Phase 3 Trial to Evaluate the Efficacy and Safety of Aficamten Compared to Placebo in Adults With Symptomatic oHCM
SEQUOIA-HCM
A Phase 3, Multi-Center, Randomized, Double-blind, Placebo-controlled Trial to Evaluate the Efficacy and Safety of CK-3773274 in Adults With Symptomatic Hypertrophic Cardiomyopathy and Left Ventricular Outflow Tract Obstruction
2 other identifiers
interventional
282
14 countries
114
Brief Summary
The purpose of this study is to evaluate the efficacy and safety of aficamten (CK-3773274) versus placebo in adults with symptomatic hypertrophic cardiomyopathy (HCM) and left ventricular outflow tract obstruction.
Trial Health
Trial Health Score
Automated assessment based on enrollment pace, timeline, and geographic reach
participants targeted
Target at P50-P75 for phase_3
Started Feb 2022
114 active sites
Health score is calculated from publicly available data and should be used for screening purposes only.
Trial Relationships
Click on a node to explore related trials.
Study Timeline
Key milestones and dates
First Submitted
Initial submission to the registry
December 23, 2021
CompletedFirst Posted
Study publicly available on registry
January 11, 2022
CompletedStudy Start
First participant enrolled
February 1, 2022
CompletedPrimary Completion
Last participant's last visit for primary outcome
November 10, 2023
CompletedStudy Completion
Last participant's last visit for all outcomes
December 18, 2023
CompletedResults Posted
Study results publicly available
March 3, 2026
CompletedMarch 3, 2026
February 1, 2025
1.8 years
December 23, 2021
January 15, 2026
February 20, 2026
Conditions
Keywords
Outcome Measures
Primary Outcomes (1)
Change From Baseline in pVO2 at Week 24
The effect of CK-3773274 on exercise capacity in participants with symptomatic obstructive hypertrophic cardiomyopathy (oHCM) was determined through changes in peak oxygen uptake (pVO2) after 24 weeks of treatment. pVO2 was measured by cardiopulmonary exercise testing (CPET) on a treadmill or bicycle. A higher pVO2 indicates better cardiorespiratory fitness.
Baseline to Week 24
Secondary Outcomes (10)
Change From Baseline in KCCQ-CSS at Week 24
Baseline to Week 24
Change From Baseline in KCCQ-CSS at Week 12
Baseline to Week 12
Proportion of Participants With ≥1 Class Improvement in New York Heart Association (NYHA) Functional Class From Baseline to Week 24
Baseline to Week 24
Proportion of Participants With ≥1 Class Improvement in NYHA Functional Class From Baseline to Week 12
Baseline to Week 12
Change From Baseline in Valsalva Left Ventricular Outflow Tract Gradient (LVOT-G) at Week 24
Baseline to Week 24
- +5 more secondary outcomes
Study Arms (2)
Aficamten up to 20 mg
EXPERIMENTALParticipants received 5 mg, 10 mg, 15 mg, or 20 mg of aficamten; dose levels were guided by echocardiography assessments. Treatment was administered for up to 24 weeks.
Placebo to match aficamten
PLACEBO COMPARATORParticipants received placebo for up to 24 weeks.
Interventions
Aficamten tablets were administered orally once daily.
Placebo tablets were administered orally once daily.
Eligibility Criteria
You may qualify if:
- Males and females between 18 and 85 years of age, inclusive, at screening.
- Body mass index \<35 kg/m2.
- Diagnosed with HCM per the following criteria:
- Has LV hypertrophy and non-dilated LV chamber in the absence of other cardiac disease and
- Has an end-diastolic LV wall thickness as measured by the echocardiography core laboratory of:
- ≥15 mm in one or more myocardial segments OR
- ≥13 mm in one or more wall segments and a known-disease-causing gene mutation or positive family history of HCM
- Has resting LVOT-G ≥30 mmHg and post-Valsalva LVOT G ≥50 mmHg during screening as determined by the echocardiography core laboratory.
- LVEF ≥60% at screening as determined by the echocardiography core laboratory.
- New York Heart Association (NYHA) Functional Class II or III at screening.
- Hemoglobin ≥10g/dL at screening.
- Respiratory exchange ratio (RER) ≥1.05 and pVO2 ≤90% predicted on the screening CPET per the core laboratory.
