Age Related Macular DegenerationPhase 3NCT05003245
Compare the Efficacy and Safety of HLX04-O with Ranibizumab in Subjects with WAMD
A Phase 3 study testing HLX04-O,recombinant anti-vascular endothelial growth factor (VEGF) humanized monoclonal antibody ophthalmic injection and Lucentis in people with Age Related Macular Degeneration, run by Shanghai Henlius Biotech at 41 sites in China.
Trial summary
this study will compare the efficacy and safety of HLX04-O administered by IVT with ranibizumab in patients with active CNV secondary to AMD. Read more about this study
- Who is it for?
- Ages 50 years and older
- Conditions the study is for
- Age Related Macular Degeneration
- What is being tested?
- HLX04-O,recombinant anti-vascular endothelial growth factor (VEGF) humanized monoclonal antibody ophthalmic injection and Lucentis
- Type of treatment
- Injection or infusion
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 407 participants
- Where
- 41 sitesChina
- Study dates
- 1 Nov 2021to 7 May 2024
- 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 50 years and older
- All sexes
- No healthy volunteers
- Adult, Older adult
Who may be able to join
- Capable to understand and sign the informed consent form (ICF) which includes compliance with the ICF and this protocol. In the Investigator's judgment, willing and able to complete all visits and assessments adhering to the prohibitions and restrictions specified in this protocol.
- Women or men aged ≥50 years when signing the ICF.
- Newly diagnosed, untreated, active subfoveal or juxtafoveal CNV lesions secondary to AMD in the study eye. (Active CNV was defined as leakage on FA and subretinal or intraretinal fluid on OCT with confirmation of the reading center during screening).
- The total lesion area (including hemorrhage, scar and neovascularization) of the study eye ≤12 disc area (DA) with confirmation of the reading center before randomization a.
- The BCVA letters between 24 and 73, inclusive, in the study eye, using Early Treatment Diabetic Retinopathy Study (ETDRS) charts.
- Clear ocular media and adequate pupillary dilatation to allow acquisition of good quality retinal images to confirm the diagnosis.
- Participants' fellow (non-study) eye must have had a BCVA of 24 letters or better.
Who cannot join
- Macular-related retinal pigment epithelial tears in the study eye; scar, fibrosis or atrophy involving the fovea, or CNV due to other causes in the study eye (e.g., ocular histoplasmosis, trauma, or pathological myopia etc.) with confirmation of the reading center.
- The fellow (nonstudy) eye needs anti-VEGF IVT injection (e.g. CNV due to wAMD, trauma, pathological myopia, retina vein occlusion, diabetic macular edema, etc) in the next 3 months after randomization, in the investigator's judgment.
- Active or recent (within 1 month prior to dose 1) intraocular, extraocular or periocular infection (including conjunctivitis, keratitis, scleritis or endophthalmitis), or history of idiopathic or autoimmune-associated uveitis in either eye.
- Vitreous hemorrhage in the study eye within 3 months prior to dose 1.
- Aphakia (except intraocular lens) or posterior capsular rupture of the lens (except yttrium aluminium-garnet (YAG) laser posterior capsulotomy after intraocular lens implantation ≥1 month prior to first dose) in the study eye.
- Corneal dystrophy or history of corneal transplantation, scleral softening or history of scleral softening, history of rhegmatogenous retinal detachment or macular hole (Stage II, III or IV) in the study eye.
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- Uncontrolled glaucoma (defined as intraocular pressure [IOP] ≥25 mmHg despite treatment with antiglaucoma medication), and/or glaucoma filtering surgery (e.g., trabeculectomy, scleral nipping, non-penetrating trabeculectomy, etc.), or advanced glaucoma resulting in a cup/disc ratio >0.8 in the study eye
- Equivalent spherical diopter of the study eye ≥-8D. For participants who had undergone refractive correction or cataract surgery, the equivalent spherical diopter of the study eye before surgery ≥-8D.
- Estimated by the Investigator, any concurrent intraocular condition except wAMD (e.g., diabetic retinopathy, dry AMD, retina vein occlusion, uveitis, angioid streaks, retinal detachment, epiretinal membrane, amblyopia, central serous chorioretinopathy, etc.) in the study eye that limited the potential to gain visual acuity upon treatment with the investigational product, or could have required medical or surgical intervention during the study to prevent or treat visual loss.
- Underwent intraocular surgery including verteporfin photodynamic therapy (PDT), transpupillary thermotherapy, macular translocation, vitrectomy, laser photocoagulation in macular area, other surgery in macular area or surgery to treat AMD.
