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Palmoplantar Pustulosis (PPP)Phase 2NCT04015518

A Study to Test How Effective and Safe Different Doses of BI 655130 Are in Patients With a Moderate to Severe Form of the Skin Disease Palmoplantar Pustulosis

A Phase 2 study testing Spesolimab in people with Palmoplantar Pustulosis (PPP), run by Boehringer Ingelheim at 88 sites in 15 countries.

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
Search all trials

Trial summary

The primary objective is to provide dose-ranging data for 4 dose regimens of BI 655130 compared to placebo on the primary endpoint of percentage change from baseline in PPP ASI at Week 16. Read more about this study

Who is it for?
Ages 18 to 75 years
Conditions the study is for
Palmoplantar Pustulosis (PPP)
What is being tested?
Spesolimab
Type of treatment
Injection or infusion
Could I receive a placebo?
Yes, some participants may receive a placebo
How many people
152 participants
Where
88 sitesin 15 countries
Study dates
31 Jul 2019to 28 Jul 2021
Phase
Phase 2
Are there results?
Yes, posted in the registrySummary in the doctors' view

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
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • 18 to 75 years of legal age (according to local legislation) at screening.
  • Diagnosis of Palmoplantar Pustulosis defined as presence of primary, persistent (>3 months duration), sterile, macroscopically visible pustules on the palms and/or soles, without or with plaque psoriasis elsewhere on the body.
  • PPP PGA of at least moderate severity (≥3) at screening and baseline.
  • A minimum PPP ASI score of 12 at screening and baseline.
  • Male or female patients. Women of childbearing potential (WOCBP) must be ready and able to use highly effective methods of birth control per ICH M3 (R2).
  • Signed and dated written informed consent in accordance with ICH GCP and local legislation prior to admission to the trial.
  • Further criteria apply.

Who cannot join

  • Women who are pregnant, nursing, or who plan to become pregnant while in the trial.
  • Severe, progressive, or uncontrolled condition such as renal, hepatic, haematological, endocrine, pulmonary, cardiac, neurologic, cerebral, or psychiatric disease, or signs and symptoms thereof.
  • Presence or known history of anti-TNF-induced PPP-like disease.
  • Patient with a transplanted organ (with exception of a corneal transplant >12 weeks Prior to screening) or who have ever received stem cell therapy (e.g., Prochymal).
  • Known history of lymphoproliferative disease, including lymphoma, or signs and symptoms suggestive of possible lymphoproliferative disease, such as lymphadenopathy and/or splenomegaly.
  • Further criteria apply.

Trial locations and contacts

88 sites in 15 countries.

