HypogonadismPhase 3TestILNCT02672592
Effects of Interleukin-1 Beta on Low Testosterone Levels in Men With Obesity and Metabolic Syndrome
A Phase 3 study testing Anakinra and Sodium Chloride 0.9% in people with Hypogonadism and Metabolic Syndrome X, run by University Hospital, Basel, Switzerland at 2 sites in Switzerland.
Trial summary
Obesity and the metabolic syndrome in men are associated with a high prevalence of hypogonadism of up to 50%. Increased fat mass leads to augmented release of adipocytokines and pro-inflammatory cytokines such as IL-1-beta, IL-6 and tumor necrosis factor-alpha which in turn suppress the hypothalamic-pituitary-gonadal… Read more about this study
- Who is it for?
- Ages 18 to 75 years, men only
- Conditions the study is for
- Hypogonadism, Metabolic Syndrome X, Obesity
- What is being tested?
- Anakinra and Sodium Chloride 0.9%
- Could I receive a placebo?
- Yes, some participants may receive a placebo
- How many people
- 70 participants
- Where
- 2 sitesSwitzerland
- Study dates
- Jan 2016to Jun 2017
- Phase
- Phase 3
- Are there results?
- None posted in the registry
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages 18 to 75 years
- Men only
- No healthy volunteers
- Adult, Older adult
Who may be able to join
- Informed consent as documented by signature,
- Men at the age between 18 and 75 years,
- BMI >30 kg/m2 and at least 1 manifestation of the metabolic syndrome (i.e. prediabetes, diabetes, hypertension, dyslipidemia),
- Total testosterone level <12 nmol/l.
Who cannot join
- Previous or current medication with testosterone,
- Testosterone deficiency of other cause, i.e. primary hypogonadism caused e.g. by Klinefelters syndrome, cryptorchidism, condition following orchiectomy. Known secondary hypogonadism caused by pituitary adenoma. Patients on antiandrogen medication,
- Clinical signs of infection in the week before inclusion or history of a severe infection during the last 2 months,
- Severe immunosuppression (e.g. patients with previously known infection with human immunodeficiency virus and a cluster of differentiation 4 (CD4) count below 350 x 109/L, patients on immunosuppressive therapy after solid organ transplantation and neutropenic patients with neutrophil count < 500 x 109/L and patients under chemotherapy with neutrophils 500-1000 x 109/L with an expected decrease to values < 500 x 109/L),
- Hematologic disease (leukocyte count < 1.5 x 109/l, hemoglobin < 11 g/dl, platelets <100 x 103/µl),
- Other clinically significant concomitant disease states (e.g., renal failure [Creatinine-Clearance < 30 ml/min], hepatic dysfunction [transaminases >3x upper normal range], active carcinoma,
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- History of tuberculosis,
- Known or suspected non-compliance, drug or alcohol abuse,
- Contraindications to the class of drugs under study, e.g. known hypersensitivity or allergy to anakinra/Kineret®,
- Inability to follow the procedures of the study, e.g. due to language problems, psychological disorders, dementia, etc. of the participant,
- Previous enrolment into the current study.
Trial locations and contacts
2 sites in 1 country.
Switzerland2 sites
University Department of Medicine, Kantonsspital Aarau
Aarau, 5001
University Hospital Basel
Basel, 4031
About this study
Official title: Effects of IL-1 Beta on the Hypothalamic-pituitary-gonadal (HPG) Axis in Men With Obesity and Metabolic Syndrome - The TestIL Trial
Obesity and the metabolic syndrome in men are associated with a high prevalence of hypogonadism of up to 50%. Increased fat mass leads to augmented release of adipocytokines and pro-inflammatory cytokines such as IL-1-beta, IL-6 and tumor necrosis factor-alpha which in turn suppress the hypothalamic-pituitary-gonadal (HPG) axis, leading to hypogonadism. This pathophysiological interplay is termed hypogonadal-obesity-adipocytokine hypothesis. TestIL is a prospective, multicenter, randomized, double-blinded, placebo-controlled trial to test the hypothesis that inhibition of IL-1-activity diminishes the inhibitory effects on HPG axis and increases testosterone levels in men with metabolic syndrome.
