TTP - Thrombotic Thrombocytopenic PurpuraMITHONCT07615244
MICROVASCULAR DAMAGE IN THROMBOTIC THROMBOCYTOPENIC PURPURA
A study testing Factor VIII (FVIII), Von Willebrand factor (VWF) antigen and VWF:RCo in people with TTP - Thrombotic Thrombocytopenic Purpura, run by Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico at 1 site in Italy.
Trial summary
The goal of this interventional, non-pharmacological clinical study is to assess microcirculatory dysfunction in patients with thrombotic thrombocytopenic purpura (TTP), both during the acute phase and in remission, compared with the general population. Read more about this study
- Who is it for?
- Ages 18 years and older
- Conditions the study is for
- TTP - Thrombotic Thrombocytopenic Purpura
- What is being tested?
- Factor VIII (FVIII), Von Willebrand factor (VWF) antigen and VWF:RCo
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 79 participants
- Where
- 1 siteItaly
- Study dates
- 28 Feb 2026to 31 Jan 2032
- 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 years and older
- All sexes
- No healthy volunteers
- Adult, Older adult
Who may be able to join
- aged ≥18 years
- diagnosis of TTP (either congenital or acquired immune-mediated TTP)
- referred at our hospital (Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, S.C. Medicina - Emostasi e Trombosi)
- providing a signed informed consent
Who cannot join
- Patients who do not possess the above inclusion criteria
- Patients who have known contraindications to the instrumental exam included in the study.
Trial locations and contacts
1 site in 1 country.
Italy1 site
Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico
Milan, Milano, 20122
About this study
Official title: STUDY OF MICROVASCULAR DAMAGE IN PATIENTS WITH THROMBOTIC THROMBOCYTOPENIC PURPURA
The goal of this interventional, non-pharmacological clinical study is to assess microcirculatory dysfunction in patients with thrombotic thrombocytopenic purpura (TTP), both during the acute phase and in remission, compared with the general population.
Microcirculatory damage will be defined as the presence of at least one abnormal instrumental finding among brain magnetic resonance imaging (MRI), optical coherence tomography angiography (OCT-A), and nailfold videocapillaroscopy.
Read more
This is a monocentric, national study including two patient cohorts:
Cohort 1: patients enrolled during the acute phase Cohort 2: patients enrolled during remission Participants will be followed for three years with a total of five study visits.
Researchers will not test any drug but will perform detailed clinical, laboratory, and instrumental assessments to evaluate microvascular involvement over time.
Participants will:
- Undergo clinical evaluation, including internal medicine and neurological assessments
- Provide blood and urine samples for laboratory analyses
- Undergo instrumental examinations such as brain MRI, OCT-A, and nailfold videocapillaroscopy
- Receive psychological/neuropsychological evaluations
- Attend follow-up visits over a 3-year period (at baseline, 3 months [cohort 1 only], 12, 24, and 36 months)
- Being tested
- Factor VIII (FVIII), Von Willebrand factor (VWF) antigen, VWF:RCo, VWF-propeptide, VWF multimers
- Medical subject headings
- Purpura, Thrombotic Thrombocytopenic
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
Factor VIII (FVIII)Diagnostic test
The study is defined as interventional because it includes assessments that are not part of routine clinical practice
Von Willebrand factor (VWF) antigenDiagnostic test
The study is defined as interventional because it includes assessments that are not part of routine clinical practice
VWF:RCoDiagnostic test
The study is defined as interventional because it includes assessments that are not part of routine clinical practice
VWF-propeptideDiagnostic test
The study is defined as interventional because it includes assessments that are not part of routine clinical practice
VWF multimersDiagnostic test
The study is defined as interventional because it includes assessments that are not part of routine clinical practice
sP-selectinDiagnostic test
The study is defined as interventional because it includes assessments that are not part of routine clinical practice
sCD40LDiagnostic test
The study is defined as interventional because it includes assessments that are not part of routine clinical practice
F1+2Diagnostic test
