end-of-intervention (days 3 and 5) standardised supper, assessed using a blinded continuous glucose monitoring system (Freestyle Libre Pro IQ).
11 secondary outcomes
Incremental area under the interstitial glucose curve after a standardised test meal
Time frame: 0-120 minutes following a standardised test meal
Time-to-peak interstitial glucose after a standardised test meal
Time frame: 0-120 minutes following a standardised test meal
Time out of interstitial glucose range after a standardised test meal
Time frame: 0-180 minutes following a standardised test meal
Interstitial glucose dip after a standardised test meal
Time frame: 0-180 minutes following a standardised test meal
Interstitial glucose concentrations during specific activities
Time frame: 24 hours
Within-day standard deviation of interstitial glucose
Time frame: 24 hours
Within-day coefficient of variation of interstitial glucose
Time frame: 24 hours
Mean amplitude of glycaemic excursions (MAGE)
Time frame: 24 hours
Large amplitude of glycaemic excursions (LAGE)
Time frame: 24 hours
Within-day time out of interstitial glucose range
Time frame: 24 hours
Between-day glycaemic variability
Time frame: 24 hours
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 5 Dec 2025.
- Individual participant dataSharing planned: Yes. Anonymised IPD will be made available upon reasonable request directed to the corresponding author.
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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.
Rita Giro principal investigator
Faculty of Nutrition and Food Sciences of the University of Porto (FCNAUP); FPF Academy, Federação Portuguesa de Futebol
1 site in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A study testing Carbohydrate-last meal pattern and Carbohydrate-first meal pattern in people with Healthy and Nutrition, run by Universidade do Porto at 1 site in Portugal.
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 6 inclusion and 4 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 5 Dec 2025. 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 Portugal. 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.
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?
Incremental interstitial glucose peak after a standardised test meal (time frame: 0-120 minutes following a standardised test meal). 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 5 Dec 2025; AzTrials last refreshed its copy on 26 Oct 2026.