Schizophrenia and Predominant Negative SymptomsTMSNSNCT07428460
Accelerated Neuromodulation Therapy for Negative Symptoms of Schizophrenia
A study testing Neuronavigated Intermittent Theta Burst Stimulation and BEAM-F3 Intermittent theta burst stimulation in people with Schizophrenia and Predominant Negative Symptoms, run by Douglas Mental Health University Institute at 3 sites in Canada.
Trial summary
The goal of this clinical trial is to learn if an accelerated form of neuromodulation therapy can help improve negative symptoms of schizophrenia. Negative symptoms can include low motivation, reduced emotional expression, and difficulty with social interaction. Read more about this study
- Who is it for?
- Ages 18 to 65 years
- Conditions the study is for
- Schizophrenia and Predominant Negative Symptoms
- What is being tested?
- Neuronavigated Intermittent Theta Burst Stimulation and BEAM-F3 Intermittent theta burst stimulation
- Type of treatment
- Medical device
- Could I receive a placebo?
- Yes, some participants may receive a placebo
- How many people
- 75 participants
- Where
- 3 sitesCanada
- Study dates
- 1 Feb 2026to May 2028
- 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 18 to 65 years
- All sexes
- No healthy volunteers
- Adult, Older adult
Who may be able to join
- Confirmed diagnosis of schizophrenia, schizoaffective disorder, or schizophreniform disorder
- Duration of illness ≥ 6 months
- Clinically significant negative symptoms
- Must have been on a stable pharmacological treatment for at least 4 weeks before entering the study
- Clinicians will confirm that patients' negative and positive symptoms have been stable per their clinical opinion for at least 3 months.
- Participants must be able to provide informed consent
- Ability to undergo MRI scanning
Who cannot join
- Pregnancy, lactation, or an intrauterine device
- History of electroconvulsive therapy (ECT) in the past 6 months
- Use of licit or illicit substances (excluding cannabis) during the week of treatment and in the 24 hours prior to fMRI scans
- Contraindications for TMS
- Previous treatment with rTMS
- Documented history of significant intellectual disability
- Primary diagnosis of psychotic disorder secondary to a medical condition or substance-induced psychosis.
Trial locations and contacts
3 sites in 1 country. Contact the study team or a site near you to ask about taking part.
Canada3 sites, 3 recruiting
- Not yet recruiting
Institut Universitaire en Santé Mentale de Montréal
Montreal, Quebec, H1N 3M5
Stéphane Potvin, PhD, (514) 251-4015, stephane.potvin@umontrela.ca
Stéphane Potvin, PhD
- Not yet recruiting
Institut universitaire de santé mentale de Québec - Centre de recherche CERVO
Québec, Quebec, G1J 2G3
Olivier Roy Roy, MD, MSc, PhD, FRCPC, 418-663-5000 ext. 24615, olivier.roy@cervo.ulaval.ca
Olivier Roy, MD, MSc, PhD, FRCPC
- Recruiting
McGill Lab for Computational Psychiatry and Translation - Burland Pavilion 6875 Boulevard LaSalle Montreal, QC
Verdun, Quebec, H4H 1R3
Ashley Choucroun, 5146593488, ashley.choucroun.comtl@ssss.gouv.qc.ca
David Benrimoh, MD.CM., MSc., MSc., FRCPC
About this study
Official title: Accelerated, Neuronavigated Neuromodulation Therapy for Negative Symptoms of Schizophrenia
The goal of this clinical trial is to learn if an accelerated form of neuromodulation therapy can help improve negative symptoms of schizophrenia. Negative symptoms can include low motivation, reduced emotional expression, and difficulty with social interaction. The study will also look at how safe and tolerable this treatment is when given over a short period of time.
Participants will be randomly assigned to receive either active neuromodulation therapy or sham (placebo) stimulation. The study will also compare two different ways of choosing where to place the stimulation.
Read more
The investigators want to learn whether this accelerated treatment approach is safe and feasible for people with schizophrenia, whether negative symptoms improve after treatment, and whether the way the stimulation site is chosen affects outcomes
Participants will be asked to complete clinical interviews and questionnaires, undergo a brain scan, receive neuromodulation therapy or sham stimulation over five consecutive days, and attend follow-up visits after treatment
This study is being conducted at three hospitals in Canada and is designed to help plan larger studies in the future.
Read the detailed description
Negative symptoms of schizophrenia, including diminished motivation, reduced emotional expression, and impaired social functioning, are a major contributor to long-term disability and remain inadequately treated by existing interventions. Repetitive transcranial magnetic stimulation targeting the left dorsolateral prefrontal cortex has demonstrated potential benefit for negative symptoms, but conventional treatment schedules often require multiple weeks of daily sessions, which may limit feasibility in this population.
