Overview
Sponsor-declared trial summary
Type 1 Diabetes Mellitus with Impaired Hypoglycemic Awareness and Severe Hypoglycemia
Evaluate the efficacy of VX-880 infusion in subjects who have T1D with impaired hypoglycemic awareness (IAH) and severe hypoglycemia
Key facts
- Sponsor
- Vertex Pharmaceuticals Inc.
- Participant type
- Patients
- Age range
- 18-64 years, 65+ years
- Gender
- Male and Female
- Therapeutic area
- Diseases [C] - Nutritional and Metabolic Diseases [C18]
- Trial duration
- 26 May 2023 → ongoing
- Decision date (initial)
- 2024-10-07
- Transition trial
- Yes
- Low-intervention
- No
- Rare-disease indication
- No
- Vulnerable population
- Yes
External identifiers
- EU CT number
- 2024-513929-23-00
- EudraCT number
- 2022-002292-11
- ClinicalTrials.gov
- NCT04786262
Trial design
CTIS Part I — objectives, methods, condition coding
Main objective
Scope: Efficacy, Safety, Therapy
Evaluate the efficacy of VX-880 infusion in subjects who have T1D with impaired hypoglycemic awareness (IAH) and severe hypoglycemia
Secondary objectives 2
- Evaluate the efficacy of VX-880 infusion on metabolic control
- Evaluate the safety and tolerability of VX-880 infusion in subjects who have T1D with IAH and severe hypoglycemia
Conditions and MedDRA coding
Type 1 Diabetes Mellitus with Impaired Hypoglycemic Awareness and Severe Hypoglycemia
| Version | Level | Code | Term | System organ class |
|---|---|---|---|---|
| 21.1 | LLT | 10081605 | Severe hypoglycemia | 10027433 |
| 20.0 | PT | 10012601 | Diabetes mellitus | 100000004861 |
Study design 1 period
| # | Title | Allocation | Blinding | Roles blinded | Arms |
|---|---|---|---|---|---|
| 1 | Phase 1/2 Study Phase 1/2 Study
|
2 | None |
Regulatory references
- Plan to share IPD
- No
- IPD plan description
- Details on Vertex data sharing criteria and process for requesting access can be found at: https://www.vrtx.com/independent-research/clinical-trial-data-sharing
| EU CT number | Title | Sponsor |
|---|---|---|
| 2022-002292-11 | A Phase 1/2 Study to Evaluate the Safety, Tolerability, and Efficacy of VX-880 in Subjects Who Have Type 1 Diabetes Mellitus With Impaired Hypoglycemic Awareness and Severe Hypoglycemia, Studio di fase 1/2 per valutare la sicurezza, la tollerabilità e l’efficacia di VX-880 in soggetti affetti da diabete mellito di tipo 1 con alterata sensibilità all’ipoglicemia e ipoglicemia grave |
Eligibility criteria
Principal inclusion / exclusion criteria as submitted by sponsor
Inclusion criteria 5
- Clinical history and laboratory evidence of T1D
- At least 2 episodes of severe hypoglycemia (confirmed by independent adjudication for subjects in Parts B and C) in the 12 months prior to signing of informed consent at Screening.
- Reduced awareness of hypoglycemia at Screening
- Consistent use of continuous glucose monitor (CGM) for at least 3 months before Screening. In regions where CGM is not standard of care for T1D, subjects are exempted from the requirement for use of CGM before Screening.
- Compatible blood group (A or AB)
Exclusion criteria 5
- Prior islet cell transplant, organ transplant, or cell therapy
- Advanced complications associated with diabetes including untreated proliferative retinopathy, skin ulcers, or amputations attributable to diabetes.
- Subjects who have any 1 of the following criteria: o Insulin requirements: >0.8 U/(kg*day), >55 U/day, or <10 U/day; o HbA1c: <6.0% or >9.5%
- Clinically significant active infection or chronic infection such as hepatitis B, hepatitis C, human immunodeficiency virus (HIV), and/or tuberculosis (TB); or invasive aspergillus, histoplasmosis, or coccidioidomycosis infection within 1 year prior to signing of informed consent at Screening.
