Overview
Sponsor-declared trial summary
Thrombolysis of symptomatic proximal vein thrombosis
The primary objectives are to quantify the effect of BAY 3018250 on clot lysis in patients with proximal DVT, and to assess the safety of BAY 3018250 in patients with proximal DVT.
Key facts
- Sponsor
- Bayer AG
- Participant type
- Patients
- Age range
- 18-64 years, 65+ years
- Gender
- Male and Female
- Therapeutic area
- Diseases [C] - Cardiovascular Diseases [C14]
- Trial duration
- 20 Dec 2023 → 3 Dec 2025
- Decision date (initial)
- 2023-11-06
- Transition trial
- No
- Low-intervention
- No
- Rare-disease indication
- No
- Vulnerable population
- No
- Funding sources
- Funds of Bayer AG
Trial design
CTIS Part I — objectives, methods, condition coding
Main objective
Scope: Dose response, Pharmacodynamic, Pharmacokinetic, Efficacy, Safety, Pharmacogenetic
The primary objectives are to quantify the effect of BAY 3018250 on clot lysis in patients with proximal DVT, and to assess the safety of BAY 3018250 in patients with proximal DVT.
Secondary objectives 1
- The secondary objective is to quantify the effect of BAY 3018250 on clot lysis in patients with proximal DVT based on additional endpoints
Conditions and MedDRA coding
Thrombolysis of symptomatic proximal vein thrombosis
| Version | Level | Code | Term | System organ class |
|---|---|---|---|---|
| 20.0 | PT | 10043568 | Thrombolysis | 100000004865 |
| 21.1 | LLT | 10049918 | Deep venous thrombosis proximal | 10047065 |
Study design 1 period
| # | Title | Allocation | Blinding | Roles blinded | Arms |
|---|---|---|---|---|---|
| 1 | Overall study Following screening visit, participants will be randomized, treated and will be followed during the 90-day period. That includes one in-hospital overnight stay after study intervention administration.
|
Randomised Controlled | Double | [{"id":157818,"code":4,"name":"Analyst"},{"id":157819,"code":2,"name":"Investigator"},{"id":157817,"code":5,"name":"Carer"},{"id":157815,"code":3,"name":"Monitor"},{"id":157816,"code":1,"name":"Subject"}] | BAY3018250 Dose 1: Participants will receive single dose of BAY 3018250 Dose 1. BAY3018250 Dose 2: Participants will receive single dose of BAY3018250 Dose 2. Placebo to BAY3018250: Participants will receive single dose of placebo to BAY3018250. |
Eligibility criteria
Principal inclusion / exclusion criteria as submitted by sponsor
Inclusion criteria 4
- Male and female (if postmenopausal or hysterectomized) aged 18 years or older
- Acute symptomatic proximal deep vein thrombosis (DVT) documented by compression ultrasound (CUS) and all of the following: a. duration of symptoms 14 days or less b. Proximal DVT involving at least 1 of the following proximal veins: the popliteal vein, the femoral vein, the common femoral vein and the external iliac vein c. adequate visualization of the most proximal end of the thrombus d. receiving therapeutic dose anticoagulation with LMWHs and/or DOACs according to the respective product labels
- Measured body weight within 50 to 130 kg
- Signed informed consent
Exclusion criteria 7
- Acute symptomatic PE requiring systemic or catheter-directed thrombolytic therapy, catheter-directed mechanical thrombectomy, or surgical embolectomy
- Active bleeding or high risk for bleeding (at the discretion of the investigator)
- Recent (<3 months) ischemic stroke, myocardial infarction, intracranial hemorrhage, or major surgery or severe trauma (at the discretion of the investigator)
- Active cancer, i.e., locally active, regionally invasive or metastatic and/or anticancer therapy within the last 6 months, except basal cell or squamous cell carcinoma
- Therapeutic-dose anticoagulants for > 72 hours before randomization, or current use of vitamin K antagonists
- Planned or current use of the following medications: Planned or current use of the following medications: a. Any antiplatelet therapy, except ASA ≤100 mg/day, b. Antifibrinolytic drugs, c.Therapeutic antibodies
- Male participants with WOCBP partners unwilling to use highly effective contraception from start of study intervention until end of study.