88 sites in 15 countries

Japan30 sites
  • Nagoya City University Hospital

    Aichi, Nagoya, 467-8602

  • Fujita Health University Hospital

    Aichi, Toyoake, 470-1192

  • Tokyo Dental College Ichikawa General Hospital

    Chiba, Ichikawa, 272-8513

  • Ehime University Hospital

    Ehime, Toon, 791-0295

  • Fukuoka University Hospital

    Fukuoka, Fukuoka, 814-0180

  • Gifu University Hospital

    Gifu, Gifu, 501-1194

  • Asahikawa Kosei General Hospital

    Hokkaido, Asahikawa, 078-8211

  • Asahikawa Medical University Hospital

    Hokkaido, Asahikawa, 078-8510

  • Takagi Dermatological Clinic

    Hokkaido, Obihiro, 080-0013

  • Hosui General Medical Clinic

    Hokkaido, Sapporo, 064-0807

  • Takamatsu Red Cross Hospital

    Kagawa, Takamatsu, 760-0017

  • Sagamihara National Hospital

    Kanagawa, Sagamihara, 252-0392

  • Kumamoto University Hospital

    Kumamoto, Kumamoto, 860-8556

  • University Hospital Kyoto Prefectural University of Medicine

    Kyoto, Kyoto, 602-8566

  • Tohoku University Hospital

    Miyagi, Sendai, 980-8574

  • Shinshu University Hospital

    Nagano, Matsumoto, 390-8621

  • Okayama University Hospital

    Okayama, Okayama, 700-8558

  • University of the Ryukyus Hospital

    Okinawa, Nakagami-gun, 903-0215

  • Nakatsu Dermatology Clinic

    Osaka, Osaka, 531-0072

  • Osaka City University Hospital

    Osaka, Osaka, 545-8586

  • Kindai University Hospital

    Osaka, Osaka-sayama, 589-8511

  • Osaka University Hospital

    Osaka, Suita, 565-0871

  • Shiga University of Medical Science Hospital

    Shiga, Otsu, 520-2192

  • Jichi Medical University Hospital

    Tochigi, Shimotsuke, 329-0498

  • Teikyo University Hospital

    Tokyo, Itabashi-ku, 173-8606

  • Nihon University Itabashi Hospital

    Tokyo, Itabashi-ku, 173-8610

  • Seibo Hospital

    Tokyo, Shinjuku, 161-8521

  • Tokyo Medical University Hospital

    Tokyo, Shinjuku-ku, 160-0023

  • Shirasaki Dermatology and Neurology Clinic

    Toyama, Takaoka, 933-0871

  • Wakayama Medical University Hospital

    Wakayama, Wakayama, 641-8509

Other trials in Japan

United States14 sites
  • Wallace Medical Group

    Beverly Hills, California, 90211

  • Total Skin and Beauty Dermatology Center, PC

    Birmingham, Alabama, 35205

  • University of Missouri Health System

    Columbia, Missouri, 65212

  • Menter Dermatology Research Institute

    Dallas, Texas, 75246

  • The Psoriasis Treatment Center of Central New Jersey

    East Windsor, New Jersey, 08520

  • University of Utah Health

    Murray, Utah, 84107

  • Virginia Clinical Research, Inc.

    Norfolk, Virginia, 23502

  • Skin Specialists, P.C.

    Omaha, Nebraska, 68144

  • Epiphany Dermatology of Kansas, LLC

    Overland Park, Kansas, 66215

  • Paddington Testing Co., Inc.

    Philadelphia, Pennsylvania, 19103

  • University of Pittsburgh Medical Center

    Pittsburgh, Pennsylvania, 15213

  • Therapeutics Clinical Research

    San Diego, California, 92123

  • Advanced Medical Research PC

    Sandy Springs, Georgia, 30328

  • Washington University School of Medicine

    St Louis, Missouri, 63108

Other trials in United States

Canada7 sites
  • SimcoDerm Medical and Surgical Dermatology Centre

    Barrie, Ontario, L4M 7G1

  • Dr. Irina Turchin PC Inc.

    Fredericton, New Brunswick, E3B 1G9

  • The Guenther Dermatology Research Centre

    London, Ontario, N6A 3H7

  • Innovaderm Research Inc.

    Montreal, Quebec, H2X 2V1

  • CARe Clinic

    Red Deer, Alberta, T4P 1K4

  • York Dermatology Clinic and Research Centre

    Richmond Hill, Ontario, L4C 9M7

  • K. Papp Clinical Research Inc.