The study is defined as interventional because it includes assessments that are not part of routine clinical practice
VEGF-ADiagnostic test
The study is defined as interventional because it includes assessments that are not part of routine clinical practice
VCAMDiagnostic test
The study is defined as interventional because it includes assessments that are not part of routine clinical practice
ICAMDiagnostic test
The study is defined as interventional because it includes assessments that are not part of routine clinical practice
IL-1βDiagnostic test
The study is defined as interventional because it includes assessments that are not part of routine clinical practice
IL-6Diagnostic test
The study is defined as interventional because it includes assessments that are not part of routine clinical practice
PTX3Diagnostic test
The study is defined as interventional because it includes assessments that are not part of routine clinical practice
BlySDiagnostic test
The study is defined as interventional because it includes assessments that are not part of routine clinical practice
Neutrophil elastase and myeloperoxidase (NETs) markersDiagnostic test
The study is defined as interventional because it includes assessments that are not part of routine clinical practice
soluble C5b-9Diagnostic test
The study is defined as interventional because it includes assessments that are not part of routine clinical practice
C5aDiagnostic test
The study is defined as interventional because it includes assessments that are not part of routine clinical practice
NFLDiagnostic test
The study is defined as interventional because it includes assessments that are not part of routine clinical practice
GFAPDiagnostic test
The study is defined as interventional because it includes assessments that are not part of routine clinical practice
evaluation of thrombus formation with Total Thrombus formation Analysis System (T-TAS)Diagnostic test
The study is defined as interventional because it includes assessments that are not part of routine clinical practice
Microfluidic Flow ChamberDiagnostic test
The study is defined as interventional because it includes assessments that are not part of routine clinical practice
Whole exome sequencing - WESGenetic
The study is defined as interventional because it includes assessments that are not part of routine clinical practice
Proteomic AnalysisDiagnostic test
The study is defined as interventional because it includes assessments that are not part of routine clinical practice
| Study group | Role | What they receive |
|---|---|---|
| Acute TTP | Other | Patients enrolled during acute phase (cohort 1), T0= within 15 days from hospital admission. Receives: Diagnostic Test: Factor VIII (FVIII); Diagnostic Test: Von Willebrand factor (VWF) antigen; Diagnostic Test: VWF:RCo; Diagnostic Test: VWF-propeptide; Diagnostic Test: VWF multimers; Diagnostic Test: sP-selectin; Diagnostic Test: sCD40L; Diagnostic Test: F1+2; Diagnostic Test: VEGF-A; Diagnostic Test: VCAM; Diagnostic Test: ICAM; Diagnostic Test: IL-1β; Diagnostic Test: IL-6; Diagnostic Test: PTX3; Diagnostic Test: BlyS; Diagnostic Test: Neutrophil elastase and myeloperoxidase (NETs) markers; Diagnostic Test: soluble C5b-9; Diagnostic Test: C5a; Diagnostic Test: NFL; Diagnostic Test: GFAP; Genetic: Whole exome sequencing - WES; Diagnostic Test: Proteomic Analysis |
| Remission TTP | Other | Patients enrolled during clinical remission (cohort 2), T0= check-up visit performed at more than 3 months from clinical response of the previous episode Receives: Diagnostic Test: Factor VIII (FVIII); Diagnostic Test: Von Willebrand factor (VWF) antigen; Diagnostic Test: VWF:RCo; Diagnostic Test: VWF-propeptide; Diagnostic Test: VWF multimers; Diagnostic Test: sP-selectin; Diagnostic Test: sCD40L; Diagnostic Test: F1+2; Diagnostic Test: VEGF-A; Diagnostic Test: VCAM; Diagnostic Test: ICAM; Diagnostic Test: IL-1β; Diagnostic Test: IL-6; Diagnostic Test: PTX3; Diagnostic Test: Neutrophil elastase and myeloperoxidase (NETs) markers; Diagnostic Test: soluble C5b-9; Diagnostic Test: C5a; Diagnostic Test: NFL; Diagnostic Test: GFAP; Diagnostic Test: evaluation of thrombus formation with Total Thrombus formation Analysis System (T-TAS); Diagnostic Test: Microfluidic Flow Chamber; Genetic: Whole exome sequencing - WES; Diagnostic Test: Proteomic Analysis |
What is being measured
The primary outcome is the main question the study is designed to answer.