Accelerated neuromodulation therapy delivers multiple stimulation sessions per day over a condensed time period and may improve accessibility, adherence, and tolerability. This pilot study evaluates an accelerated iTBS protocol delivered over five consecutive days in individuals with schizophrenia spectrum disorders who exhibit clinically significant negative symptoms.
Participants are randomized to receive either active neuromodulation therapy or sham stimulation. In addition, the study evaluates two approaches to stimulation targeting. Targeting approach is assigned according to study procedures designed to preserve participant and rater blinding.
All participants undergo baseline clinical, behavioral, and functional assessments, followed by the accelerated treatment protocol and post-treatment follow-up assessments. Primary outcomes focus on changes in negative symptom severity, while secondary outcomes assess depressive symptoms, functional outcomes, and task-based behavioral measures.
- Being tested
- Neuronavigated Intermittent Theta Burst Stimulation, BEAM-F3 Intermittent theta burst stimulation, Sham Intermittent Theta Burst Stimulation
- Keywords
- Negative symptoms, Neuromodulation therapy, Non-invasive brain stimulation, Accelerated treatment, Schizophrenia spectrum disorders, TMS, Transcranial Magnetic Stimulation, Outpatient treatment
- Medical subject headings
- Schizophrenia
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
Neuronavigated Intermittent Theta Burst StimulationDevice
Neuronavigated intermittent theta burst stimulation (iTBS) is delivered using a transcranial magnetic stimulation device with a figure-of-eight coil targeting the left dorsolateral prefrontal cortex. Individualized stimulation targets are identified using functional MRI data and are imported into a neuronavigation system to guide coil positioning and orientation throughout treatment.
Treatment is delivered over five consecutive days using an accelerated schedule consisting of ten stimulation sessions per day. Each iTBS session is delivered at an intensity corresponding to 110% of the participant's resting motor threshold, with stimulation intensity adjusted for individual cortical depth.
BEAM-F3 Intermittent theta burst stimulationDevice
BEAM-F3 intermittent theta burst stimulation (iTBS) is delivered using a transcranial magnetic stimulation device with a figure-of-eight coil targeting the left dorsolateral prefrontal cortex. Stimulation targets are identified according to the BEAM-F3 procedure.
Treatment is delivered over five consecutive days using an accelerated schedule consisting of ten stimulation sessions per day. Each iTBS session is delivered at an intensity corresponding to 110% of the participant's resting motor threshold, with stimulation intensity adjusted for individual cortical depth.
Sham Intermittent Theta Burst StimulationDevice
Sham intermittent theta burst stimulation is delivered using a transcranial magnetic stimulation device with a figure-of-eight coil positioned over the left dorsolateral prefrontal cortex. Coil placement, session structure, and treatment schedule are identical to those used for active stimulation.
Treatment is delivered over five consecutive days using an accelerated schedule consisting of ten stimulation sessions per day. Sham stimulation is administered using procedures designed to mimic the experience of active iTBS without producing therapeutic cortical stimulation.
| Study group | Role | What they receive |
|---|---|---|
| Active iTBS (Neuronavigated Targeting) | Experimental | Participants receive iTBS over five consecutive days (ten sessions/day) targeting the left dorsolateral prefrontal cortex using neuronavigation-guided targeting. Receives: Device: Neuronavigated Intermittent Theta Burst Stimulation |
| Active iTBS (BEAM-F3 Targeting) | Experimental | Participants receive iTBS over five consecutive days (ten sessions/day) targeting the left dorsolateral prefrontal cortex using BEAM-F3 targeting. Receives: Device: BEAM-F3 Intermittent theta burst stimulation |
| Sham iTBS | Sham comparator | Participants receive sham iTBS over five consecutive days (ten sessions/day) using the same session structure and procedures as active treatment. Receives: Device: Sham Intermittent Theta Burst Stimulation |
What is being measured
The primary outcome is the main question the study is designed to answer.
Change in Avolition/Apathy Subscale Score
Change in score on the Avolition/Apathy subscale of the Scale for the Assessment of Negative Symptoms (SANS). The SANS Avolition/Apathy subscale ranges from 0 to 25, with higher scores indicating greater negative symptom severity.
Measured: Baseline to 1 week, 1 month, and 3 months post-treatment
Change in Scale for the Assessment of Negative Symptoms Total Score
Change in total score on the Scale for the Assessment of Negative Symptoms (SANS). Total scores range from 0 to 125, with higher scores indicating greater negative symptom severity.