Endpoints
Primary and secondary outcome measures (English text)
Primary endpoints 2
- Area under the curve AUCn(6h-30d) of the ratio to baseline of clot burden, as assessed by repeated quantitative ultrasound at 6h, 24h, Day 7 and Day 30
- Number of participants with composite of major and clinically relevant non-major (CRNM) bleeding events (ISTH definition) up to Day 15
Secondary endpoints 4
- Ratio to baseline of clot burden, as assessed by repeated quantitative ultrasound at 6h, 24h, Day 7, Day 30 and Day 90, respectively.
- Change from baseline in leg pain severity at 6h, 24h, Day 7, Day 30 and Day 90 (Likert pain scale)
- Change from baseline in post- venous thromboembolism functional status (PVFS) scale at Day 7, Day 30 and Day 90
- Number participants with recurrent venous thromboembolism (VTE) up to Day 90
Investigational products
Investigational medicinal products (IMPs), comparators, placebo, auxiliary
Test 1
PRD9764741 · Product
- Active substance
- BAY 3018250
- Pharmaceutical form
- CONCENTRATE FOR SOLUTION FOR INFUSION
- Route of administration
- OTHER USE
- Max daily dose
- 00 mg milligram(s)
- Max total dose
- 00 mg milligram(s)
- Max treatment duration
- 1111 Day(s)
- Authorisation status
- Not Authorised
- MA holder
- BAYER AG
- Paediatric formulation
- No
- Orphan designation
- No
Placebo 1
Placebo solution for BAY 3018250 solution
N/A · Product
- Other product name
- N/A
- Pharmaceutical form
- N/A
- ATC code
- N/A — N/A
- Marketing authorisation
- N/A
- MA holder
- N/A
- MA country
- Iceland
- Paediatric formulation
- No
Auxiliary 1
-
B01AB · Product
- Pharmaceutical form
- PHF00006MIG
- Route of administration
- SUBCUTANEOUS
- Max daily dose
- 2 mg/kg milligram(s)/kilogram
- Max total dose
- 60 mg/kg milligram(s)/kilogram
- Max treatment duration
- 30 Day(s)
- Authorisation status
- Authorised
- ATC code
- B01AB — HEPARIN GROUP
- Marketing authorisation
- -
- Paediatric formulation
- No
- Orphan designation
- No
- Modified vs. Marketing Authorisation
- No
Sponsors and contacts
Sponsor organisations, regulatory contacts, third parties
Bayer AG
- Sponsor organisation
- Bayer AG
- Address
- -
- City
- Leverkusen
- Postcode
- 51368
- Country
- Germany
Scientific contact point
- Organisation
- Bayer AG
- Contact name
- Therapeutic Area Head
Public contact point
- Organisation
- Bayer AG
- Contact name
- Therapeutic Area Head
Third parties 6
| Organisation | City, country | Duties |
|---|---|---|
| 4G Clinical B.V. ORG-100044721
|
Amsterdam, Netherlands | Interactive response technologies (IRT) |
| Medidata Solutions Inc. ORG-100016256
|
New York, United States | E-data capture |
| LKF Laboratorium fuer Klinische Forschung GmbH ORG-100017343
|
Schwentinental, Germany | Laboratory analysis |
| DATAN Analytics GmbH ORG-100048165
|
Muenster, Germany | Code 10 |
| Nuvisan GmbH ORG-100011873
|
Neu-Ulm, Germany | Laboratory analysis |
| Mlm Medical Labs GmbH ORG-100043721
|
Mönchengladbach, Germany | Laboratory analysis |
Locations
11 EU/EEA countries · 84 investigational sites
By country
| Country | MS status | Planned subjects | Sites |
|---|---|---|---|
| Belgium | Ended | 57 | 8 |
| Bulgaria | Ended | 16 | 7 |
| Czechia | Ended | 46 | 9 |
| France | Ended | 63 | 11 |
| Germany | Ended | 45 | 8 |
| Greece | Ended | 30 | 6 |
| Hungary | Ended | 40 | 8 |
| Italy | Ended | 49 | 8 |
| Netherlands | Ended | 38 | 7 |
| Slovakia | Ended | 31 | 8 |
| Spain | Ended | 28 | 4 |
| Rest of world
Canada
|
— | 3 | — |
Investigational sites
Country notifications
Trial-start, recruitment-start, end and early-termination notifications submitted per Member State
| Country | Trial start | Trial end | Recruitment start | Recruitment end | Early termination |
|---|---|---|---|---|---|
| Belgium | 2024-01-04 | 2025-11-06 | 2024-01-15 | 2025-09-05 | |
| Bulgaria | 2024-11-27 | 2025-12-02 | 2024-12-10 | 2025-09-05 | |
| Czechia | 2024-11-11 | 2025-12-02 | 2024-11-27 | 2025-09-05 | |
| France | 2023-12-20 | 2025-10-21 | 2024-01-23 | 2025-09-05 | |
| Germany | 2024-01-25 | 2025-11-20 | 2024-02-01 | 2025-09-05 | |
| Greece | 2025-01-09 | 2025-10-09 | 2025-01-13 | 2025-09-05 | |
| Hungary | 2024-12-19 | 2025-12-02 | 2025-01-08 | 2025-09-05 | |
| Italy | 2024-04-15 | 2025-11-27 | 2024-05-23 | 2025-09-05 | |
| Netherlands | 2024-03-08 | 2025-10-13 | 2024-09-25 | 2025-09-05 | |
| Slovakia | 2024-12-04 | 2025-10-07 | 2024-12-20 | 2025-09-05 | |
| Spain | 2024-12-20 | 2025-09-06 | 2025-03-20 | 2025-09-05 |
Results and documents
Annex IV summary of results, Annex V layperson summary, and all documents registered in CTIS for this trial
Documents 99 files
Public protocol annexes, IB summaries, regulatory submissions and post-authorisation documents registered in CTIS.