- Patients on beta-blockers, verapamil, diltiazem, or disopyramide should have been on stable doses for \>6 weeks prior to randomization and anticipate remaining on the same medication regimen during the trial. Patients treated with disopyramide must also be concomitantly treated with a beta blocker and/or calcium channel blocker.
You may not qualify if:
- Known or suspected infiltrative, genetic or storage disorder causing cardiac hypertrophy that mimics oHCM (eg, Noonan syndrome, Fabry disease, amyloidosis).
- Significant valvular heart disease (per investigator judgment).
- Moderate-severe valvular aortic stenosis.
- Moderate-severe mitral regurgitation not due to systolic anterior motion of the mitral valve.
- History of LV systolic dysfunction (LVEF \<45%) or stress cardiomyopathy at any time during their clinical course.
- Inability to exercise on a treadmill or bicycle (eg, orthopedic limitations).
- Has been treated with septal reduction therapy (surgical myectomy or percutaneous alcohol septal ablation) or has plans for either treatment during the trial period.
- Documented paroxysmal atrial fibrillation during the screening period.
- Paroxysmal or permanent atrial fibrillation is only excluded IF:
- rhythm restoring treatment (eg, direct-current cardioversion, atrial fibrillation ablation procedure, or antiarrhythmic therapy) has been required ≤6 months prior to screening.
- rate control and anticoagulation have not been achieved for at least 6 months prior to screening.
- History of syncope or sustained ventricular tachyarrhythmia with exercise within 6 months prior to screening.
- Has received prior treatment with CK-3773274 or mavacamten.
Contact the study team to confirm eligibility.
Sponsors & Collaborators
- Cytokineticslead
- Corxel Pharmaceuticalscollaborator
Study Sites (114)
Alaska Heart and Vascular Institute
Anchorage, Alaska, 99508, United States
UC San Diego Health - Sulpizio Cardiovascular Center
La Jolla, California, 92037, United States
Cedars-Sinai Medical Center - Smidt Heart Institute Clinic
Los Angeles, California, 90048, United States
University of California San Francisco
San Francisco, California, 94143, United States
Stanford University Hospital
Stanford, California, 94305, United States
Yale School of Medicine
New Haven, Connecticut, 06511, United States
Yale University School of Medicine
New Haven, Connecticut, 06519, United States
MedStar Washington Hospital Center
Washington D.C., District of Columbia, 20010, United States
Holy Cross Hospital / Cardiology Associates
Fort Lauderdale, Florida, 33308, United States
Mayo Clinic Florida
Jacksonville, Florida, 32224, United States
Emory Clinic
Atlanta, Georgia, 30322, United States
Piedmont Fayette Hospital
Fayetteville, Georgia, 30214, United States
Northwestern University
Chicago, Illinois, 60614, United States
University of Iowa
Iowa City, Iowa, 52242, United States
MedStar Medical Group Cardiology at Union Memorial
Baltimore, Maryland, 21218, United States
Medstar Franklin Square Medical Center
Baltimore, Maryland, 21237, United States
Massachusetts General Hospital
Boston, Massachusetts, 02114, United States
Brigham and Women's Hospital
Boston, Massachusetts, 02115, United States
Lahey Hospital & Medical Center
Burlington, Massachusetts, 01805, United States
Michigan Medicine
Ann Arbor, Michigan, 48109, United States
Henry Ford Medical Center
Detroit, Michigan, 48202, United States
Spectrum Health Medical Group Cardiovascular Medicine
Grand Rapids, Michigan, 49525, United States
M Health Fairview University of Minnesota Medical Center - East Bank
Minneapolis, Minnesota, 55455, United States
Mayo Clinic
Rochester, Minnesota, 55905, United States
Saint Luke's Hospital of Kansas City
Kansas City, Missouri, 64111, United States