- Previous extraocular or periocular surgery within 1 month or intraocular surgery (including cataract surgery, etc.) within 3 months prior to dose 1, or current unhealed wound, moderate or severe ulcer or history of fracture in the study eye.
- Subconjunctival or intraocular or systemic use of corticosteroids within 3 months (including subconjunctival or intraocular long-acting implant within 6 months) prior to dose 1 in the study eye.
- Previous systemic anti-VEGF therapy or IVT injection of any anti-VEGF drug into either eye or other ocular use of anti-VEGF drug within 3 months prior to dose 1.
- Participated in any drug (other than vitamins and minerals) or device clinical trials within 3 months or the duration of 5 half-lives of the study drug (which is longer) prior to dose 1 and have used the test drug or received device treatment.
- Pregnancy or lactation.
- Infertile women fail to meet either of the following ones: 1) menopause (≥12 continuous months of amenorrhea with no identified cause other than menopause before screening); 2) surgically sterilized.
- Men or fertile women fail to meet both of the following ones: 1) women of childbearing potential must have a negative urine or serum pregnancy test result within 14 days prior to initiation of the study intervention, and should not breastfeed; If the urine pregnancy test is positive, it must be confirmed by a serum pregnancy test; 2) agreement to remain abstinent (refrain from heterosexual intercourse) or use effective contraceptive methods from signed ICF to at least 6 months following the last dose of the study intervention. Effective contraceptive methods include bilateral tubal ligation, male sterilization, established, proper use of hormonal contraceptives that inhibit ovulation, hormone-releasing intrauterine devices (IUDs), and copper IUDs.
- In the Investigator's judgment, there is evidence of a disease or condition that contraindicates the use an investigational drug or that might affect interpretation of the results of the study or render the participant at high risk for treatment complications (e.g. stroke or myocardial infarction within 6 months prior todose1, uncontrolled hypertension (systolic blood pressure≥160 mmHg, or diastolic blood pressure ≥100 mmHg), etc.).
- Uncontrolled diabetes (defined as HbA1c>10.0%).
- Alanine aminotransferase (ALT) and/or aspartate aminotransferase (AST) is more than twice the upper limit of normal (ULN), and/or serum creatinine is 1.2 times more than the ULN, and is clinically significant in the opinion of the Investigator.
- Abnormal coagulation function(prothrombin time ≥ 3 seconds over ULN, activated partial thromboplastin time ≥ 10 seconds over ULN)
- Active disseminated intravascular coagulation and obvious bleeding tendency within 3 months prior to dose 1.
- Evidence of significant uncontrolled concomitant diseases such as cardiovascular diseases, nervous system diseases, respiratory system diseases, urinary system diseases, digestive system diseases and endocrine diseases.
- Current treatment for active systemic infection, or history of recurrent serious infections.
- Known active or suspected autoimmune diseases, requiring systemic immunosuppressive therapy.
- Positive for syphilis screening test or positive for human immunodeficiency virus (HIV) screening test.
- Known allergy to any component of the study intervention or history of allergy to fluorescein or indocyanine green, any anesthetics or antimicrobial agents used during the course of the study.
- In the Investigator's judgment, other conditions considered not amenable to this study.
- Participant who has been diagnosed to be COVID-19 or who has received COVID-19 vaccine within 1 month prior to dose 1.
- Other protocol defined inclusion and exclusion criteria may apply.
Trial locations and contacts
41 sites in 1 country.