Read the detailed description
Obesity and the metabolic syndrome are considered as chronic low-grade inflammatory states. Elevated pro-inflammatory mediators in obesity and metabolic syndrome have an inhibitory effect on the hypothalamic-pituitary-gonadal axis (HPG axis) leading to hypogonadism. Decreased testosterone production in obese men in turn promotes additional fat deposition, contributing to a vicious cycle of fat accumulation. This complex pathophysiological interplay is termed hypogonadal-obesity-adipocytokine hypothesis, describing a bidirectional relationship between low levels of testosterone and the metabolic syndrome.
TestIL is a prospective, multicenter, randomized, double-blinded, placebo-controlled trial to test the hypothesis that inhibition of IL-1-activity diminishes the inhibitory effects on HPG axis and increases testosterone levels in men with metabolic syndrome.
- Conditions
- Hypogonadism, Metabolic Syndrome X, Obesity
- Being tested
- Anakinra, Sodium Chloride 0.9%
- Keywords
- Metabolic syndrome X, Hypogonadism, Testosterone, Inflammation, Obesity
- Medical subject headings
- Hypogonadism, Metabolic Syndrome, Obesity, Inflammation
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
AnakinraDrug
Also called KINERET
Anakinra 100mg s.c. bid
Sodium Chloride 0.9%Drug
Also called NaCl 0.9%
Sodium Chloride 0.9% s.c. bid
| Study group | Role | What they receive |
|---|---|---|
| Anakinra | Active comparator | Anakinra//Kineret® 100mg s.c. bid Receives: Drug: Anakinra |
| Placebo | Placebo comparator | Sodium Chloride 0.9% s.c. bid Receives: Drug: Sodium Chloride 0.9% |
What is being measured
The primary outcome is the main question the study is designed to answer.
Total morning testosterone (nmol/l)
Measured: 4 weeks
Secondary outcomes (31)
Total morning testosterone (nmol/l)
Measured: 1 week and 3 months
Free testosterone (nmol/l)
Assessed by equilibrium dialysis
Measured: 1 week, 4 weeks and 3 months
Bioavailable testosterone (nmol/l)
Assessed by equilibrium dialysis
Measured: 1 week, 4 weeks and 3 months
Erectile dysfunction as assessed by International Index of Erectile Function (IIEF) score
Measured: 1 week, 4 weeks and 3 months
Clinical severity of hypogonadism as assessed by quantitative Androgen Deficiency in the Aging Male (qADAM) questionnaire
Measured: 1 week, 4 weeks and 3 months
Proportion of muscle mass as assessed by bioelectrical impedance Analysis
Measured: 1 week, 4 weeks and 3 months
Proportion of fat mass as assessed by bioelectrical impedance Analysis
Measured: 1 week, 4 weeks and 3 months
HbA1c (%)
Measured: 1 week, 4 weeks and 3 months
LH and FSH (IU/l)
Measured: 1 week, 4 weeks and 3 months
Inhibin B, ACTH (pg/ml)
Measured: 1 week, 4 weeks and 3 months
Prolactin, TSH, Insulin (mIU/l)
Measured: 1 week, 4 weeks and 3 months
Interleukin-1, Interleukin-6 (pg/ml)
Measured: 1 week, 4 weeks and 3 months
Cortisol basal (nmol/l)
Measured: 1 week, 4 weeks and 3 months
C-reactive protein (mg/l)
Measured: 1 week, 4 weeks and 3 months
free T4 (pmol/l)
Measured: 1 week, 4 weeks and 3 months
T3 (nmol/l)
Measured: 1 week, 4 weeks and 3 months
IGF-1 (nmol/l)
Measured: 1 week, 4 weeks and 3 months
GH (mU/l)
Measured: 1 week, 4 weeks and 3 months
Androstendione (μg/l)