| Type | Title | Version |
|---|---|---|
| Protocol (for publication) | D1_Protocol 2023-503315-15-00_For Publication | 4 |
| Protocol (for publication) | D1_Protocol_EL_GR_2023-503315-15-00_public | 4 |
| Recruitment arrangements (for publication) | K1_Recruitment arrangements_BG_BG_Procedure Template_public | 1 |
| Recruitment arrangements (for publication) | K1_Recruitment arrangements_CZ_CZ_IC Procedure Form_public | 2 |
| Recruitment arrangements (for publication) | K1_Recruitment arrangements_EN_DE_Procedure Template_Public | 4 |
| Recruitment arrangements (for publication) | K1_Recruitment arrangements_EN_ES_Recruitment and ICF Procedure_Public | 1 |
| Recruitment arrangements (for publication) | K1_Recruitment arrangements_EN_GR_Procedure Template_public | 1 |
| Recruitment arrangements (for publication) | K1_Recruitment arrangements_EN_SK_Procedure Template_public | NA |
| Recruitment arrangements (for publication) | K1_Recruitment arrangements_For Publication | NA |
| Recruitment arrangements (for publication) | K1_Recruitment arrangements_For Publication | 4 |
| Recruitment arrangements (for publication) | K1_Recruitment arrangements_For Publication | 3 |
| Recruitment arrangements (for publication) | K1_Recruitment arrangements_FR_FR_Procedure Template_Public | 5 |
| Recruitment arrangements (for publication) | K2_Recruitment material_ICF Tabletop_DU_BE_For Publication | 2 |
| Recruitment arrangements (for publication) | K2_Recruitment material_ICF Tabletop_For Publication | 2 |
| Recruitment arrangements (for publication) | K2_Recruitment material_ICF Tabletop_For Publication | 2 |
| Recruitment arrangements (for publication) | K2_Recruitment material_ICF Tabletop_FR_BE_For Publication | 2 |
| Recruitment arrangements (for publication) | K2_Recruitment material_Information Sheet_DU_BE_For Publication | 2 |
| Recruitment arrangements (for publication) | K2_Recruitment material_Information Sheet_For Publication | 2 |
| Recruitment arrangements (for publication) | K2_Recruitment material_Information Sheet_For Publication | 2 |
| Recruitment arrangements (for publication) | K2_Recruitment material_Information Sheet_FR_BE_For Publication | 2 |
| Recruitment arrangements (for publication) | K2_Recruitment material_Patient flyer_For Publication | 2 |
| Recruitment arrangements (for publication) | K2_Recruitment material_Poster_FR_BE_For Publication | 3 |
| Recruitment arrangements (for publication) | K2_Recruitment material_Poster_NL_BE_For Publication | 3 |
| Recruitment arrangements (for publication) | K2_Recruitment materials_BG_BG_ICF Tabletop_public | 2 |
| Recruitment arrangements (for publication) | K2_Recruitment materials_BG_BG_Information Sheet_public | 2 |
| Recruitment arrangements (for publication) | K2_Recruitment materials_BG_BG_Site Poster_public | 3 |
| Recruitment arrangements (for publication) | K2_Recruitment materials_CZ_CZ_ICF Tabletop_public | 2 |
| Recruitment arrangements (for publication) | K2_Recruitment materials_CZ_CZ_Information Sheet_public | 2 |
| Recruitment arrangements (for publication) | K2_Recruitment materials_CZ_CZ_Site Poster_public | 3 |
| Recruitment arrangements (for publication) | K2_Recruitment materials_DE_DE_Poster_Public | 3 |
| Recruitment arrangements (for publication) | K2_Recruitment materials_EL_GR_ICF Tabletop_public | 2 |
| Recruitment arrangements (for publication) | K2_Recruitment materials_EL_GR_Information Sheet_public | 2 |
| Recruitment arrangements (for publication) | K2_Recruitment materials_EL_GR_Site Poster_public | 3 |