41 sites in 1 country
China41 sites
Beijing Tongren Hospital, Capital Medical University
Beijing, Beijing Municipality
Chinese PLA General Hospital
Beijing, Beijing Municipality
Xuanwu Hospital, Capital Medical University
Beijing, Beijing Municipality
The first affiliated hospital of bengbu medical college
Bengbu, Anhui
Cangzhou Central Hospital
Cangzhou, Hebei
The First Affiliated Hospital of Third Military Medical University (Southwest Hospital)
Chongqing, Chongqing Municipality
The Second Affiliated Hospital of Chongqing Medical University
Chongqing, Chongqing Municipality
The First Affiliated Hospital of Jinan University (Guangzhou Overseas Chinese Hospital )
Guangzhou, Guangdong
Zhujiang Hospital of Southern Medical University
Guangzhou, Guangdong
Affiliated Hospital of Guizhou Medical University
Guiyang, Guizhou
Zhejiang provincial people's hospital
Hangzhou, Zhejiang
The First Affiliated Hospital of Harbin Medical University
Harbin, Heilongjiang
The Second Affiliated Hospital of Anhui Medical University
Hefei, Anhui
Jieyang People's Hospital
Jieyang, Guangdong
The First Hospital of Jilin University
Jilin City, Jilin
Shangdong Provincial Hospital
Jinan, Shandong
The Second Hospital of Lanzhou University
Lanzhou, Gansu
Lishui Municioal Central Hospital
Lishui, Zhejiang
Luoyang Third People's Hospital
Luoyang, Henan
Affiliated Eye Hospital of Nanchang University
Nanchang, Jiangxi
the First Affiliated Hospital of Nanchang University
Nanchang, Jiangxi
The First Affiliated Hospital of Guangxi Medical University
Nanjing, Guangxi
The People's Hospital of Guangxi Zhuang Autonomous Region
Nanning, Guangxi
Pingxiang People's Hospital
Pingxiang, Jiangxi
The Affiliated Hospital of Qingdao University
Qingdao, Shandong
Shanghai General Hospital
Shanghai, Shanghai Municipality, 200233
Shanghai Tenth People's Hospital
Shanghai, Shanghai Municipality
Shenyang AIER Eye Hospital
Shenyang, Liaoning
Shanxi Eye Hospital
Taiyuan, Shanxi
Tianjin Eye Hospital
Tianjin, Tianjin Municipality
Weifang Eye Hospital
Weifang, Shandong
People's Hospital of Wuhan University (Hubei Provincial People's Hospital)
Wuhan, Hubei
Tongji hospital, Tongji medical college, Huazhong University of Science and Technology
Wuhan, Hubei
Wuhan AIER Eye Hospital
Wuhan, Hubei
Wuhan Puren Hospital
Wuhan, Hubei
The First Affiliated Hospital of Xinxiang Medical College
Xinxiang, Henan
The Third Affiliated Hospital of Xinxiang Medical College
Xinxiang, Henan
Yichang Central People's Hospital
Yichang, Hubei
Ningxia Hui Autonomous Region Peoples Hospital
Yinchuan, Ningxia
Henan Eye Hospital
Zhengzhou, Henan
The First People's Hospital of Zunyi
Zunyi, Guizhou
About this study
Official title: A Phase 3 Randomized Double-masked Active Controlled Study to Compare the Efficacy and Safety of HLX04-O Administered by Intravitreal Injection with Ranibizumab in Subjects with Wet Age Related Macular Degeneration (wAMD)
this study will compare the efficacy and safety of HLX04-O administered by IVT with ranibizumab in patients with active CNV secondary to AMD.
Read the detailed description
This is a Phase 3, multicenter, randomized double masked active controlled study to compare the efficacy and safety of HLX04-O administered by IVT with ranibizumab in patients with active CNV secondary to AMD. The study will be conducted in approximately 60 sites in China.
Either HLX04-O (1.25 mg) IVT or ranibizumab (0.5 mg) IVT will be administered at a 4-week interval for 1 year (12 cycles).
- Conditions
- Age Related Macular Degeneration
- Being tested
- HLX04-O,recombinant anti-vascular endothelial growth factor (VEGF) humanized monoclonal antibody ophthalmic injection, Lucentis
- Medical subject headings
- Macular Degeneration
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
HLX04-O,recombinant anti-vascular endothelial growth factor (VEGF) humanized monoclonal antibody ophthalmic injectionDrug
0.05mL solution at a 4-week interval for intravitreal injection
LucentisDrug
0.05mL solution at a 4-week interval for intravitreal injection
| Study group | Role | What they receive |
|---|---|---|
| HLX04-O | Experimental | Biologic recombinant anti-VEGF humanized monoclonal antibody Receives: Drug: HLX04-O,recombinant anti-vascular endothelial growth factor (VEGF) humanized monoclonal antibody ophthalmic injection |
| Ranibizumab | Active comparator | Biologic anti-VEGF recombinant humanized monoclonal antibody fragment Receives: Drug: Lucentis |
What is being measured
The primary outcome is the main question the study is designed to answer.
Mean change of letters from baseline in best-corrected visual acuity (BCVA) at Week 48.