- Negative screen for Epstein-Barr virus (EBV) by immunoglobulin G (IgG) determination
Endpoints
Primary and secondary outcome measures (English text)
Primary endpoints 2
- Part A - Safety and tolerability based on treatment-emergent adverse events (TEAEs; including incidence and severity of adverse events [AEs] and serious adverse events [SAEs]), clinical laboratory values, vital signs, standard 12-lead ECGs, and imaging findings
- Part B and C - The following endpoints apply to the analysis of all infused subjects who intended to receive 0.8 × 10E9 total SC-islet cells with 1 infusion: •Proportion of subjects who are insulin independent at Day 365 after VX-880 infusion
Secondary endpoints 5
- Part B and C: Secondary Endpoints - Proportion of subjects free of SHEs from Day 90 through Day 365 (inclusive) and HbA1c <7.0% at Day 365 after VX 880 infusion
- Part B and C: Secondary Endpoints - Change from baseline in HbA1c at Day 365 after VX-880 infusion
- Part B and C: Secondary Endpoints- Proportion of subjects who achieve insulin independence and are insulin independent 12 months later, with absence of SHEs
- Part B and C: Secondary Endpoints- Proportion of subjects who maintain insulin independence for at least 1 year
- Part B and C: afety and tolerability based on TEAEs (including incidence and severity of AEs and SAEs), clinical laboratory values, vital signs, standard 12-lead ECGs, and imaging findings
Investigational products
Investigational medicinal products (IMPs), comparators, placebo, auxiliary
Test 1
PRD8501686 · Product
- Active substance
- Zimislecel
- Substance synonyms
- VX-880, Allogeneic human stem cell-derived fully differentiated pancreatic islet cells, STx-02
- Other product name
- zimislecel
- Pharmaceutical form
- SOLUTION FOR INFUSION
- Route of administration
- INTRAPORTAL USE
- Max daily dose
- 8000000000 Other
- Max total dose
- 8000000000 Other
- Max treatment duration
- 1 Day(s)
- Authorisation status
- Not Authorised
- MA holder
- VERTEX PHARMACEUTICALS, INCORPORATED
- Paediatric formulation
- No
- Orphan designation
- No
Sponsors and contacts
Sponsor organisations, regulatory contacts, third parties
Vertex Pharmaceuticals Inc.
- Sponsor organisation
- Vertex Pharmaceuticals Inc.
- Address
- 50 Northern Avenue
- City
- Boston
- Postcode
- 02210-1862
- Country
- United States
Scientific contact point
- Organisation
- Vertex Pharmaceuticals Inc.
- Contact name
- Clinical Trials and Medical Info
Public contact point
- Organisation
- Vertex Pharmaceuticals Inc.
- Contact name
- Clinical Trials and Medical Info
Locations
5 EU/EEA countries · 6 investigational sites
By country
| Country | MS status | Planned subjects | Sites |
|---|---|---|---|
| France | Ongoing, recruiting | 1 | 2 |
| Germany | Ongoing, recruiting | 1 | 1 |
| Italy | Ongoing, recruiting | 1 | 1 |
| Netherlands | Ongoing, recruiting | 1 | 1 |
| Norway | Ongoing, recruiting | 4 | 1 |
| Rest of world
United States, Canada, United Kingdom, Switzerland
|
— | 36 | — |
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 |
|---|---|---|---|---|---|
| France | 2023-07-31 | 2023-10-30 | |||
| Germany | 2023-08-18 | 2023-10-17 | |||
| Italy | 2023-09-15 | 2023-09-18 | |||
| Netherlands | 2023-05-26 | 2023-07-26 | |||
| Norway | 2023-06-21 | 2024-06-17 |
Results and documents
Annex IV summary of results, Annex V layperson summary, and all documents registered in CTIS for this trial
Documents 128 files
Public protocol annexes, IB summaries, regulatory submissions and post-authorisation documents registered in CTIS.