Prevalence
Prevalence of microcirculation damage in iTTP patients compared to general population
Measured: From enrollment to the last visit (after 36 months from Time 0)
Secondary outcomes (6)
Cerebral microcirculation lesions
Evaluate cerebral microcirculation lesions (via brain MRI) in both acute and remission phases of TTP to monitor organ damage progression over time
Measured: From enrollment to the last visit (after 36 months from Time 0)
Retinal microcirculation changes
Assess retinal microcirculation changes (using OCT and OCT-A) during acute and remission phases of TTP to track organ damage evolution
Measured: From enrollment to the last visit (after 36 months from Time 0)
Peripheral microcirculation
Analyze peripheral microcirculation (with nailfold videocapillaroscopy) in acute and remission phases to evaluate progression of organ involvement in TTP
Measured: From enrollment to the last visit (after 36 months from Time 0)
Association between cerebral MRI lesions and cognitive or psychological symptoms
Explore the relationship between cerebral MRI lesions and cognitive or psychological symptoms during TTP remission, assessing symptom progression
Measured: From enrollment to the last visit (36 months from Time 0)
Modification of preclinical biomarkers
Explore the modification of preclinical biomarkers over time at different stage of the disease
Measured: From enrollment to the last visit (36 months from Time 0)
Associations between preclinical biomarkers and microcirculatory damage
Identify associations between preclinical biomarkers and microcirculatory damage in both acute and remission phases of TTP to predict risk and progression
Measured: From enrollment to the last visit (36 months from Time 0)
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted29 May 2026
- Study start28 Feb 2026
- Primary completion31 Jan 2031 (estimated)
- Study completion31 Jan 2032 (estimated)
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Other trials for TTP - Thrombotic Thrombocytopenic PurpuraStudies of the same condition, open and under way.
- More trials run by Fondazione IRCCS Ca' Granda, Ospedale Maggiore PoliclinicoThe 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 N/A
- Primary purpose
- Diagnosis
- Allocation
- Non-randomised
- Intervention model
- Parallel groups
- Masking
- None (open label)
- Enrolment
- 79 participants (estimated)
Sponsor and investigators
- Sponsor type
- University, hospital or other
- Collaborators
- Istituto Auxologico Italiano, Centro Cardiologico Monzino, Politecnico di Milano
- Responsible party
- Principal investigator, Flora Peyvandi, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT07615244
- Sponsor's protocol ID
- IRCCSMaggioreH
- Acronym
- MITHO
- Status last verified
- Jun 2026
- First submitted
- 22 May 2026
- Last updated
- 9 Jun 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 9 Jun 2026. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- STUDY OF MICROVASCULAR DAMAGE IN PATIENTS WITH THROMBOTIC THROMBOCYTOPENIC PURPURA
- ClinicalTrials.gov ID
- NCT07615244
- Acronym / sponsor ID
- MITHO / IRCCSMaggioreH
- Study type
- Interventional
- Recruitment status
- Active, not recruiting
- Enrolment
- 79 participants (estimated)
- Lead sponsor
- Fondazione IRCCS Ca' Granda, Ospedale Maggiore PoliclinicoUniversity, hospital or other
- Collaborators
- Istituto Auxologico Italiano, Centro Cardiologico Monzino, Politecnico di Milano
- Study start
- 28 Feb 2026 (actual)
- Primary completion
- 31 Jan 2031 (estimated)
- Study completion
- 31 Jan 2032 (estimated)
- First posted
- 29 May 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 interventional, non-pharmacological clinical study is to assess microcirculatory dysfunction in patients with thrombotic thrombocytopenic purpura (TTP), both during the acute phase and in remission, compared with the general population.
Microcirculatory damage will be defined as the presence of at least one abnormal instrumental finding among brain magnetic resonance imaging (MRI), optical coherence tomography angiography (OCT-A), and nailfold videocapillaroscopy.
This is a monocentric, national study including two patient cohorts:
Cohort 1: patients enrolled during the acute phase Cohort 2: patients enrolled during remission Participants will be followed for three years with a total of five study visits.
Researchers will not test any drug but will perform detailed clinical, laboratory, and instrumental assessments to evaluate microvascular involvement over time.