Detailed Outcome Measure will be defined in the Statistical Analysis Plan
Measured: from baseline to week 48
Secondary outcomes (8)
Mean change of letters from baseline in the BCVA over time
Detailed Outcome Measure will be defined in the Statistical Analysis Plan
Measured: From baseline to week 48
Proportion of patients gaining at least 15/10/5 letters in the BCVA at Week 12, 24, 36 and 48
Detailed Outcome Measure will be defined in the Statistical Analysis Plan
Measured: From baseline to week 48
Mean change from baseline in the total area of CNV and the total area of fluorescein leakage on fluorescein angiography (FA) at Week 12, 24 and 48
Detailed Outcome Measure will be defined in the Statistical Analysis Plan
Measured: From baseline to week 48
Mean change from baseline in central retina thickness (CRT) on optical coherence tomography (OCT) at Week 12, 24, 36 and 48
Detailed Outcome Measure will be defined in the Statistical Analysis Plan
Measured: From baseline to week 48
Change from baseline in National Eye Institute Visual Functioning Questionnaire - 25 scale score at Week 12, 24, and 48
Detailed Outcome Measure will be defined in the Statistical Analysis Plan
Measured: From baseline to week 48
Percentage and severity of ocular AEs (IVT procedure related and Investigation Medication related), non-ocular AEs; laboratory abnormalities; vital sign, physical examination abnormalities, etc.
Detailed Outcome Measure will be defined in the Statistical Analysis Plan
Measured: From baseline to week 48
Incidence of ADAs and NAbs against HLX04-O following IVT administration
Detailed Outcome Measure will be defined in the Statistical Analysis Plan
Measured: From baseline to week 48
HLX04-O serum concentrations before Dose 1, Dose 2, Dose 6, Dose 9 and Dose 12 and the last visit as data permit.
Detailed Outcome Measure will be defined in the Statistical Analysis Plan
Measured: From baseline to week 48
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted12 Aug 2021
- Study start1 Nov 2021
- Primary completion7 May 2024
- Study completion7 May 2024
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Other trials for Age Related Macular DegenerationStudies of the same condition, open and under way.
- More trials run by Shanghai Henlius BiotechThe 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
- Double blind
- Who is masked
- Participant, Investigator
- Enrolment
- 407 participants (actual)
Sponsor and investigators
- Lead sponsor
- Shanghai Henlius Biotech
- Sponsor type
- Industry (pharma, biotech, devices)
- Responsible party
- Sponsor
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT05003245
- Sponsor's protocol ID
- HLX04-O-wAMD-CN
- Status last verified
- Mar 2025
- First submitted
- 8 Jul 2021
- Last updated
- 24 Mar 2025
- Results posted
- No
- Data monitoring committee
- Yes
- FDA-regulated drug
- No
- FDA-regulated device
- No
- Individual data sharing
- No
Study at a glance
From the registry record, last updated by the sponsor on 24 Mar 2025. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- A Phase 3 Randomized Double-masked Active Controlled Study to Compare the Efficacy and Safety of HLX04-O Administered by Intravitreal Injection with Ranibizumab in Subjects with Wet Age Related Macular Degeneration (wAMD)
- ClinicalTrials.gov ID
- NCT05003245
- Acronym / sponsor ID
- HLX04-O-wAMD-CN
- Conditions
- Age Related Macular Degeneration
- Phase
- Phase 3
- Study type
- Interventional
- Recruitment status
- Completed
- Enrolment
- 407 participants (actual)
- Lead sponsor
- Shanghai Henlius BiotechIndustry (pharma, biotech, devices)
- Study start
- 1 Nov 2021 (actual)
- Primary completion
- 7 May 2024 (actual)
- Study completion
- 7 May 2024 (actual)
- First posted
- 12 Aug 2021 (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.
this study will compare the efficacy and safety of HLX04-O administered by IVT with ranibizumab in patients with active CNV secondary to AMD.
Detailed description
This is a Phase 3, multicenter, randomized double masked active controlled study to compare the efficacy and safety of HLX04-O administered by IVT with ranibizumab in patients with active CNV secondary to AMD. The study will be conducted in approximately 60 sites in China.
Either HLX04-O (1.25 mg) IVT or ranibizumab (0.5 mg) IVT will be administered at a 4-week interval for 1 year (12 cycles).