| Type | Title | Version |
|---|---|---|
| Protocol (for publication) | D1_Protocol _2024-513929-23-00_ Redacted | 11.9 |
| Recruitment arrangements (for publication) | K1_Addtional document_FR_Fr_redacted | 1 |
| Recruitment arrangements (for publication) | K1_Recruitment arrangements_FR_Fr | 1 |
| Recruitment arrangements (for publication) | K1_Recruitment arrangements_Germany_English | 1.0 |
| Recruitment arrangements (for publication) | K1_Recruitment Arrangements_Italy_English | 1 |
| Recruitment arrangements (for publication) | K1_Recruitment arrangements_Netherlands_English | 1.0 |
| Recruitment arrangements (for publication) | K1_Recruitment Arrangements_Norway_English | 1 |
| Recruitment arrangements (for publication) | K2_Recruitment Material_HCP Flyer_FR_En | 1 |
| Recruitment arrangements (for publication) | K2_Recruitment Material_HCP Flyer_Germany_English | 1 |
| Recruitment arrangements (for publication) | K2_Recruitment Material_HCP Flyer_Italy_English | 1 |
| Recruitment arrangements (for publication) | K2_Recruitment Material_HCP Slide Deck_FR_Fr_redacted | 4.0 |
| Recruitment arrangements (for publication) | K2_Recruitment Material_HCP Slide Deck_Germany_English_redacted | 4 |
| Recruitment arrangements (for publication) | K2_Recruitment Material_HCP Slide Deck_Italy_English_redacted | 4.0 |
| Recruitment arrangements (for publication) | K2_Recruitment Material_HCP Websites_FR_Fr | NA |
| Recruitment arrangements (for publication) | K2_Recruitment Material_HCP Websites_Germany_English | NA |
| Recruitment arrangements (for publication) | K2_Recruitment Material_HCP Websites_Italy_English | NA |
| Recruitment arrangements (for publication) | K2_Recruitment Material_MyTomorrows Facebook Advertisements_FR_Fr | 1.0 |
| Recruitment arrangements (for publication) | K2_Recruitment Material_MyTomorrows Facebook Advertisements_Germany_German | 1.0 |
| Recruitment arrangements (for publication) | K2_Recruitment Material_MyTomorrows Facebook Advertisements_Italy_Italian | 1 |
| Recruitment arrangements (for publication) | K2_Recruitment Material_MyTomorrows Facebook Advertisements_Netherlands_Dutch | 1.0 |
| Recruitment arrangements (for publication) | K2_Recruitment Material_MyTomorrows Facebook Advertisements_Norway_Norwegian | 1 |
| Recruitment arrangements (for publication) | K2_Recruitment Material_MyTomorrows Google Advertisements_FR_Fr | 1 |
| Recruitment arrangements (for publication) | K2_Recruitment Material_MyTomorrows Google Advertisements_Germany_German | 1.0 |
| Recruitment arrangements (for publication) | K2_Recruitment Material_MyTomorrows Google Advertisements_Italy_Italian | 1 |
| Recruitment arrangements (for publication) | K2_Recruitment Material_MyTomorrows Google Advertisements_Netherlands_Dutch | 1.0 |
| Recruitment arrangements (for publication) | K2_Recruitment Material_MyTomorrows Google Advertisements_Norway_Norwegian | 1 |
| Recruitment arrangements (for publication) | K2_Recruitment Material_MyTomorrows Landing Page Copy_FR_Fr | 1.0 |
| Recruitment arrangements (for publication) | K2_Recruitment Material_MyTomorrows Landing Page Copy_Germany_German | 1.0 |
| Recruitment arrangements (for publication) | K2_Recruitment Material_MyTomorrows Landing Page Copy_Italy_Italian | 1.0 |
| Recruitment arrangements (for publication) | K2_Recruitment Material_MyTomorrows Landing Page Copy_Netherlands_Dutch | 1.0 |
| Recruitment arrangements (for publication) | K2_Recruitment Material_MyTomorrows Landing Page Copy_Norway_Norwegian | 1 |
| Recruitment arrangements (for publication) | K2_Recruitment Material_MyTomorrows Landing Page Screenshots_FR_Fr | 1 |
| Recruitment arrangements (for publication) | K2_Recruitment Material_MyTomorrows Landing Page Screenshots_Germany_German | 1.0 |
| Recruitment arrangements (for publication) | K2_Recruitment Material_MyTomorrows Landing Page Screenshots_Italy_Italian | 1.0 |
| Recruitment arrangements (for publication) | K2_Recruitment Material_MyTomorrows Landing Page Screenshots_Netherlands_Dutch | 1.0 |
| Recruitment arrangements (for publication) | K2_Recruitment Material_MyTomorrows Landing Page Screenshots_Norway_Norwegian | 1 |