Washington University School of Medicine
St Louis, Missouri, 63110, United States
Morristown Medical Center
Morristown, New Jersey, 07960, United States
NYU Langone Health
New York, New York, 10016, United States
Mount Sinai Hospital
New York, New York, 10029, United States
Columbia University Medical Center/NY Presbyterian Hospital
New York, New York, 10032, United States
Westchester Medical Center
Valhalla, New York, 10595, United States
Sanger Heart and Vascular Institute
Charlotte, North Carolina, 10595, United States
Sanger Heart and Vascular Institute - HCM Clinic
Charlotte, North Carolina, 28204, United States
Duke Health Center Arringdon
Morrisville, North Carolina, 27560, United States
Cleveland Clinic
Cleveland, Ohio, 44195, United States
The Ohio State University Wexner Medical Center
Columbus, Ohio, 43210, United States
Ascension St. John Clinical Research Institute
Tulsa, Oklahoma, 74104, United States
Oregon Health & Science University
Portland, Oregon, 97239, United States
Hospital of the University of Pennsylvania (University of Pennsylvania School of Medicine)
Philadelphia, Pennsylvania, 19104, United States
UPMC Presbyterian
Pittsburgh, Pennsylvania, 15213, United States
Stern Cardiovascular Foundation, Inc
Germantown, Tennessee, 38138, United States
Vanderbilt University Medical Center
Nashville, Tennessee, 37232, United States
The University of Texas Southwestern Medical Center
Dallas, Texas, 75390, United States
Houston Methodist Hospital
Houston, Texas, 77030, United States
University of Utah Hospital
Salt Lake City, Utah, 84132, United States
University of Virginia Health System University Hospital
Charlottesville, Virginia, 22908, United States
University of Washington Medical
Seattle, Washington, 98195, United States
Froedtert Hospital
Milwaukee, Wisconsin, 53226, United States
Beijing Chao-Yang Hospital, Capital Medical University
Beijing, Beijing Municipality, 100020, China
Beijing Anzhen Hospital
Beijing, Beijing Municipality, 100029, China
Peking University Third Hospital
Beijing, Beijing Municipality, 10019, China
Nanfang Hospital Southern Medical University
Guanzhou, Guangdong, 516006, China
The First Affiliated Hospital of Zhengzhou University
Zhengzhou, Henan, 450018, China
Union Hospital affiliated to Tongji Medical College of Huazhong University of Science and Technology
Wuhan, Hubei, 430022, China
Xiangya Hospital of the Central South University
Changsha, Hunan, 410008, China
The First Hospital of Jinlin University
Changchun, Jinlin, 130031, China
The First Affiliated Hospital of Xi'an Jiaotong University
Xi’an, Shanxi, 710061, China
Charles University
Prague, 128 08, Czechia
Interni klinika kardiologie a angiologie
Prague, 12808, Czechia
Aalborg University Hospital, Department of Cardiology
Aalborg, 9100, Denmark
Department of Cardiology Aarhus University Hospital
Aarhus, 8200, Denmark
Hjertecentret (The Heart Center)
Copenhagen, 2100, Denmark
Copenhagen University Hospital
Copenhagen, 2400, Denmark
Hopital Universitaire de Rangueil (CHU de Toulouse) Service de Cardiologie
Toulouse, Cedex, 31059, France
CHU de Marseille - Hopital de la Timone Service de cardiologie
Marseille, 13005, France
CHU de Nantes
Nantes, 44093, France
Hopital Lariboisiere, Service de Cardiologie
Paris, 75010, France
Hôpital Européen Georges Pompidou
Paris, 75015, France
CHU Pitie-Salpetriere, Centre de reference maladies cardiaques hereditaires ou rares
Paris, France
CHU de Bordeaux Hopital Cardiologique Haut-Leveque
Pessac, 33600, France
CHU du Haut Lveque Cardiologie
Pessac, 33604, France
Kerckhoff-Klinik GmbH Abteilung Administration Forschung und Lehre
Bad Nauheim, 61231, Germany
Charite-Universitaetsmedizin Berlin Campus Virchow-Klinikum (CVK) Medizinische Klinik mit Schwerpunkt Kardiologie