Measured: Baseline to 1 week, 1 month, and 3 months post-treatment
Change in Brief Negative Symptom Scale Total Score
Change in total score on the Brief Negative Symptom Scale (BNSS). Total scores range from 0 to 78, with higher scores indicating greater negative symptom severity.
Measured: Baseline to 1 week, 1 month, and 3 months post-treatment
Effect of Targeting Method on Negative Symptoms
Difference in change in negative symptom severity between targeting methods, as measured by negative symptom outcomes.
Measured: Baseline to 1 week, 1 month, and 3 months post-treatment
Secondary outcomes (6)
Change in Affective Processing
Change in affective processing as measured by performance on a behavioural task assessing conditioned hallucinations related to valenced auditory information.
Measured: Baseline to 1 week, 1 month, and 3 months post-treatment
Change in Social Appraisal
Change in social appraisal and belief updating as measured by performance on a behavioral task assessing social inference and valuation.
Measured: Baseline to 1 week, 1 month, and 3 months post-treatment
Change in Cognitive Performance
Change in cognitive performance as measured by an automated cognitive battery assessing attention, processing speed, working memory, verbal memory, verbal fluency, and executive function.
Measured: Baseline to 1 week, 1 month, and 3 months post-treatment
Change in Montgomery-Åsberg Depression Rating Scale Score
Change in score on the Montgomery-Åsberg Depression Rating Scale. Total scores range from 0 to 60, with higher scores indicating greater depressive symptom severity.
Measured: Baseline to 1 week, 1 month, and 3 months post-treatment
Change in Calgary Depression Scale for Schizophrenia Score
Change in score on the Calgary Depression Scale for Schizophrenia. Total scores range from 0 to 27, with higher scores indicating greater depressive symptom severity.
Measured: Baseline to 1 week, 1 month, and 3 months post-treatment
Change in Social and Occupational Functioning Assessment Scale Score
Change in score on the Social and Occupational Functioning Assessment Scale. Scores range from 0 to 100, with higher scores indicating better functioning.
Measured: Baseline to 1 week, 1 month, and 3 months post-treatment
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted23 Feb 2026
- Study start1 Feb 2026
- Primary completionDec 2027 (estimated)
- Study completionMay 2028 (estimated)
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Other trials for Schizophrenia and Predominant Negative SymptomsStudies 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
- Masking
- Triple blind
- Who is masked
- Participant, Care provider, Outcomes assessor
- Enrolment
- 75 participants (estimated)
Sponsor and investigators
- Lead sponsor
- Douglas Mental Health University Institute
- Sponsor type
- University, hospital or other
- Collaborators
- Centre de recherche CERVO, Magnus Medical, Centre de Recherche de l'Institut Universitaire en santé Mentale de Montréal
- Responsible party
- Principal investigator, David Benrimoh, Douglas Mental Health University Institute
- Investigators
- David Benrimoh, MD.CM., MSc., MSc., FRCPC, Principal investigator, McGill University, Department of PsychiatryOlivier Roy, MD, Principal investigator, Centre de recherche CERVO - Université LavalStéphane Potvin, PhD, Principal investigator, Institut Universitaire en Santé Mentale de MontréalLena Palaniyappan, MD, PhD, Principal investigator, Douglas Mental Health Institute
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT07428460
- Sponsor's protocol ID
- MP-18-2025-1206
- Other IDs
- 8401470ASMQ, CIHR-8401550
- Acronym
- TMSNS
- Status last verified
- Aug 2026
- First submitted
- 12 Feb 2026
- Last updated
- 20 Aug 2026
- Results posted
- No
- Data monitoring committee
- No
- FDA-regulated drug
- No
- FDA-regulated device
- No
- Individual data sharing
- Undecided
Study at a glance
From the registry record, last updated by the sponsor on 20 Aug 2026. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Accelerated, Neuronavigated Neuromodulation Therapy for Negative Symptoms of Schizophrenia
- ClinicalTrials.gov ID
- NCT07428460
- Acronym / sponsor ID
- TMSNS / MP-18-2025-1206
- Keywords
- Negative symptoms, Neuromodulation therapy, Non-invasive brain stimulation, Accelerated treatment, Schizophrenia spectrum disorders, TMS, Transcranial Magnetic Stimulation, Outpatient treatment
- Study type
- Interventional
- Recruitment status
- Recruiting
- Enrolment
- 75 participants (estimated)
- Lead sponsor
- Douglas Mental Health University InstituteUniversity, hospital or other
- Collaborators
- Centre de recherche CERVO, Magnus Medical, Centre de Recherche de l'Institut Universitaire en santé Mentale de Montréal
- Study start
- 1 Feb 2026 (actual)
- Primary completion
- Dec 2027 (estimated)
- Study completion
- May 2028 (estimated)
- First posted
- 23 Feb 2026 (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 learn if an accelerated form of neuromodulation therapy can help improve negative symptoms of schizophrenia. Negative symptoms can include low motivation, reduced emotional expression, and difficulty with social interaction. The study will also look at how safe and tolerable this treatment is when given over a short period of time.