| Recruitment arrangements (for publication) | K2_Recruitment Material_MyTomorrows Patient Navigator Scripts_FR_Fr | 3.0 |
| Recruitment arrangements (for publication) | K2_Recruitment Material_MyTomorrows Patient Navigator Scripts_Germany_German | 3.0 |
| Recruitment arrangements (for publication) | K2_Recruitment Material_MyTomorrows Patient Navigator Scripts_Italy_Italian | 3.0 |
| Recruitment arrangements (for publication) | K2_Recruitment Material_MyTomorrows Patient Navigator Scripts_Netherlands_Dutch | 3.0 |
| Recruitment arrangements (for publication) | K2_Recruitment Material_MyTomorrows Patient Navigator Scripts_Norway_Norwegian | 3 |
| Recruitment arrangements (for publication) | K2_Recruitment Material_Patient Invitation to Trial Letter_FR_Fr | 1 |
| Recruitment arrangements (for publication) | K2_Recruitment Material_Patient Invitation to Trial Letter_Germany_German | 1 |
| Recruitment arrangements (for publication) | K2_Recruitment Material_Patient Invitation to Trial Letter_Italy_Italian | 2 |
| Recruitment arrangements (for publication) | K2_Recruitment Material_Patient Invitation to Trial Letter_Netherlands_Dutch | 1.0 |
| Recruitment arrangements (for publication) | K2_Recruitment Material_Patient Invitation to Trial Letter_Norway_Norwegian | 1 |
| Recruitment arrangements (for publication) | K2_Recruitment Material_Patient Invitation to Trial Letter_Norway_Norwegian_Superseded | 1 |
| Recruitment arrangements (for publication) | K2_Recruitment Material_PI to Physician Letter_FR_Fr | 3.0 |
| Recruitment arrangements (for publication) | K2_Recruitment Material_PI to Physician Letter_Germany_German | 1 |
| Recruitment arrangements (for publication) | K2_Recruitment Material_PI to Physician Letter_Italy_Italian | 3 |
| Recruitment arrangements (for publication) | K2_Recruitment Material_PI to Physician Letter_Netherlands_Dutch | 1.0 |
| Recruitment arrangements (for publication) | K2_Recruitment Material_Poster_Study Specific_FR_Fr | 4.0 |
| Recruitment arrangements (for publication) | K2_Recruitment Material_Poster_Study Specific_Germany_German | 4 |
| Recruitment arrangements (for publication) | K2_Recruitment Material_Poster_Study Specific_Italy_Italian | 4 |
| Recruitment arrangements (for publication) | K2_Recruitment Material_Poster_Study Specific_Netherlands_Dutch | 4.0 |
| Recruitment arrangements (for publication) | K2_Recruitment Material_Poster_Study Specific_Norway_Norwegian | 4 |
| Recruitment arrangements (for publication) | K2_Recruitment Material_Poster_T1D Specific_Germany_German | 1.0 |
| Recruitment arrangements (for publication) | K2_Recruitment Material_Poster_T1D Specific_Italy_Italian | 1 |
| Recruitment arrangements (for publication) | K2_Recruitment Material_Poster_T1D_Netherlands_Dutch | 1.0 |
| Recruitment arrangements (for publication) | K2_Recruitment Material_Press Release Text_FR_Fr | 1 |
| Recruitment arrangements (for publication) | K2_Recruitment Material_Press Release Text_Germany_German | 1.0 |
| Recruitment arrangements (for publication) | K2_Recruitment Material_Press Release Text_Italy_Italian | NA |
| Recruitment arrangements (for publication) | K2_Recruitment Material_Press Release Text_Netherlands_Dutch | 1.0 |
| Recruitment arrangements (for publication) | K2_Recruitment Material_Press Release Text_Norway_Norwegian_approved under CTD | 1 |
| Recruitment arrangements (for publication) | K2_Recruitment Material_Press Release Text_Study Specific_FR_Fr | 1 |
| Recruitment arrangements (for publication) | K2_Recruitment Material_Press Release Text_Study Specific_Germany_German | 1 |
| Recruitment arrangements (for publication) | K2_Recruitment Material_Press Release Text_Study Specific_Italy_Italian | 1 |
| Recruitment arrangements (for publication) | K2_Recruitment Material_Press Release Text_Study Specific_Netherlands_Dutch | 1 |
| Recruitment arrangements (for publication) | K2_Recruitment Material_Press Release Text_Study Specific_Norway_Norwegian | 1 |
| Recruitment arrangements (for publication) | K2_Recruitment Material_Press Release Text_Study Specific_Norway_Norwegian_Superseded | 1 |