    Waterloo, Ontario, N2J 1C4

Other trials in Canada

Australia5 sites
  • Skin Health Institute Inc

    Carlton, Victoria, 3053

  • Royal Melbourne Hospital

    Parkville, Victoria, 3050

  • Paratus Clinical Research Woden

    Phillip, Australian Capital Territory, 2606

  • Westmead Hospital

    Westmead, New South Wales, 2145

  • Veracity Clinical Research

    Wooloongabba, Queensland, 4102

Other trials in Australia

Germany5 sites
  • Charité - Universitätsmedizin Berlin

    Berlin, 10117

  • Universitätsklinikum Erlangen

    Erlangen, 91054

  • Universitätsklinikum Frankfurt

    Frankfurt am Main, 60596

  • Universitätsklinikum Heidelberg

    Heidelberg, 69120

  • Universitätsklinikum Schleswig-Holstein, Campus Kiel

    Kiel, 24105

Other trials in Germany

Poland5 sites
  • Barbara Rewerska Diamond Clinic, Krakow

    Krakow, 31-559

  • Dermoklinika medical center, Lodz

    Lodz, 90-436

  • Independent Public Clin.Hosp.no1 Lublin

    Lublin, 20-081

  • Municipal Hospital Complex in Olsztyn

    Olsztyn, 10-229

  • Dermmedica Sp. z o.o., Wroclaw

    Wroclaw, 51-318

Other trials in Poland

Hungary4 sites
  • CRU Hungary Ltd, Private Practice, Miskolc

    Miskolc, 3529

  • University of Pecs

    Pécs, 7632

  • Markusovszky University Teaching Hospital

    Szombathely, 9700

  • Veszprem County Csolnoky Ferenc Hospital

    Veszprém, 8200

Other trials in Hungary

Czechia3 sites
  • CCBR Czech a.s.

    Pardubice, 530 02

  • Sanatorium Prof. Arenebergera

    Prague, 11000

  • CCBR Czech Prague s.r.o.

    Prague, 130 00

Other trials in Czechia

France3 sites
  • HOP l'Archet

    Nice, 06202

  • HOP Saint-Louis

    Paris, 75010

  • HOP Larrey

    Toulouse, 31059

Other trials in France

Russia3 sites
  • SBHI Chelyabinsk Reg.Clin.Derma.Dispen.

    Chelyabinsk, 454048

  • LLC "Medical Center Azbuka Zdorovia"

    Kazan', 420111

  • Dermatovenereological Dispensary #10, St. Petersburg

    Saint Petersburg, 194021

Other trials in Russia

South Korea3 sites
  • Gachon University Gil Medical Center

    Incheon, 21565

  • Seoul National University Bundang Hospital

    Seongnam, 13620

  • Seoul National University Hospital

    Seoul, 03080

Other trials in South Korea

Belgium2 sites
  • Brussels - UNIV Saint-Luc

    Brussels, 1200

  • UZ Leuven

    Leuven, 3000

Other trials in Belgium

United Kingdom2 sites
  • Royal Devon and Exeter Hospital

    Exeter, EX2 5DW

  • Guy's Hospital

    London, SE1 9RT

Other trials in United Kingdom

Netherlands1 site
  • Amphia Ziekenhuis

    Breda, 4818 CK

Other trials in Netherlands

Taiwan1 site
  • National Taiwan University Hospital

    Taipei, 10002

Other trials in Taiwan

About this study

Official title: Multi-center, Double-blind, Randomised, Placebo-controlled, Phase IIb Dose-finding Study to Evaluate Safety and Efficacy of Different Subcutaneous Doses of BI 655130 in Patients With Moderate to Severe Palmoplantar Pustulosis (PPP)

The primary objective is to provide dose-ranging data for 4 dose regimens of BI 655130 compared to placebo on the primary endpoint of percentage change from baseline in PPP ASI at Week 16. The target dose(s) will be estimated from the model by incorporating information on the minimum clinically relevant effect and accounting for safety.

Supportive dose-ranging assessments will also be done on pre-specified secondary endpoints.

Being tested
Spesolimab, Placebo
Medical subject headings
Psoriasis

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • SpesolimabDrug

    Subcutaneous injections of Spesolimab starting at week 16, for a total treatment time until week 52.

  • PlaceboDrug

    Subcutaneous injections of placebo matching Spesolimab from week 0 to 16.

  • SpesolimabDrug

    Subcutaneous injections of Spesolimab in a low dose scheme for a total treatment time of 52 weeks.

  • SpesolimabDrug

    Subcutaneous injections of Spesolimab in a medium-low dose scheme for a total treatment time of 52 weeks.

  • SpesolimabDrug

    Subcutaneous injections of Spesolimab in a medium-high dose scheme for a total treatment time of 52 weeks.