Participants will be randomly assigned to receive either active neuromodulation therapy or sham (placebo) stimulation. The study will also compare two different ways of choosing where to place the stimulation.
The investigators want to learn whether this accelerated treatment approach is safe and feasible for people with schizophrenia, whether negative symptoms improve after treatment, and whether the way the stimulation site is chosen affects outcomes
Participants will be asked to complete clinical interviews and questionnaires, undergo a brain scan, receive neuromodulation therapy or sham stimulation over five consecutive days, and attend follow-up visits after treatment
This study is being conducted at three hospitals in Canada and is designed to help plan larger studies in the future.
Detailed description
Negative symptoms of schizophrenia, including diminished motivation, reduced emotional expression, and impaired social functioning, are a major contributor to long-term disability and remain inadequately treated by existing interventions. Repetitive transcranial magnetic stimulation targeting the left dorsolateral prefrontal cortex has demonstrated potential benefit for negative symptoms, but conventional treatment schedules often require multiple weeks of daily sessions, which may limit feasibility in this population.
Accelerated neuromodulation therapy delivers multiple stimulation sessions per day over a condensed time period and may improve accessibility, adherence, and tolerability. This pilot study evaluates an accelerated iTBS protocol delivered over five consecutive days in individuals with schizophrenia spectrum disorders who exhibit clinically significant negative symptoms.
Participants are randomized to receive either active neuromodulation therapy or sham stimulation. In addition, the study evaluates two approaches to stimulation targeting. Targeting approach is assigned according to study procedures designed to preserve participant and rater blinding.
All participants undergo baseline clinical, behavioral, and functional assessments, followed by the accelerated treatment protocol and post-treatment follow-up assessments. Primary outcomes focus on changes in negative symptom severity, while secondary outcomes assess depressive symptoms, functional outcomes, and task-based behavioral measures.
Study design
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Triple blind (participant, care provider, outcomes assessor)
- Number of arms
- 3
| Arm | Type | Receives |
|---|---|---|
| Active iTBS (Neuronavigated Targeting) | Experimental | Device: Neuronavigated Intermittent Theta Burst StimulationParticipants receive iTBS over five consecutive days (ten sessions/day) targeting the left dorsolateral prefrontal cortex using neuronavigation-guided targeting. |
| Active iTBS (BEAM-F3 Targeting) | Experimental | Device: BEAM-F3 Intermittent theta burst stimulationParticipants receive iTBS over five consecutive days (ten sessions/day) targeting the left dorsolateral prefrontal cortex using BEAM-F3 targeting. |
| Sham iTBS | Sham comparator | Device: Sham Intermittent Theta Burst StimulationParticipants receive sham iTBS over five consecutive days (ten sessions/day) using the same session structure and procedures as active treatment. |
Who may qualify
- Ages
- 18 to 65 years
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult, Older adult
Key inclusion criteria (7 listed)
- Confirmed diagnosis of schizophrenia, schizoaffective disorder, or schizophreniform disorder
- Duration of illness ≥ 6 months
- Clinically significant negative symptoms
- Must have been on a stable pharmacological treatment for at least 4 weeks before entering the study
- Clinicians will confirm that patients' negative and positive symptoms have been stable per their clinical opinion for at least 3 months.