| Recruitment arrangements (for publication) | K2_Recruitment Material_Recruitment Brochure_FR_Fr | 3.0 |
| Recruitment arrangements (for publication) | K2_Recruitment Material_Recruitment Brochure_Germany_German | 3 |
| Recruitment arrangements (for publication) | K2_Recruitment Material_Recruitment Brochure_Italy_Italian | 3 |
| Recruitment arrangements (for publication) | K2_Recruitment Material_Recruitment Brochure_Netherlands_Dutch | 3.0 |
| Recruitment arrangements (for publication) | K2_Recruitment Material_Recruitment Brochure_Norway_Norwegian | 3 |
| Recruitment arrangements (for publication) | K2_Recruitment Material_Recruitment Flyer_FR_Fr | 3.0 |
| Recruitment arrangements (for publication) | K2_Recruitment Material_Recruitment Flyer_Germany_German | 3 |
| Recruitment arrangements (for publication) | K2_Recruitment Material_Recruitment Flyer_Italy_Italian | 3 |
| Recruitment arrangements (for publication) | K2_Recruitment Material_Recruitment Flyer_Netherlands_Dutch | 3.0 |
| Recruitment arrangements (for publication) | K2_Recruitment Material_Recruitment Flyer_Norway_Norwegian | 4.0 |
| Subject information and informed consent form (for publication) | L1_SIS and ICF Main Adult Appendix A_Germany_German | 3.0 |
| Subject information and informed consent form (for publication) | L1_SIS and ICF Main Adult Appendix_Norway_Norwegian | 4.0 |
| Subject information and informed consent form (for publication) | L1_SIS and ICF Main Adult Part C_Netherlands_Dutch_redacted | 9.0 |
| Subject information and informed consent form (for publication) | L1_SIS and ICF Main Adult Privacy_FR_Fr_redacted | 2.0 |
| Subject information and informed consent form (for publication) | L1_SIS and ICF Main Adult Privacy_Italy_Italian_redacted | 5.0 |
| Subject information and informed consent form (for publication) | L1_SIS and ICF Main Adult_FR_Fr_redacted | 9.0 |
| Subject information and informed consent form (for publication) | L1_SIS and ICF Main Adult_Germany_German_redacted | 10.1 |
| Subject information and informed consent form (for publication) | L1_SIS and ICF Main Adult_Italy_Italian_redacted | 9.1 |
| Subject information and informed consent form (for publication) | L1_SIS and ICF Main Adult_Norway_Norwegian_Redacted | 9.0 |
| Subject information and informed consent form (for publication) | L1_SIS and ICF Main Adult_Norway_Norwegian_Superseded_redacted | 5 |
| Subject information and informed consent form (for publication) | L1_SIS and ICF Pre-Screening_FR_Fr_redacted | 4.0 |
| Subject information and informed consent form (for publication) | L1_SIS and ICF Pre-Screening_Germany_German_redacted | 5.0 |
| Subject information and informed consent form (for publication) | L1_SIS and ICF Pre-Screening_Italy_Italian_redacted | 4.0 |
| Subject information and informed consent form (for publication) | L1_SIS and ICF Pre-Screening_Netherlands_Dutch_redacted | 3.1 |
| Subject information and informed consent form (for publication) | L1_SIS and ICF Pre-screening_Norway_Norwegian_redacted | 4.0 |
| Subject information and informed consent form (for publication) | L1_SIS and ICF Pre-Screening_Privacy_Italy_Italian_redacted | 4.0 |
| Subject information and informed consent form (for publication) | L1_SIS and ICF Pregnancy Adult ICF_FR_Fr | 3.0 |
| Subject information and informed consent form (for publication) | L1_SIS and ICF Pregnancy_Germany_German | 3.0 |
| Subject information and informed consent form (for publication) | L1_SIS and ICF Pregnancy_Italy_Italian | 3.0 |
| Subject information and informed consent form (for publication) | L1_SIS and ICF Pregnancy_Netherlands_Dutch | 3.1 |
| Subject information and informed consent form (for publication) | L1_SIS and ICF Pregnancy_Norway_Norwegian_redacted | 3.0 |
| Subject information and informed consent form (for publication) | L1_SIS and ICF Pregnancy_Privacy_Italy_Italian | 2.0 |
| Subject information and informed consent form (for publication) | L1_SIS and ICF Suvoda_Germany_German | 3.0 |
| Subject information and informed consent form (for publication) | L1_SIS and ICF Suvoda_Netherlands_Dutch | 2.0 |