Berlin, 13353, Germany
Universitaetsklinikum Essen Westdeutsches Herz-Gefaesszentrum
Essen, 45147, Germany
Klinikumder Georg-August-Universitaet
Göttingen, 37075, Germany
Universitaetsmedizin Goettingen
Göttingen, 37075, Germany
Universitaetsklinikum Heidelberg
Heidelberg, Germany
Universitaetsklinikum Jena Klinik fuer Innere Medizin 1
Jena, 07747, Germany
Unniversitaetsklinikum Magdeburg Klinik fur Kardiologie und Anglologie
Magdeburg, 39120, Germany
Universitätsklinikum Würzburg
Würzburg, Germany
Semmelweis Egyetem Varosmajori Sziv es Ergyogyasazati Klinika
Budapest, Hungary
The Olga & Lev Leviev Heart Center The Chaim Sheba Medical Center
Ramat Gan, Tel Hasomer, 5265601, Israel
The Barzilai University Medical Center
Ashkelon, 78100, Israel
The Barzilai University Medical Center
Ashkelon, 7830604, Israel
Hadassah Medical Center- Ein Kerem
Jerusalem, 9112001, Israel
Kaplan Medical Center
Rehovot, 76100, Israel
Ziv Medical Center
Safed, 13100, Israel
UOC Cardiologica Azienda Ospedaliera Spedali Civili di Brescia
Brescia, 25123, Italy
Azienda Ospedaliero Universitaria Careggi Dipartimento Cardiotoracovascolare - Cardiomiopatie Unit
Florence, 50134, Italy
Fondazione toscana Gabriele Monesterio per la ricarca medica Dipartimento Cardiotoracico UOC Cardiologia e Medicina Cardiovasculare Ospedale San Cataldo
Pisa, 56124, Italy
Dipartimento di Medicina Clinica e Molecolare Universita Sapienza di Roma Unita di Terapia Intensiva Cardiologica Azienda Ospedaliero Universitaria Sant'Andrea
Roma, 1035-39, Italy
Amsterdam UMC, location AMC
Amsterdam, 1105, Netherlands
University Hospital Maastricht
Maastricht, 6229HX, Netherlands
Erasmus Medical Center
Rotterdam, 3015, Netherlands
Narodowy Instytut Kardiologii Stefana Kardynała Wyszynskiego- Panstwowy Instytut Badawczy
Warsaw, Masovian Voivodeship, 04-628, Poland
Kardio Brynow S.C
Katowice, Poland
Krakowskie Centrum
Krakow, Poland
Centro Hospitalar Do Baixo Vouga, EPE AV ARTUR RAVARA
Aveiro, 3814-501, Portugal
Hospital da Luz
Lisbon, 1500-650, Portugal
Complejo Hospitalario Universitario
A Coruña, La Coruna, 15006, Spain
Hospital Universitario Puerta de Hierro
Madrid, Majadahonda, Spain
Hospital Clinic de Barcelona
Barcelona, 08036, Spain
Hospital Clinico Universitario Virgen de la Arrixaca
Murcia, Spain
Hospital Universitario Son Llatzer Secretaria de Cardiologia
Palma, 07198, Spain
Hospital Universitario de Salamanca
Salamanca, 37007, Spain
Hospital Universitario Virgen Macarena-merge
Seville, 41009, Spain
Queen Elizabeth Hospital Birmingham University Hospitals Birmingham NHS Foundation Trust
Edgbaston, Birmingham, B15 2GW, United Kingdom
Queen Elizabeth University Hospital - HWS Greater Glasgow and Clyde
Glasgow, G1 4TF, United Kingdom
Liverpool Heart and Chest Hospital - Liverpool Heart and Chest Hospital NHS Foundation Trust- HWS Greater Glasgow and Clyde
Liverpool, L14 3LB, United Kingdom
Barts Health NS Trust
London, EC1A 7BE, United Kingdom
St George's University Hospitals NHS Foundation Trust
London, SW17 0QT, United Kingdom
Royal Brompton Hospital
London, SW3 6NP, United Kingdom
Oxford Centre for Clinical Magnetic Resonance Research
Oxford, OX3 9DU, United Kingdom
Radcliffe Department of Medicine
Oxford, OX3 9DU, United Kingdom
Related Publications (10)
Kaski JP, Kantor PF, Nakano SJ, Olivotto I, Russell MW, Godown J, Chiu M, German P, Heitner SB, Jacoby DL, Kupfer S, Lutz J, Maharao N, Malik FI, Melloni C, Nieto Morales PF, Simkins T, Wei J, Ho CY; CEDAR-HCM Investigators. Efficacy and Safety of Aficamten in Children and Adolescents With Obstructive Hypertrophic Cardiomyopathy: Study Design and Rationale of CEDAR-HCM. Circ Heart Fail. 2026 Feb;19(2):e013418. doi: 10.1161/CIRCHEARTFAILURE.125.013418. Epub 2025 Dec 5.