Key exclusion criteria (7 listed)
- Pregnancy, lactation, or an intrauterine device
- History of electroconvulsive therapy (ECT) in the past 6 months
- Use of licit or illicit substances (excluding cannabis) during the week of treatment and in the 24 hours prior to fMRI scans
- Contraindications for TMS
- Previous treatment with rTMS
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 |
|---|---|---|
| Neuronavigated Intermittent Theta Burst StimulationNeuronavigated intermittent theta burst stimulation (iTBS) is delivered using a transcranial magnetic stimulation device with a figure-of-eight coil targeting the left dorsolateral prefrontal cortex. Individualized stimulation targets are identified using functional MRI data and are imported into a neuronavigation system to guide coil positioning and orientation throughout treatment. Treatment is delivered over five consecutive days using an accelerated schedule consisting of ten stimulation sessions per day. Each iTBS session is delivered at an intensity corresponding to 110% of the participant's resting motor threshold, with stimulation intensity adjusted for individual cortical depth. | Device | Active iTBS (Neuronavigated Targeting) |
| BEAM-F3 Intermittent theta burst stimulationBEAM-F3 intermittent theta burst stimulation (iTBS) is delivered using a transcranial magnetic stimulation device with a figure-of-eight coil targeting the left dorsolateral prefrontal cortex. Stimulation targets are identified according to the BEAM-F3 procedure. Treatment is delivered over five consecutive days using an accelerated schedule consisting of ten stimulation sessions per day. Each iTBS session is delivered at an intensity corresponding to 110% of the participant's resting motor threshold, with stimulation intensity adjusted for individual cortical depth. | Device | Active iTBS (BEAM-F3 Targeting) |
| Sham Intermittent Theta Burst StimulationSham intermittent theta burst stimulation is delivered using a transcranial magnetic stimulation device with a figure-of-eight coil positioned over the left dorsolateral prefrontal cortex. Coil placement, session structure, and treatment schedule are identical to those used for active stimulation. Treatment is delivered over five consecutive days using an accelerated schedule consisting of ten stimulation sessions per day. Sham stimulation is administered using procedures designed to mimic the experience of active iTBS without producing therapeutic cortical stimulation. | Device | Sham iTBS |
Primary outcome
Change in Avolition/Apathy Subscale Score
Time frame: Baseline to 1 week, 1 month, and 3 months post-treatment
Change in score on the Avolition/Apathy subscale of the Scale for the Assessment of Negative Symptoms (SANS). The SANS Avolition/Apathy subscale ranges from 0 to 25, with higher scores indicating greater negative symptom severity.
Change in Scale for the Assessment of Negative Symptoms Total Score
Time frame: Baseline to 1 week, 1 month, and 3 months post-treatment
Change in total score on the Scale for the Assessment of Negative Symptoms (SANS). Total scores range from 0 to 125, with higher scores indicating greater negative symptom severity.
Change in Brief Negative Symptom Scale Total Score
Time frame: Baseline to 1 week, 1 month, and 3 months post-treatment
Change in total score on the Brief Negative Symptom Scale (BNSS). Total scores range from 0 to 78, with higher scores indicating greater negative symptom severity.
Effect of Targeting Method on Negative Symptoms
Time frame: Baseline to 1 week, 1 month, and 3 months post-treatment
Difference in change in negative symptom severity between targeting methods, as measured by negative symptom outcomes.
6 secondary outcomes
Change in Affective Processing
Time frame: Baseline to 1 week, 1 month, and 3 months post-treatment
Change in Social Appraisal
Time frame: Baseline to 1 week, 1 month, and 3 months post-treatment
Change in Cognitive Performance
Time frame: Baseline to 1 week, 1 month, and 3 months post-treatment
Change in Montgomery-Åsberg Depression Rating Scale Score
Time frame: Baseline to 1 week, 1 month, and 3 months post-treatment
Change in Calgary Depression Scale for Schizophrenia Score
Time frame: Baseline to 1 week, 1 month, and 3 months post-treatment
Change in Social and Occupational Functioning Assessment Scale Score
Time frame: Baseline to 1 week, 1 month, and 3 months post-treatment
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 20 Aug 2026.
- Individual participant dataSharing planned: Undecided
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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.
David Benrimoh, MD.CM., MSc., MSc., FRCPC principal investigator
McGill University, Department of Psychiatry
Olivier Roy, MD principal investigator
Centre de recherche CERVO - Université Laval
Stéphane Potvin, PhD principal investigator
Institut Universitaire en Santé Mentale de Montréal
3 sites in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A study testing Neuronavigated Intermittent Theta Burst Stimulation and BEAM-F3 Intermittent theta burst stimulation in people with Schizophrenia and Predominant Negative Symptoms, run by Douglas Mental Health University Institute at 3 sites in Canada.
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 7 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: looking for participants now, as of the sponsor's last update on 20 Aug 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 Canada. Whether a site is taking part right now should be confirmed with that site. See every site.
What are the possible benefits and risks?
They depend on the study and the treatment, and no study can promise a benefit. Some participants in this study may receive a placebo. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
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 Ashley S. Choucroun (5146593488, ashley.choucroun.comtl@ssss.gouv.qc.ca), or a site near the patient. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
Change in Avolition/Apathy Subscale Score (time frame: Baseline to 1 week, 1 month, and 3 months post-treatment). The study lists 4 primary outcomes in all. 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 Aug 2026; AzTrials last refreshed its copy on 26 Oct 2026.