| Subject information and informed consent form (for publication) | L1_SIS and ICF Suvoda_Norway_Norwegian | 3.0 |
| Subject information and informed consent form (for publication) | L2_GP Letter_Italy_Italian | 3.0 |
| Subject information and informed consent form (for publication) | L2_Other subject information material_ICF tool_FR_Fr | 1 |
| Subject information and informed consent form (for publication) | L2_Other subject information material_ICF tool_Germany_German | 1 |
| Subject information and informed consent form (for publication) | L2_Other subject information material_ICF tool_Italy_Italian | 1 |
| Subject information and informed consent form (for publication) | L2_Other subject information material_ICF tool_Netherlands_Dutch | 1.0 |
| Subject information and informed consent form (for publication) | L2_Other subject information material_ICF tool_Norway_Norwegian | 1 |
| Subject information and informed consent form (for publication) | L2_Other subject information material_Study Fact Sheet_FR_Fr | 5.0 |
| Subject information and informed consent form (for publication) | L2_Other subject information material_Study Fact Sheet_Germany_German | 5 |
| Subject information and informed consent form (for publication) | L2_Other subject information material_Study Fact Sheet_Italy_Italian | 5 |
| Subject information and informed consent form (for publication) | L2_Other subject information material_Study Fact Sheet_Netherlands_Dutch | 5.0 |
| Subject information and informed consent form (for publication) | L2_Other subject information material_Study Fact Sheet_Norway_Norwegian | 5 |
| Synopsis of the Protocol - Extract (for publication) | D1_Protocol lay summary DE 2024-513929-23-00 | 11.9 |
| Synopsis of the Protocol - Extract (for publication) | D1_Protocol lay summary ENG 2024-513929-23-00 | 11.9 |
| Synopsis of the Protocol - Extract (for publication) | D1_Protocol lay summary FR 2024-513929-23-00 | 11.9 |
| Synopsis of the Protocol - Extract (for publication) | D1_Protocol lay summary IT 2024-513929-23-00 | 11.9 |
| Synopsis of the Protocol - Extract (for publication) | D1_Protocol lay summary NL 2024-513929-23-00 | 11.9 |
| Synopsis of the Protocol - Extract (for publication) | D1_Protocol lay summary NO 2024-513929-23-00 | 11.9 |
| Synopsis of the protocol (for publication) | D1_Protocol synopsis ENG 2024-513929-23-00_Redacted | 11.9 |
| Synopsis of the protocol (for publication) | D1_Protocol_synopsis DE 2024-513929-23-00_Redacted | 11.9 |
| Synopsis of the protocol (for publication) | D1_Protocol_synopsis FR 2024-513929-23-00_Redacted | 11.9 |
| Synopsis of the protocol (for publication) | D1_Protocol_synopsis IT 2024-513929-23-00_Redacted | 11.9 |
| Synopsis of the protocol (for publication) | D1_Protocol_synopsis NL 2024-513929-23-00_Redacted | 11.9 |
| Synopsis of the protocol (for publication) | D1_Protocol_synopsis NO 2024-513929-23-00_Redacted | 11.9 |
Application history
10 submissions — initial application plus substantial / non-substantial modifications
| # | Type | Code | Submitted | Reference MS | Conclusion | Decision date |
|---|---|---|---|---|---|---|
| 1 | INITIAL | IN | 2024-09-05 | Netherlands | Acceptable with conditions 2024-10-02
|
2024-10-02 |
| 2 | SUBSTANTIAL MODIFICATION | SM-1 | 2024-12-11 | Netherlands | Acceptable 2025-04-04
|
2025-04-04 |
| 3 | SUBSTANTIAL MODIFICATION | SM-2 | 2025-06-16 | Netherlands | Acceptable 2025-09-17
|
2025-09-17 |
| 4 | NON SUBSTANTIAL MODIFICATION | NSM-1 | 2025-09-23 | Netherlands | Acceptable 2025-09-17
|
2025-09-23 |
| 5 | SUBSTANTIAL MODIFICATION | SM-4 | 2025-09-24 | Acceptable | 2025-10-28 | |
| 6 | SUBSTANTIAL MODIFICATION | SM-7 | 2025-09-24 | Acceptable | 2025-10-01 | |
| 7 | SUBSTANTIAL MODIFICATION | SM-5 | 2025-09-25 | Netherlands | Acceptable | 2025-10-23 |
| 8 | SUBSTANTIAL MODIFICATION | SM-6 | 2025-09-25 | Acceptable | 2025-10-23 | |
| 9 | SUBSTANTIAL MODIFICATION | SM-3 | 2025-09-26 | Acceptable | 2025-11-12 | |
| 10 | SUBSTANTIAL MODIFICATION | SM-8 | 2026-02-09 | Netherlands | Acceptable 2026-04-21
|
2026-04-21 |