Measured: 1 week, 4 weeks and 3 months
DHEAS (μmol/l)
Measured: 1 week, 4 weeks and 3 months
Oestradiol (pmol/l)
Measured: 1 week, 4 weeks and 3 months
Oestron (ng/l)
Measured: 1 week, 4 weeks and 3 months
17-OH-progesterone (nmol/l)
Measured: 1 week, 4 weeks and 3 months
Copeptin (pmol/l)
Measured: 1 week, 4 weeks and 3 months
Sex hormone-binding globulin (SHBG)
Measured: 1 week, 4 weeks and 3 months
Muscle strength as assessed by grip strength test
Measured: 1 week, 4 weeks and 3 months
Waist-hip-ratio
Measured: 1 week, 4 weeks and 3 months
BMI in kg/m2
Measured: 1 week, 4 weeks and 3 months
Insulin sensitivity as assessed by homeostasis model assessment insulin resistance (HOMA-IR)
Measured: 1 week, 4 weeks and 3 months
Total cholesterol, LDL-cholesterol, HDL-cholesterol, triglycerides (mmol/l)
Measured: 1 week, 4 weeks and 3 months
Leptin (μg/l)
Measured: 1 week, 4 weeks and 3 months
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted3 Feb 2016 (estimated)
- Study startJan 2016
- Primary completionJun 2017
- Study completionJun 2017
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Publications (4)Papers the sponsor has linked to this study.
- Other trials for HypogonadismStudies of the same condition, open and under way.
- More trials run by University Hospital, Basel, SwitzerlandThe sponsor's other registered studies.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Interventional
- Phase
- Phase 3
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Quadruple blind
- Who is masked
- Participant, Care provider, Investigator, Outcomes assessor
- Enrolment
- 70 participants (actual)
Sponsor and investigators
- Lead sponsor
- University Hospital, Basel, Switzerland
- Sponsor type
- University, hospital or other
- Responsible party
- Sponsor
- Investigators
- Mirjam Christ-Crain, Professor, Principal investigator, Endocrinology, Diabetes and Metabolism; University Hospital BaselBeat Müller, Professor, Principal investigator, University Department of Medicine; Kantonsspital Aarau
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT02672592
- Sponsor's protocol ID
- EKNZ 2015-376
- Acronym
- TestIL
- Status last verified
- Jul 2017
- First submitted
- 22 Jan 2016
- Last updated
- 13 Jul 2017
- Results posted
- No
- Data monitoring committee
- No
- Individual data sharing
- No
Publications
Ebrahimi F, Urwyler SA, Betz MJ, Christ ER, Schuetz P, Mueller B, Donath MY, Christ-Crain M. Effects of interleukin-1 antagonism and corticosteroids on fibroblast growth factor-21 in patients with metabolic syndrome. Sci Rep. 2021 Apr 12;11(1):7911. doi: 10.1038/s41598-021-87207-w.
PubMed 33846498Urwyler SA, Ebrahimi F, Burkard T, Schuetz P, Poglitsch M, Mueller B, Donath MY, Christ-Crain M. IL (Interleukin)-1 Receptor Antagonist Increases Ang (Angiotensin [1-7]) and Decreases Blood Pressure in Obese Individuals. Hypertension. 2020 Jun;75(6):1455-1463. doi: 10.1161/HYPERTENSIONAHA.119.13982. Epub 2020 Apr 10.
PubMed 32275191Ebrahimi F, Urwyler SA, Schuetz P, Mueller B, Bernasconi L, Neyer P, Donath MY, Christ-Crain M. Effects of interleukin-1 antagonism on cortisol levels in individuals with obesity: a randomized clinical trial. Endocr Connect. 2019 Jun 1;8(6):701-708. doi: 10.1530/EC-19-0201.