  • SpesolimabDrug

    Subcutaneous injections of Spesolimab in a high dose scheme for a total treatment time of 52 weeks.

Study groups in NCT04015518
Study groupRoleWhat they receive
Placebo & SpesolimabOtherSubcutaneous injections of placebo matching Spesolimab, with subcutaneous injections of Spesolimab starting at week 16, for a total treatment time of 52 weeks.
Receives: Drug: Spesolimab; Drug: Placebo
Spesolimab 'Speso Low'ExperimentalSubcutaneous injections of Spesolimab in a low dose scheme for a total treatment time of 52 weeks.
Receives: Drug: Spesolimab
Spesolimab 'Speso Medium-low'ExperimentalSubcutaneous injections of Spesolimab in a medium-low dose scheme for a total treatment time of 52 weeks.
Receives: Drug: Spesolimab
Spesolimab 'Speso Medium-high'ExperimentalSubcutaneous injections of Spesolimab in a medium-high dose scheme for a total treatment time of 52 weeks.
Receives: Drug: Spesolimab
Spesolimab 'Speso High'ExperimentalSubcutaneous injections of Spesolimab in a high dose scheme for a total treatment time of 52 weeks.
Receives: Drug: Spesolimab

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. The Percentage Change in Palmoplantar Pustulosis Area and Severity Index (PPP ASI) at Week 16 From Baseline

    The percentage change in PPP ASI at Week 16 from baseline. The PPP ASI is a tool that provides a numeric scoring for patients overall PPP disease state, ranging from 0 (best) to 72 (worst). It is a linear combination of the percent of surface area of skin that is affected on the palms and soles of the body and the severity of erythema, pustules, and scaling (desquamation): The percent change from baseline is calculated as (PPP ASI current - PPP ASI baseline) / PPP ASI baseline * 100%.

    Least square (LS) means, differences and confidence intervals were estimated by (Restricted maximum likelihood)-based Mixed effect model for repeated measurements (MMRM) including the fixed, categorical effects of treatment at each visit, region and the continuous effect of baseline at each visit as well as random effects of subject. Values post rescue medication or 6 weeks following last study treatment before discontinuation were censored. Unstructured covariance matrix was used.

    Measured: week 0 (baseline) and week 16

Secondary outcomes (8)
  1. Change From Baseline in Palmoplantar Pustulosis Pain Visual Analogue Scale (VAS) Score at Week 4

    Change from baseline in Palmoplantar Pustulosis Pain Visual Analogue Scale (VAS) score at Week 4. The PPP Pain VAS is a unidimensional measure of pain intensity due to palmoplantar pustulosis on palms and/or soles. It is a continuous scale comprised of a horizontal or vertical line, 10 centimeters (cm) in length, anchored by word descriptors at each end (score ranges from "no pain" at 0 cm to "very severe pain" at 10 cm). The patient was asked to place a vertical ( | ) mark on the horizontal line to indicate the severity of the pain.

    Least square (LS) means, differences and confidence intervals were estimated by (Restricted maximum likelihood)-based MMRM including the fixed, categorical effects of treatment at each visit, region and the continuous effect of baseline at each visit as well as random effects of subject. Values post rescue medication or 6 weeks following last study treatment before discontinuation were censored. Unstructured covariance matrix was used.

    Measured: week 0 (baseline) and week 4.

  2. Change From Baseline in Palmoplantar Pustulosis Pain Visual Analogue Scale (VAS) Score at Week 16

    Change from baseline in Palmoplantar Pustulosis Pain Visual Analogue Scale (VAS) score at Week 16. The PPP Pain VAS is a unidimensional measure of pain intensity due to palmoplantar pustulosis on palms and/or soles. It is a continuous scale comprised of a horizontal or vertical line, 10 centimeters (cm) in length, anchored by word descriptors at each end (score ranges from "no pain" at 0 cm to "very severe pain" at 10 cm). The patient was asked to place a vertical ( | ) mark on the horizontal line to indicate the severity of the pain.