| Recruitment arrangements (for publication) | K2_Recruitment materials_ES_ES_ICF Tabletop_Public | 3 |
| Recruitment arrangements (for publication) | K2_Recruitment materials_ES_ES_Information Sheet_Public | 3 |
| Recruitment arrangements (for publication) | K2_Recruitment materials_ES_ES_Site Poster_Public | 3 |
| Recruitment arrangements (for publication) | K2_Recruitment materials_FR_FR _Poster_Public | 3 |
| Recruitment arrangements (for publication) | K2_Recruitment materials_HU_HU_Information Sheet_public | 2 |
| Recruitment arrangements (for publication) | K2_Recruitment materials_ICF Tabletop_Public | 2 |
| Recruitment arrangements (for publication) | K2_Recruitment materials_Information Sheet_Public | 2 |
| Recruitment arrangements (for publication) | K2_Recruitment materials_IT_IT_Poster_public | 3 |
| Recruitment arrangements (for publication) | K2_Recruitment materials_NL_NL_Site Poster_Public | 3 |
| Recruitment arrangements (for publication) | K2_Recruitment materials_SK_SK_ICF Tabletop_public | 2 |
| Recruitment arrangements (for publication) | K2_Recruitment materials_SK_SK_Information Sheet_public | 2 |
| Recruitment arrangements (for publication) | K2_Recruitment materials_SK_SK_Site Poster_public | 3 |
| Subject information and informed consent form (for publication) | L1_ICF_BG _BG_Core_public | 1 |
| Subject information and informed consent form (for publication) | L1_ICF_BG_BG_Expecting Parents_Female_public | 1 |
| Subject information and informed consent form (for publication) | L1_ICF_BG_BG_Expecting Parents_Male_public | 1 |
| Subject information and informed consent form (for publication) | L1_ICF_CZ_CZ_Core_public | 1 |
| Subject information and informed consent form (for publication) | L1_ICF_CZ_CZ_Expecting parents Female_public | 1 |
| Subject information and informed consent form (for publication) | L1_ICF_CZ_CZ_Expecting parents Male_public | 1 |
| Subject information and informed consent form (for publication) | L1_ICF_CZ_CZ_Supplemental_public | 1 |
| Subject information and informed consent form (for publication) | L1_ICF_EL_GR_Core_public | 1 |
| Subject information and informed consent form (for publication) | L1_ICF_EL_GR_Expecting parents female participant_public | 1 |
| Subject information and informed consent form (for publication) | L1_ICF_EL_GR_Expecting parents male participant_public | 1 |
| Subject information and informed consent form (for publication) | L1_ICF_ES_ES_Core_Appendix 1_Public | 1 |
| Subject information and informed consent form (for publication) | L1_ICF_ES_ES_Core_Public | 1.1 |
| Subject information and informed consent form (for publication) | L1_ICF_ES_ES_Expecting Parents_Female_Public | 1 |
| Subject information and informed consent form (for publication) | L1_ICF_ES_ES_Expecting Parents_Male_Public | 1 |
| Subject information and informed consent form (for publication) | L1_ICF_Expecting mother - Males Partner_public | 1 |
| Subject information and informed consent form (for publication) | L1_ICF_Expecting parents_public | 2 |
| Subject information and informed consent form (for publication) | L1_ICF_FR_FR_Core ICF_Public | 6 |
| Subject information and informed consent form (for publication) | L1_ICF_HU_HU_Core_public | 1.2 |
| Subject information and informed consent form (for publication) | L1_ICF_HU_HU_Expecting parents female participant_Public | 1 |
| Subject information and informed consent form (for publication) | L1_ICF_HU_HU_Expecting parents male participant_Public | 1.1 |