PubMed 31042669Ebrahimi F, Urwyler SA, Straumann S, Doerpfeld S, Bernasconi L, Neyer P, Schuetz P, Mueller B, Donath MY, Christ-Crain M. IL-1 Antagonism in Men With Metabolic Syndrome and Low Testosterone: A Randomized Clinical Trial. J Clin Endocrinol Metab. 2018 Sep 1;103(9):3466-3476. doi: 10.1210/jc.2018-00739.
PubMed 29939279
Study at a glance
From the registry record, last updated by the sponsor on 13 Jul 2017. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Effects of IL-1 Beta on the Hypothalamic-pituitary-gonadal (HPG) Axis in Men With Obesity and Metabolic Syndrome - The TestIL Trial
- ClinicalTrials.gov ID
- NCT02672592
- Acronym / sponsor ID
- TestIL / EKNZ 2015-376
- Conditions
- Hypogonadism, Metabolic Syndrome X, Obesity
- Keywords
- Metabolic syndrome X, Hypogonadism, Testosterone, Inflammation, Obesity
- Phase
- Phase 3
- Study type
- Interventional
- Recruitment status
- Completed
- Enrolment
- 70 participants (actual)
- Lead sponsor
- University Hospital, Basel, SwitzerlandUniversity, hospital or other
- Study start
- Jan 2016
- Primary completion
- Jun 2017 (actual)
- Study completion
- Jun 2017 (actual)
- First posted
- 3 Feb 2016 (estimated)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
Obesity and the metabolic syndrome in men are associated with a high prevalence of hypogonadism of up to 50%. Increased fat mass leads to augmented release of adipocytokines and pro-inflammatory cytokines such as IL-1-beta, IL-6 and tumor necrosis factor-alpha which in turn suppress the hypothalamic-pituitary-gonadal (HPG) axis, leading to hypogonadism. This pathophysiological interplay is termed hypogonadal-obesity-adipocytokine hypothesis. TestIL is a prospective, multicenter, randomized, double-blinded, placebo-controlled trial to test the hypothesis that inhibition of IL-1-activity diminishes the inhibitory effects on HPG axis and increases testosterone levels in men with metabolic syndrome.
Detailed description
Obesity and the metabolic syndrome are considered as chronic low-grade inflammatory states. Elevated pro-inflammatory mediators in obesity and metabolic syndrome have an inhibitory effect on the hypothalamic-pituitary-gonadal axis (HPG axis) leading to hypogonadism. Decreased testosterone production in obese men in turn promotes additional fat deposition, contributing to a vicious cycle of fat accumulation. This complex pathophysiological interplay is termed hypogonadal-obesity-adipocytokine hypothesis, describing a bidirectional relationship between low levels of testosterone and the metabolic syndrome.
TestIL is a prospective, multicenter, randomized, double-blinded, placebo-controlled trial to test the hypothesis that inhibition of IL-1-activity diminishes the inhibitory effects on HPG axis and increases testosterone levels in men with metabolic syndrome.
Study design
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Quadruple blind (participant, care provider, investigator, outcomes assessor)
- Number of arms
- 2
| Arm | Type | Receives |
|---|---|---|
| Anakinra | Active comparator | Drug: AnakinraAnakinra//Kineret® 100mg s.c. bid |
| Placebo | Placebo comparator | Drug: Sodium Chloride 0.9%Sodium Chloride 0.9% s.c. bid |
Who may qualify
- Ages
- 18 to 75 years
- Sex
- Male only
- Healthy volunteers
- Not accepted
- Age groups
- Adult, Older adult
Key inclusion criteria (4 listed)
- Informed consent as documented by signature,
- Men at the age between 18 and 75 years,
- BMI >30 kg/m2 and at least 1 manifestation of the metabolic syndrome (i.e. prediabetes, diabetes, hypertension, dyslipidemia),
- Total testosterone level <12 nmol/l.