    Least square (LS) means, differences and confidence intervals were estimated by (Restricted maximum likelihood)-based MMRM including the fixed, categorical effects of treatment at each visit, region and the continuous effect of baseline at each visit as well as random effects of subject. Values post rescue medication or 6 weeks following last study treatment before discontinuation were censored. Unstructured covariance matrix was used.

    Measured: week 0 (baseline) and week 16.

  3. Palmoplantar Pustulosis Severity Index (PPP SI) Change From Baseline at Week 16

    PPP SI change from baseline at Week 16. The PPP SI is based on the severity score of individual components (erythema, pustules, and scaling/desquamation) of PPP ASI assessments. The most severely affected area based on pustules was identified by the investigator at baseline and assessed at all subsequent visits. The PPP SI was calculated by summing up the individual components of PPP ASI assessment (range 0 (best) to 12 (worst)) at each visit for the identified location.

    Least square (LS) means, differences and confidence intervals were estimated by (Restricted maximum likelihood)-based Mixed effect model for repeated measurements (MMRM) including the fixed, categorical effects of treatment at each visit, region and the continuous effect of baseline at each visit as well as random effects of subject. Values post rescue medication or 6 weeks following last study treatment before discontinuation were censored. Unstructured covariance matrix was used.

    Measured: week 0 (baseline) and week 16.

  4. Number of Patients Achieving a 50% Decrease From Baseline in Palmoplantar Pustulosis Area and Severity Index Score at Week 16 (PPP ASI50)

    Number of patients achieving a 50% decrease from baseline in Palmoplantar Pustulosis Area and Severity Index score at week 16 (PPP ASI50). The PPP ASI is an investigator assessment of the extent and severity of palmoplantar pustulosis lesions on the palms and soles in PPP patients. This tool provides a numeric scoring for patients overall PPP disease state, ranging from 0 (best) to 72 (worst). It is a linear combination of the percent of surface area of skin that is affected on the palms and soles of the body and the severity of erythema, pustules, and scaling (desquamation). When (PPP ASI baseline - PPP ASI current)/ PPP ASI baseline * 100% >= 50%, PPP ASI50 = 1.

    Measured: week 0 (baseline) and week 16

  5. Number of Patients Achieving a 75% Decrease From Baseline in Palmoplantar Pustulosis Area and Severity Index Score at Week 16 (PPP ASI75)

    Number of patients achieving a 75% decrease from baseline in Palmoplantar Pustulosis Area and Severity Index score at week 16 (PPP ASI75). The PPP ASI is an investigator assessment of the extent and severity of palmoplantar pustulosis lesions on the palms and soles in PPP patients. This tool provides a numeric scoring for patients overall PPP disease state, ranging from 0 (best) to 72 (worst). It is a linear combination of the percent of surface area of skin that is affected on the palms and soles of the body and the severity of erythema, pustules, and scaling (desquamation). When (PPP ASI baseline - PPP ASI current)/ PPP ASI baseline * 100% >= 75%, PPP ASI75 = 1.

    Measured: week 0 (baseline) and week 16

  6. Number of Patients With Palmoplantar Pustulosis Physician Global Assessment (PPP PGA) Clear/Almost Clear (0 or 1) at Week 16

    Number of patients with Palmoplantar Pustulosis Physician Global Assessment (PPP PGA) clear/almost clear (0 or 1) at Week 16. The PPP PGA relies on investigator assessment of the patient's skin presentation on the palms and soles. The investigator scored the individual components (erythema, pustules, and scaling/crusting) from 0 (best) to 4 (worst) as clear, almost clear, mild, moderate or severe. PPP PGA categorization is based on the mean of the four individual components.

    Measured: week 0 (baseline) and week 16

  7. Number of Patients With Palmoplantar Pustulosis Physician Global Assessment (PPP PGA) Pustules Clear/Almost Clear (0 or 1) at Week 16

    Number of patients with Palmoplantar Pustulosis Physician Global Assessment (PPP PGA) pustules clear/almost clear (0 or 1) at Week 16. The PPP PGA relies on investigator assessment of the patient's skin presentation on the palms and soles. The investigator scored the pustules from 0 (best) to 4 (worst) as clear, almost clear, mild, moderate or severe.