Participants will:
- Undergo clinical evaluation, including internal medicine and neurological assessments
- Provide blood and urine samples for laboratory analyses
- Undergo instrumental examinations such as brain MRI, OCT-A, and nailfold videocapillaroscopy
- Receive psychological/neuropsychological evaluations
- Attend follow-up visits over a 3-year period (at baseline, 3 months [cohort 1 only], 12, 24, and 36 months)
Study design
- Primary purpose
- Diagnosis
- Allocation
- Non-randomised
- Intervention model
- Parallel groups
- Masking
- None (open label)
- Number of arms
- 2
| Arm | Type | Receives |
|---|---|---|
| Acute TTP | Other | Diagnostic Test: Factor VIII (FVIII), Diagnostic Test: Von Willebrand factor (VWF) antigen, Diagnostic Test: VWF:RCo, Diagnostic Test: VWF-propeptide, Diagnostic Test: VWF multimers, Diagnostic Test: sP-selectin, Diagnostic Test: sCD40L, Diagnostic Test: F1+2, Diagnostic Test: VEGF-A, Diagnostic Test: VCAM, Diagnostic Test: ICAM, Diagnostic Test: IL-1β, Diagnostic Test: IL-6, Diagnostic Test: PTX3, Diagnostic Test: BlyS, Diagnostic Test: Neutrophil elastase and myeloperoxidase (NETs) markers, Diagnostic Test: soluble C5b-9, Diagnostic Test: C5a, Diagnostic Test: NFL, Diagnostic Test: GFAP, Genetic: Whole exome sequencing - WES, Diagnostic Test: Proteomic AnalysisPatients enrolled during acute phase (cohort 1), T0= within 15 days from hospital admission. |
| Remission TTP | Other | Diagnostic Test: Factor VIII (FVIII), Diagnostic Test: Von Willebrand factor (VWF) antigen, Diagnostic Test: VWF:RCo, Diagnostic Test: VWF-propeptide, Diagnostic Test: VWF multimers, Diagnostic Test: sP-selectin, Diagnostic Test: sCD40L, Diagnostic Test: F1+2, Diagnostic Test: VEGF-A, Diagnostic Test: VCAM, Diagnostic Test: ICAM, Diagnostic Test: IL-1β, Diagnostic Test: IL-6, Diagnostic Test: PTX3, Diagnostic Test: Neutrophil elastase and myeloperoxidase (NETs) markers, Diagnostic Test: soluble C5b-9, Diagnostic Test: C5a, Diagnostic Test: NFL, Diagnostic Test: GFAP, Diagnostic Test: evaluation of thrombus formation with Total Thrombus formation Analysis System (T-TAS), Diagnostic Test: Microfluidic Flow Chamber, Genetic: Whole exome sequencing - WES, Diagnostic Test: Proteomic AnalysisPatients enrolled during clinical remission (cohort 2), T0= check-up visit performed at more than 3 months from clinical response of the previous episode |
Who may qualify
- Ages
- 18 years and older
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult, Older adult
Key inclusion criteria (4 listed)
- aged ≥18 years
- diagnosis of TTP (either congenital or acquired immune-mediated TTP)
- referred at our hospital (Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, S.C. Medicina - Emostasi e Trombosi)
- providing a signed informed consent
Key exclusion criteria (2 listed)
- Patients who do not possess the above inclusion criteria
- Patients who have known contraindications to the instrumental exam included in the study.
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 |
|---|---|---|
| Factor VIII (FVIII)The study is defined as interventional because it includes assessments that are not part of routine clinical practice | Diagnostic test | Acute TTP, Remission TTP |
| Von Willebrand factor (VWF) antigenThe study is defined as interventional because it includes assessments that are not part of routine clinical practice | Diagnostic test | Acute TTP, Remission TTP |
| VWF:RCoThe study is defined as interventional because it includes assessments that are not part of routine clinical practice | Diagnostic test | Acute TTP, Remission TTP |
| VWF-propeptideThe study is defined as interventional because it includes assessments that are not part of routine clinical practice | Diagnostic test | Acute TTP, Remission TTP |
| VWF multimersThe study is defined as interventional because it includes assessments that are not part of routine clinical practice | Diagnostic test | Acute TTP, Remission TTP |
| sP-selectinThe study is defined as interventional because it includes assessments that are not part of routine clinical practice | Diagnostic test | Acute TTP, Remission TTP |
| sCD40LThe study is defined as interventional because it includes assessments that are not part of routine clinical practice | Diagnostic test | Acute TTP, Remission TTP |
| F1+2The study is defined as interventional because it includes assessments that are not part of routine clinical practice | Diagnostic test | Acute TTP, Remission TTP |
| VEGF-AThe study is defined as interventional because it includes assessments that are not part of routine clinical practice | Diagnostic test | Acute TTP, Remission TTP |
| VCAMThe study is defined as interventional because it includes assessments that are not part of routine clinical practice | Diagnostic test | Acute TTP, Remission TTP |
| ICAMThe study is defined as interventional because it includes assessments that are not part of routine clinical practice | Diagnostic test | Acute TTP, Remission TTP |
| IL-1βThe study is defined as interventional because it includes assessments that are not part of routine clinical practice | Diagnostic test | Acute TTP, Remission TTP |