Key exclusion criteria (11 listed)
- Previous or current medication with testosterone,
- Testosterone deficiency of other cause, i.e. primary hypogonadism caused e.g. by Klinefelters syndrome, cryptorchidism, condition following orchiectomy. Known secondary hypogonadism caused by pituitary adenoma. Patients on antiandrogen medication,
- Clinical signs of infection in the week before inclusion or history of a severe infection during the last 2 months,
- Severe immunosuppression (e.g. patients with previously known infection with human immunodeficiency virus and a cluster of differentiation 4 (CD4) count below 350 x 109/L, patients on immunosuppressive therapy after solid organ transplantation and neutropenic patients with neutrophil count < 500 x 109/L and patients under chemotherapy with neutrophils 500-1000 x 109/L with an expected decrease to values < 500 x 109/L),
- Hematologic disease (leukocyte count < 1.5 x 109/l, hemoglobin < 11 g/dl, platelets <100 x 103/µl),
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 |
|---|---|---|
| AnakinraAlso: KINERETAnakinra 100mg s.c. bid | Drug | Anakinra |
| Sodium Chloride 0.9%Also: NaCl 0.9%Sodium Chloride 0.9% s.c. bid | Drug | Placebo |
Primary outcome
Total morning testosterone (nmol/l)
Time frame: 4 weeks
31 secondary outcomes
Total morning testosterone (nmol/l)
Time frame: 1 week and 3 months
Free testosterone (nmol/l)
Time frame: 1 week, 4 weeks and 3 months
Bioavailable testosterone (nmol/l)
Time frame: 1 week, 4 weeks and 3 months
Erectile dysfunction as assessed by International Index of Erectile Function (IIEF) score
Time frame: 1 week, 4 weeks and 3 months
Clinical severity of hypogonadism as assessed by quantitative Androgen Deficiency in the Aging Male (qADAM) questionnaire
Time frame: 1 week, 4 weeks and 3 months
Proportion of muscle mass as assessed by bioelectrical impedance Analysis
Time frame: 1 week, 4 weeks and 3 months
Proportion of fat mass as assessed by bioelectrical impedance Analysis
Time frame: 1 week, 4 weeks and 3 months
HbA1c (%)
Time frame: 1 week, 4 weeks and 3 months
LH and FSH (IU/l)
Time frame: 1 week, 4 weeks and 3 months
Inhibin B, ACTH (pg/ml)
Time frame: 1 week, 4 weeks and 3 months
Prolactin, TSH, Insulin (mIU/l)
Time frame: 1 week, 4 weeks and 3 months
Interleukin-1, Interleukin-6 (pg/ml)
Time frame: 1 week, 4 weeks and 3 months
Cortisol basal (nmol/l)
Time frame: 1 week, 4 weeks and 3 months
C-reactive protein (mg/l)
Time frame: 1 week, 4 weeks and 3 months
free T4 (pmol/l)
Time frame: 1 week, 4 weeks and 3 months
T3 (nmol/l)
Time frame: 1 week, 4 weeks and 3 months
IGF-1 (nmol/l)
Time frame: 1 week, 4 weeks and 3 months
GH (mU/l)
Time frame: 1 week, 4 weeks and 3 months
Androstendione (μg/l)
Time frame: 1 week, 4 weeks and 3 months
DHEAS (μmol/l)
Time frame: 1 week, 4 weeks and 3 months
Oestradiol (pmol/l)
Time frame: 1 week, 4 weeks and 3 months
Oestron (ng/l)
Time frame: 1 week, 4 weeks and 3 months
17-OH-progesterone (nmol/l)
Time frame: 1 week, 4 weeks and 3 months
Copeptin (pmol/l)
Time frame: 1 week, 4 weeks and 3 months
Sex hormone-binding globulin (SHBG)
Time frame: 1 week, 4 weeks and 3 months
Muscle strength as assessed by grip strength test
Time frame: 1 week, 4 weeks and 3 months
Waist-hip-ratio
Time frame: 1 week, 4 weeks and 3 months
BMI in kg/m2
Time frame: 1 week, 4 weeks and 3 months
Insulin sensitivity as assessed by homeostasis model assessment insulin resistance (HOMA-IR)
Time frame: 1 week, 4 weeks and 3 months
Total cholesterol, LDL-cholesterol, HDL-cholesterol, triglycerides (mmol/l)
Time frame: 1 week, 4 weeks and 3 months
Leptin (μg/l)
Time frame: 1 week, 4 weeks and 3 months
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 13 Jul 2017.