    Measured: week 0 (baseline) and week 16

  8. The Percentage Change in Palmoplantar Pustulosis Area and Severity Index (PPP ASI) at Week 52 From Baseline

    The percentage change in PPP ASI at Week 52 from baseline. The PPP ASI is an investigator assessment of the extent and severity of palmoplantar pustulosis lesions on the palms and soles in PPP patients. This tool provides a numeric scoring for patients overall PPP disease state, ranging from 0 (best) to 72 (worst). It is a linear combination of the percent of surface area of skin that is affected on the palms and soles of the body and the severity of erythema, pustules, and scaling (desquamation).

    LS means, differences and confidence intervals were estimated by (Restricted maximum likelihood)-based MMRM including the fixed, categorical effects of treatment at each visit, region and the continuous effect of baseline at each visit as well as random effects of subject. Values post rescue medication or 6 weeks following last study treatment before discontinuation were censored. Unstructured covariance matrix was used.

    Measured: week 0 (baseline) and week 52

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted11 Jul 2019
  2. Study start31 Jul 2019
  3. Primary completion6 Aug 2020
  4. Study completion28 Jul 2021

Resources

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 2
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Masking
Quadruple blind
Who is masked
Participant, Care provider, Investigator, Outcomes assessor
Enrolment
152 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT04015518
Sponsor's protocol ID
1368-0016
Other IDs
2018-003078-28, 2018
Status last verified
Oct 2025
First submitted
9 Jul 2019
Last updated
16 Oct 2025
Data monitoring committee
Yes
FDA-regulated drug
Yes
FDA-regulated device
No
Individual data sharing
No: Clinical studies sponsored by Boehringer Ingelheim, phases I to IV, interventional and non-interventional, are in scope for sharing of the raw clinical study data and clinical study documents. Exceptions might apply, e.g. studies in products where Boehringer Ingelheim is not the license holder; studies regarding pharmaceutical formulations and associated analytical methods, and studies pertinent to pharmacokinetics using human biomaterials; studies conducted in a single center or targeting rare diseases (in case of low number of patients and therefore limitations with anonymization). For more details refer to: https://www.mystudywindow.com/msw/datatransparency

Publications

  • Burden AD, Bissonnette R, Navarini AA, Murakami M, Morita A, Haeufel T, Ye B, Baehner F, Terui T. Spesolimab Efficacy and Safety in Patients with Moderate-to-Severe Palmoplantar Pustulosis: A Multicentre, Double-Blind, Randomised, Placebo-Controlled, Phase IIb, Dose-Finding Study. Dermatol Ther (Heidelb). 2023 Oct;13(10):2279-2297. doi: 10.1007/s13555-023-01002-1. Epub 2023 Sep 20.

    PubMed 37731086

Questions about this trial

What is this clinical trial studying?

A Phase 2 study testing Spesolimab in people with Palmoplantar Pustulosis (PPP), run by Boehringer Ingelheim at 88 sites in 15 countries.

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 6 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 16 Oct 2025. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 88 sites in Japan, United States, Canada, Australia, Germany and 10 more countries. 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.

What does this phase mean?

Phase 2 studies give the treatment to a larger group to see whether it has the intended effect and to keep checking safety.

Not every study follows the same path, and some studies (observational studies, device studies) have no phase.

Are results available for this study?

Yes. Results are posted in the registry (first posted 28 Jul 2022). A summary is in the For doctors view, and the full results are on ClinicalTrials.gov.

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?

The Percentage Change in Palmoplantar Pustulosis Area and Severity Index (PPP ASI) at Week 16 From Baseline (time frame: week 0 (baseline) and week 16). 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 NCT04015518, which also lists 1 linked publication.

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 16 Oct 2025.

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