| Subject information and informed consent form (for publication) | L1_ICF_IT_IT_Partner_public | 2 |
| Subject information and informed consent form (for publication) | L1_ICF_SK_SK_Core_public | 1.1 |
| Subject information and informed consent form (for publication) | L1_ICF_SK_SK_Expecting parents_female participant_public | 1 |
| Subject information and informed consent form (for publication) | L1_ICF_SK_SK_Expecting parents_male participant_public | 1 |
| Subject information and informed consent form (for publication) | L1_ICF_SK_SK_Supplemental information for data privacy_public | 1.1 |
| Subject information and informed consent form (for publication) | L1_SIS and ICF_DU-BE_For Publication | 4 |
| Subject information and informed consent form (for publication) | L1_SIS and ICF_For Publication | 3 |
| Subject information and informed consent form (for publication) | L1_SIS and ICF_For Publication | 3 |
| Subject information and informed consent form (for publication) | L1_SIS and ICF_For Publication | 1 |
| Subject information and informed consent form (for publication) | L1_SIS and ICF_FR-BE_For Publication | 4 |
| Subject information and informed consent form (for publication) | L2_IS and ICF_expecting parents - female_DU-BE_For Publication | 2 |
| Subject information and informed consent form (for publication) | L2_IS and ICF_expecting parents - female_For Publication | 2 |
| Subject information and informed consent form (for publication) | L2_IS and ICF_expecting parents - female_For Publication | 2 |
| Subject information and informed consent form (for publication) | L2_IS and ICF_expecting parents - female_For Publication | 1 |
| Subject information and informed consent form (for publication) | L2_IS and ICF_expecting parents - female_FR-BE_For Publication | 2 |
| Subject information and informed consent form (for publication) | L2_IS and ICF_expecting parents - male_DU-BE_For Publication | 2 |
| Subject information and informed consent form (for publication) | L2_IS and ICF_expecting parents - male_For Publication | 2 |
| Subject information and informed consent form (for publication) | L2_IS and ICF_expecting parents - male_For Publication | 2 |
| Subject information and informed consent form (for publication) | L2_IS and ICF_expecting parents - male_For Publication | 1 |
| Subject information and informed consent form (for publication) | L2_IS and ICF_expecting parents - male_FR-BE_For Publication | 2 |
| Subject information and informed consent form (for publication) | L2_IS and ICF_ICF Core Sponsor Statement_EN_For Publication | 1 |
| Subject information and informed consent form (for publication) | L2_IS and ICF_Patient Reimbursement_For Publication | 1 |
| Subject information and informed consent form (for publication) | L2_Other subject info material _HU_HU_Emergency Contact Card_public | 1 |
| Synopsis of the protocol (for publication) | D1_Protocol synopsis DE_BE_2023-503315-15-00_For Publication | 3 |
| Synopsis of the protocol (for publication) | D1_Protocol synopsis EN_2023-503315-15-00_For Publication | 3 |
| Synopsis of the protocol (for publication) | D1_Protocol synopsis FR_BE_2023-503315-15-00_For Publication | 3 |
| Synopsis of the protocol (for publication) | D1_Protocol synopsis FR_FR_2023-503315-15-00_For Publication | 3 |
| Synopsis of the protocol (for publication) | D1_Protocol synopsis IT_IT_2023-503315-15-00_For Publication | 3 |
| Synopsis of the protocol (for publication) | D1_Protocol synopsis NL_BE_2023-503315-15-00_For Publication | 3 |