- Derived from this study: PubMed 33846498Ebrahimi F, Urwyler SA, Betz MJ, Christ ER, Schuetz P, Mueller B, Donath MY, Christ-Crain M. Effects of interleukin-1 antagonism and corticosteroids on fibroblast growth factor-21 in patients with metabolic syndrome. Sci Rep. 2021 Apr 12;11(1):7911. doi: 10.1038/s41598-021-87207-w.
- Derived from this study: PubMed 32275191Urwyler SA, Ebrahimi F, Burkard T, Schuetz P, Poglitsch M, Mueller B, Donath MY, Christ-Crain M. IL (Interleukin)-1 Receptor Antagonist Increases Ang (Angiotensin [1-7]) and Decreases Blood Pressure in Obese Individuals. Hypertension. 2020 Jun;75(6):1455-1463. doi: 10.1161/HYPERTENSIONAHA.119.13982. Epub 2020 Apr 10.
- Derived from this study: PubMed 31042669Ebrahimi F, Urwyler SA, Schuetz P, Mueller B, Bernasconi L, Neyer P, Donath MY, Christ-Crain M. Effects of interleukin-1 antagonism on cortisol levels in individuals with obesity: a randomized clinical trial. Endocr Connect. 2019 Jun 1;8(6):701-708. doi: 10.1530/EC-19-0201.
- Derived from this study: PubMed 29939279Ebrahimi F, Urwyler SA, Straumann S, Doerpfeld S, Bernasconi L, Neyer P, Schuetz P, Mueller B, Donath MY, Christ-Crain M. IL-1 Antagonism in Men With Metabolic Syndrome and Low Testosterone: A Randomized Clinical Trial. J Clin Endocrinol Metab. 2018 Sep 1;103(9):3466-3476. doi: 10.1210/jc.2018-00739.
- Individual participant dataSharing planned: No
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part. This study is not recruiting at the moment.
Mirjam Christ-Crain, Professor principal investigator
Endocrinology, Diabetes and Metabolism; University Hospital Basel
Beat Müller, Professor principal investigator
University Department of Medicine; Kantonsspital Aarau
2 sites in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A Phase 3 study testing Anakinra and Sodium Chloride 0.9% in people with Hypogonadism and Metabolic Syndrome X, run by University Hospital, Basel, Switzerland at 2 sites in Switzerland.
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 11 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 13 Jul 2017. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 2 sites in Switzerland. Whether a site is taking part right now should be confirmed with that site. See every site.
What are the possible benefits and risks?
They depend on the study and the treatment, and no study can promise a benefit. Some participants in this study may receive a placebo. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
What does this phase mean?
Phase 3 studies compare the treatment with the current standard treatment or a placebo in a large group, to confirm how well it works and watch for side effects.
Not every study follows the same path, and some studies (observational studies, device studies) have no phase.
Are results available for this study?
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
How can a doctor refer a patient or contact the research team?
The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
Total morning testosterone (nmol/l) (time frame: 4 weeks). It is what the study was designed to measure, not a finding.
Where can I read the original study information?
On the ClinicalTrials.gov record for NCT02672592, which also lists 4 linked publications.
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 13 Jul 2017.