PMID: 41347307DERIVEDCampain J, Griskowitz C, Newlands C, Claggett BL, Kulac IJ, McGinnis S, Giverts I, Moreno F, Minasian A, Prasad C, Rupert L, Landsteiner I, Iskenderian N, Coats CJ, Lee MMY, Maron MS, Owens AT, Jacoby DL, Heitner SB, Kupfer S, Malik FI, Wohltman A, Malhotra R, Lewis GD. Characterization and Application of Novel Exercise Recovery Patterns That Reflect Cardiac Performance: A Substudy of the SEQUOIA-HCM Trial. Circulation. 2025 Oct 7;152(14):990-1002. doi: 10.1161/CIRCULATIONAHA.124.073585. Epub 2025 Sep 5.
PMID: 40910168DERIVEDMaron MS, Masri A, Nassif ME, Barriales-Villa R, Abraham TP, Arad M, Cardim N, Choudhury L, Claggett B, Coats CJ, Dungen HD, Garcia-Pavia P, Hagege AA, Januzzi JL, Kulac I, Lee MMY, Lewis GD, Ma CS, Michels M, Oreziak A, Owens AT, Spertus JA, Solomon SD, Tfelt-Hansen J, van Sinttruije M, Veselka J, Watkins HC, Jacoby DL, Heitner SB, Kupfer S, Malik FI, Meng L, Wohltman A, Olivotto I; SEQUOIA-HCM Investigators. Impact of Aficamten on Disease and Symptom Burden in Obstructive Hypertrophic Cardiomyopathy: Results From SEQUOIA-HCM. J Am Coll Cardiol. 2024 Nov 5;84(19):1821-1831. doi: 10.1016/j.jacc.2024.09.003. Epub 2024 Sep 30.
PMID: 39352339DERIVEDLee MMY, Masri A, Nassif ME, Barriales-Villa R, Abraham TP, Claggett BL, Coats CJ, Gimeno JR, Kulac IJ, Landsteiner I, Ma C, Maron MS, Olivotto I, Owens AT, Solomon SD, Veselka J, Jacoby DL, Heitner SB, Kupfer S, Malik FI, Meng L, Wohltman A, Lewis GD; SEQUOIA-HCM Investigators. Aficamten and Cardiopulmonary Exercise Test Performance: A Substudy of the SEQUOIA-HCM Randomized Clinical Trial. JAMA Cardiol. 2024 Nov 1;9(11):990-1000. doi: 10.1001/jamacardio.2024.2781.
PMID: 39230885DERIVEDSherrod CF 4th, Saberi S, Nassif ME, Claggett BL, Coats CJ, Garcia-Pavia P, Januzzi JL, Lewis GD, Ma C, Maron MS, Miao ZM, Olivotto I, Veselka J, Butzner M, Jacoby DL, Heitner SB, Kupfer S, Malik FI, Meng L, Wohltman A, Spertus JA. Effect of Aficamten on Health Status Outcomes in Obstructive Hypertrophic Cardiomyopathy: Results From SEQUOIA-HCM. J Am Coll Cardiol. 2024 Nov 5;84(19):1773-1785. doi: 10.1016/j.jacc.2024.08.014. Epub 2024 Sep 1.
PMID: 39217569DERIVEDMasri A, Cardoso RN, Abraham TP, Claggett BL, Coats CJ, Hegde SM, Kulac IJ, Lee MMY, Maron MS, Merkely B, Michels M, Olivotto I, Oreziak A, Jacoby DL, Heitner SB, Kupfer S, Malik FI, Meng L, Solomon SD, Wohltman A, Kwong RY, Kramer CM; SEQUOIA-HCM Investigators. Effect of Aficamten on Cardiac Structure and Function in Obstructive Hypertrophic Cardiomyopathy: SEQUOIA-HCM CMR Substudy. J Am Coll Cardiol. 2024 Nov 5;84(19):1806-1817. doi: 10.1016/j.jacc.2024.08.015. Epub 2024 Sep 1.