| Synopsis of the protocol (for publication) | D1_Protocol synopsis NL_NL_2023-503315-15-00_For Publication | 3 |
| Synopsis of the protocol (for publication) | D1_Synopsis of Protocol_CZ_CZ_2023-503315-15-00_public | 3 |
| Synopsis of the protocol (for publication) | D1_Synopsis of Protocol_EL_GR_2023-503315-15-00_public | 1 |
| Synopsis of the protocol (for publication) | D1_Synopsis of Protocol_HU_HU_2023-503315-15-00 | 3 |
| Synopsis of the protocol (for publication) | D1_Synopsis of Protocol_SK_SK_2023-503315-15-00_public | 1 |
Application history
30 submissions — initial application plus substantial / non-substantial modifications
| # | Type | Code | Submitted | Reference MS | Conclusion | Decision date |
|---|---|---|---|---|---|---|
| 1 | INITIAL | IN | 2023-07-18 | Netherlands | Acceptable with conditions 2023-11-01
|
2023-11-02 |
| 2 | NON SUBSTANTIAL MODIFICATION | NSM-2 | 2023-11-14 | Netherlands | Acceptable with conditions 2023-11-01
|
2023-11-14 |
| 3 | SUBSTANTIAL MODIFICATION | SM-1 | 2023-11-20 | Netherlands | Acceptable 2023-12-14
|
2023-12-15 |
| 4 | NON SUBSTANTIAL MODIFICATION | NSM-3 | 2023-12-19 | Netherlands | Acceptable 2023-12-14
|
2023-12-19 |
| 5 | SUBSTANTIAL MODIFICATION | SM-2 | 2023-12-19 | Acceptable | 2024-03-12 | |
| 6 | SUBSTANTIAL MODIFICATION | SM-3 | 2023-12-19 | Acceptable | 2024-03-15 | |
| 7 | SUBSTANTIAL MODIFICATION | SM-4 | 2023-12-19 | Netherlands | Acceptable | 2024-03-01 |
| 8 | SUBSTANTIAL MODIFICATION | SM-5 | 2024-01-31 | Acceptable | 2024-02-20 | |
| 9 | SUBSTANTIAL MODIFICATION | SM-7 | 2024-05-08 | Netherlands | Acceptable 2024-07-31
|
2024-08-01 |
| 10 | NON SUBSTANTIAL MODIFICATION | NSM-4 | 2024-08-08 | Acceptable 2024-07-31
|
2024-08-08 | |
| 11 | SUBSTANTIAL MODIFICATION | SM-8 | 2024-08-08 | Acceptable | 2024-09-09 | |
| 12 | SUBSTANTIAL MODIFICATION | SM-9 | 2024-08-08 | Acceptable | 2024-08-30 | |
| 13 | SUBSTANTIAL MODIFICATION | SM-10 | 2024-08-08 | Acceptable | 2024-09-20 | |
| 14 | SUBSTANTIAL MODIFICATION | SM-11 | 2024-08-08 | Acceptable | 2024-10-10 | |
| 15 | SUBSTANTIAL MODIFICATION | SM-12 | 2024-08-08 | Netherlands | Acceptable | 2024-11-04 |
| 16 | SUBSEQUENT ADDITION OF MSC | APP-16 | 2024-08-09 | Acceptable 2024-07-31
|
2024-11-01 | |
| 17 | SUBSEQUENT ADDITION OF MSC | APP-17 | 2024-08-09 | 2024-10-28 | ||
| 18 | SUBSEQUENT ADDITION OF MSC | APP-18 | 2024-08-09 | Acceptable 2024-07-31
|
2024-10-31 | |
| 19 | SUBSEQUENT ADDITION OF MSC | APP-19 | 2024-08-12 | Acceptable 2024-07-31
|
2024-10-24 | |
| 20 | SUBSEQUENT ADDITION OF MSC | APP-20 | 2024-08-12 | 2024-10-31 | ||
| 21 | SUBSEQUENT ADDITION OF MSC | APP-21 | 2024-08-13 | Acceptable 2024-07-31
|
2024-10-21 | |
| 22 | NON SUBSTANTIAL MODIFICATION | NSM-5 | 2024-11-05 | Netherlands | Acceptable 2024-07-31
|
2024-11-05 |
| 23 | SUBSTANTIAL MODIFICATION | SM-13 | 2024-11-12 | Acceptable | 2024-12-18 | |
| 24 | NON SUBSTANTIAL MODIFICATION | NSM-6 | 2025-03-25 | Acceptable | 2025-03-25 | |
| 25 | SUBSTANTIAL MODIFICATION | SM-15 | 2025-04-23 | Acceptable | 2025-05-21 | |
| 26 | SUBSTANTIAL MODIFICATION | SM-14 | 2025-04-25 | Acceptable | 2025-04-29 | |
| 27 | NON SUBSTANTIAL MODIFICATION | NSM-7 | 2025-05-26 | Netherlands | Acceptable | 2025-05-26 |
| 28 | NON SUBSTANTIAL MODIFICATION | NSM-8 | 2025-06-04 | Acceptable | 2025-06-04 | |
| 29 | NON SUBSTANTIAL MODIFICATION | NSM-9 | 2025-06-11 | Netherlands | Acceptable | 2025-06-11 |
| 30 | NON SUBSTANTIAL MODIFICATION | NSM-10 | 2025-11-18 | Netherlands | Acceptable | 2025-11-18 |