| IL-6The study is defined as interventional because it includes assessments that are not part of routine clinical practice | Diagnostic test | Acute TTP, Remission TTP |
| PTX3The study is defined as interventional because it includes assessments that are not part of routine clinical practice | Diagnostic test | Acute TTP, Remission TTP |
| BlySThe study is defined as interventional because it includes assessments that are not part of routine clinical practice | Diagnostic test | Acute TTP |
| Neutrophil elastase and myeloperoxidase (NETs) markersThe study is defined as interventional because it includes assessments that are not part of routine clinical practice | Diagnostic test | Acute TTP, Remission TTP |
| soluble C5b-9The study is defined as interventional because it includes assessments that are not part of routine clinical practice | Diagnostic test | Acute TTP, Remission TTP |
| C5aThe study is defined as interventional because it includes assessments that are not part of routine clinical practice | Diagnostic test | Acute TTP, Remission TTP |
| NFLThe study is defined as interventional because it includes assessments that are not part of routine clinical practice | Diagnostic test | Acute TTP, Remission TTP |
| GFAPThe study is defined as interventional because it includes assessments that are not part of routine clinical practice | Diagnostic test | Acute TTP, Remission TTP |
| evaluation of thrombus formation with Total Thrombus formation Analysis System (T-TAS)The study is defined as interventional because it includes assessments that are not part of routine clinical practice | Diagnostic test | Remission TTP |
| Microfluidic Flow ChamberThe study is defined as interventional because it includes assessments that are not part of routine clinical practice | Diagnostic test | Remission TTP |
| Whole exome sequencing - WESThe study is defined as interventional because it includes assessments that are not part of routine clinical practice | Genetic | Acute TTP, Remission TTP |
| Proteomic AnalysisThe study is defined as interventional because it includes assessments that are not part of routine clinical practice | Diagnostic test | Acute TTP, Remission TTP |
Primary outcome
Prevalence
Time frame: From enrollment to the last visit (after 36 months from Time 0)
Prevalence of microcirculation damage in iTTP patients compared to general population
6 secondary outcomes
Cerebral microcirculation lesions
Time frame: From enrollment to the last visit (after 36 months from Time 0)
Retinal microcirculation changes
Time frame: From enrollment to the last visit (after 36 months from Time 0)
Peripheral microcirculation
Time frame: From enrollment to the last visit (after 36 months from Time 0)
Association between cerebral MRI lesions and cognitive or psychological symptoms
Time frame: From enrollment to the last visit (36 months from Time 0)
Modification of preclinical biomarkers
Time frame: From enrollment to the last visit (36 months from Time 0)
Associations between preclinical biomarkers and microcirculatory damage
Time frame: From enrollment to the last visit (36 months from Time 0)
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 9 Jun 2026.
- Individual participant dataSharing planned: Undecided
Related trials for TTP - Thrombotic Thrombocytopenic Purpura
RecruitingObservational study
A Study in Children and, Adults With Congenital Thrombotic Thrombocytopenic Purpura (cTTP) Treated With Adzynma
Thrombotic Thrombocytopenic Purpura (TTP)
RecruitingObservational study
A Study to Learn More About the Treatment of People With Congenital Thrombotic Thrombocytopenic Purpura (cTTP) Who Received Recombinant ADAMTS13 (rADAMTS13) as Part of the Early Access Program
Thrombotic Thrombocytopenic Purpura (TTP)
RecruitingObservational study
A Survey of Recombinant ADAMTS13 in Participants With Congenital Thrombotic Thrombocytopenic Purpura
Thrombotic Thrombocytopenic Purpura (TTP)
Not yet recruitingPhase 1/2
TGD001 Treatment in Thrombotic Microangiopathies
Thrombotic Microangiopathies, ITP Immune-Mediated Thrombocytopenia
RecruitingPhase 2
A Pilot Study of Efgartigimod for Immune-mediated Thrombotic Thrombocytopenic Purpura (iTTP)
Immune-mediated Thrombotic Thrombocytopenic Purpura
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.
The record lists no contact. Use the official record to reach the sponsor.
1 site in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A study testing Factor VIII (FVIII), Von Willebrand factor (VWF) antigen and VWF:RCo in people with TTP - Thrombotic Thrombocytopenic Purpura, run by Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico at 1 site in Italy.
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 4 inclusion and 2 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: under way, not looking for participants, as of the sponsor's last update on 9 Jun 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 Italy. 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?
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?
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?
Prevalence (time frame: From enrollment to the last visit (after 36 months from Time 0)). 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 9 Jun 2026.