Study design
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Double blind (participant, investigator)
- Number of arms
- 2
| Arm | Type | Receives |
|---|---|---|
| HLX04-O | Experimental | Drug: HLX04-O,recombinant anti-vascular endothelial growth factor (VEGF) humanized monoclonal antibody ophthalmic injectionBiologic recombinant anti-VEGF humanized monoclonal antibody |
| Ranibizumab | Active comparator | Drug: LucentisBiologic anti-VEGF recombinant humanized monoclonal antibody fragment |
Who may qualify
- Ages
- 50 years and older
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult, Older adult
Key inclusion criteria (7 listed)
- Capable to understand and sign the informed consent form (ICF) which includes compliance with the ICF and this protocol. In the Investigator's judgment, willing and able to complete all visits and assessments adhering to the prohibitions and restrictions specified in this protocol.
- Women or men aged ≥50 years when signing the ICF.
- Newly diagnosed, untreated, active subfoveal or juxtafoveal CNV lesions secondary to AMD in the study eye. (Active CNV was defined as leakage on FA and subretinal or intraretinal fluid on OCT with confirmation of the reading center during screening).
- The total lesion area (including hemorrhage, scar and neovascularization) of the study eye ≤12 disc area (DA) with confirmation of the reading center before randomization a.
- The BCVA letters between 24 and 73, inclusive, in the study eye, using Early Treatment Diabetic Retinopathy Study (ETDRS) charts.
Key exclusion criteria (30 listed)
- Macular-related retinal pigment epithelial tears in the study eye; scar, fibrosis or atrophy involving the fovea, or CNV due to other causes in the study eye (e.g., ocular histoplasmosis, trauma, or pathological myopia etc.) with confirmation of the reading center.
- The fellow (nonstudy) eye needs anti-VEGF IVT injection (e.g. CNV due to wAMD, trauma, pathological myopia, retina vein occlusion, diabetic macular edema, etc) in the next 3 months after randomization, in the investigator's judgment.
- Active or recent (within 1 month prior to dose 1) intraocular, extraocular or periocular infection (including conjunctivitis, keratitis, scleritis or endophthalmitis), or history of idiopathic or autoimmune-associated uveitis in either eye.
- Vitreous hemorrhage in the study eye within 3 months prior to dose 1.
- Aphakia (except intraocular lens) or posterior capsular rupture of the lens (except yttrium aluminium-garnet (YAG) laser posterior capsulotomy after intraocular lens implantation ≥1 month prior to first dose) in the study eye.
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 |
|---|---|---|
| HLX04-O,recombinant anti-vascular endothelial growth factor (VEGF) humanized monoclonal antibody ophthalmic injection0.05mL solution at a 4-week interval for intravitreal injection | Drug | HLX04-O |
| Lucentis0.05mL solution at a 4-week interval for intravitreal injection | Drug | Ranibizumab |
Primary outcome
Mean change of letters from baseline in best-corrected visual acuity (BCVA) at Week 48.
Time frame: from baseline to week 48
Detailed Outcome Measure will be defined in the Statistical Analysis Plan
8 secondary outcomes
Mean change of letters from baseline in the BCVA over time
Time frame: From baseline to week 48
Proportion of patients gaining at least 15/10/5 letters in the BCVA at Week 12, 24, 36 and 48
Time frame: From baseline to week 48
Mean change from baseline in the total area of CNV and the total area of fluorescein leakage on fluorescein angiography (FA) at Week 12, 24 and 48
Time frame: From baseline to week 48
Mean change from baseline in central retina thickness (CRT) on optical coherence tomography (OCT) at Week 12, 24, 36 and 48
Time frame: From baseline to week 48
Change from baseline in National Eye Institute Visual Functioning Questionnaire - 25 scale score at Week 12, 24, and 48
Time frame: From baseline to week 48
Percentage and severity of ocular AEs (IVT procedure related and Investigation Medication related), non-ocular AEs; laboratory abnormalities; vital sign, physical examination abnormalities, etc.
Time frame: From baseline to week 48
Incidence of ADAs and NAbs against HLX04-O following IVT administration
Time frame: From baseline to week 48
HLX04-O serum concentrations before Dose 1, Dose 2, Dose 6, Dose 9 and Dose 12 and the last visit as data permit.
Time frame: From baseline to week 48
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 24 Mar 2025.
- 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.
The record lists no contact. Use the official record to reach the sponsor.
41 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 HLX04-O,recombinant anti-vascular endothelial growth factor (VEGF) humanized monoclonal antibody ophthalmic injection and Lucentis in people with Age Related Macular Degeneration, run by Shanghai Henlius Biotech at 41 sites in China.
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 30 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 24 Mar 2025. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 41 sites in China. 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 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?
Mean change of letters from baseline in best-corrected visual acuity (BCVA) at Week 48. (time frame: from baseline to week 48). 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 24 Mar 2025.