PMID: 39217563DERIVEDHegde SM, Claggett BL, Wang X, Jering K, Prasad N, Roshanali F, Masri A, Nassif ME, Barriales-Villa R, Abraham TP, Cardim N, Coats CJ, Kramer CM, Maron MS, Michels M, Olivotto I, Saberi S, Jacoby DL, Heitner SB, Kupfer S, Meng L, Wohltman A, Malik FI, Solomon SD; SEQUOIA-HCM Investigators. Impact of Aficamten on Echocardiographic Cardiac Structure and Function in Symptomatic Obstructive Hypertrophic Cardiomyopathy. J Am Coll Cardiol. 2024 Nov 5;84(19):1789-1802. doi: 10.1016/j.jacc.2024.08.002. Epub 2024 Sep 1.
PMID: 39217556DERIVEDCoats CJ, Masri A, Nassif ME, Barriales-Villa R, Arad M, Cardim N, Choudhury L, Claggett B, Dungen HD, Garcia-Pavia P, Hagege AA, Januzzi JL, Lee MMY, Lewis GD, Ma CS, Maron MS, Miao ZM, Michels M, Olivotto I, Oreziak A, Owens AT, Spertus JA, Solomon SD, Tfelt-Hansen J, van Sinttruije M, Veselka J, Watkins H, Jacoby DL, German P, Heitner SB, Kupfer S, Lutz JD, Malik FI, Meng L, Wohltman A, Abraham TP; SEQUOIA-HCM Investigators *. Dosing and Safety Profile of Aficamten in Symptomatic Obstructive Hypertrophic Cardiomyopathy: Results From SEQUOIA-HCM. J Am Heart Assoc. 2024 Aug 6;13(15):e035993. doi: 10.1161/JAHA.124.035993. Epub 2024 Jul 26.
PMID: 39056349DERIVEDMaron MS, Masri A, Nassif ME, Barriales-Villa R, Arad M, Cardim N, Choudhury L, Claggett B, Coats CJ, Dungen HD, Garcia-Pavia P, Hagege AA, Januzzi JL, Lee MMY, Lewis GD, Ma CS, Michels M, Olivotto I, Oreziak A, Owens AT, Spertus JA, Solomon SD, Tfelt-Hansen J, van Sinttruije M, Veselka J, Watkins H, Jacoby DL, Heitner SB, Kupfer S, Malik FI, Meng L, Wohltman A, Abraham TP; SEQUOIA-HCM Investigators. Aficamten for Symptomatic Obstructive Hypertrophic Cardiomyopathy. N Engl J Med. 2024 May 30;390(20):1849-1861. doi: 10.1056/NEJMoa2401424. Epub 2024 May 13.
PMID: 38739079DERIVEDCoats CJ, Maron MS, Abraham TP, Olivotto I, Lee MMY, Arad M, Cardim N, Ma CS, Choudhury L, Dungen HD, Garcia-Pavia P, Hagege AA, Lewis GD, Michels M, Oreziak A, Owens AT, Tfelt-Hansen J, Veselka J, Watkins HC, Heitner SB, Jacoby DL, Kupfer S, Malik FI, Meng L, Wohltman A, Masri A; SEQUOIA-HCM Investigators. Exercise Capacity in Patients With Obstructive Hypertrophic Cardiomyopathy: SEQUOIA-HCM Baseline Characteristics and Study Design. JACC Heart Fail. 2024 Jan;12(1):199-215. doi: 10.1016/j.jchf.2023.10.004. Epub 2023 Nov 29.
PMID: 38032573DERIVED
MeSH Terms
Conditions
Condition Hierarchy (Ancestors)
Results Point of Contact
- Title
- MD Cytokinetics
- Organization
- Cytokinetics, Inc.
Study Officials
- STUDY DIRECTOR
Cytokinetics MD
Cytokinetics
Publication Agreements
- PI is Sponsor Employee
- No
- Restriction Type
- OTHER
- Restrictive Agreement
- Yes
Study Design
- Study Type
- interventional
- Phase
- phase 3
- Allocation
- RANDOMIZED
- Masking
- DOUBLE
- Who Masked
- PARTICIPANT, INVESTIGATOR
- Purpose
- TREATMENT
- Intervention Model
- PARALLEL
- Sponsor Type
- INDUSTRY
- Responsible Party
- SPONSOR
Study Record Dates
First Submitted
December 23, 2021
First Posted
January 11, 2022
Study Start
February 1, 2022
Primary Completion
November 10, 2023
Study Completion
December 18, 2023
Last Updated
March 3, 2026
Results First Posted
March 3, 2026
Record last verified: 2025-02