Efficacy and Safety of Orforglipron in Participants With Peripheral Artery Disease ( ATTAIN-PAD )

2025-523283-21-00 Protocol J2A-MC-GZPR Therapeutic confirmatory (Phase III) Ongoing, recruiting

Start 17 Feb 2026 · Status Ongoing, recruiting · 4 EU/EEA countries · 17 sites · Protocol J2A-MC-GZPR

Overview

Sponsor-declared trial summary

Phase Therapeutic confirmatory (Phase III)
Status Ongoing, recruiting
Participants planned 1,250
Countries 4
Sites 17

Peripheral Arterial Disease

To demonstrate that orforglipron is superior to placebo in increasing maximum walking distance.

Key facts

Sponsor
Eli Lilly & Co.
Participant type
Patients
Age range
18-64 years, 65+ years
Gender
Male and Female
Therapeutic area
Diseases [C] - Cardiovascular Diseases [C14]
Trial duration
17 Feb 2026 → ongoing
Decision date (initial)
2026-02-17
Transition trial
No
Low-intervention
No
Rare-disease indication
No
Vulnerable population
No

Trial design

CTIS Part I — objectives, methods, condition coding

Main objective

Scope: Safety, Pharmacokinetic, Efficacy

To demonstrate that orforglipron is superior to placebo in increasing maximum walking distance.

Conditions and MedDRA coding

Peripheral Arterial Disease

Eligibility criteria

Principal inclusion / exclusion criteria as submitted by sponsor

Inclusion criteria 1

  1. Have symptoms of Peripheral Artery Disease (PAD), causing pain when you walk

Exclusion criteria 4

  1. Have a BMI less than 23 kg/m2
  2. Have HbA1c greater than 10%
  3. Have had or plan to have a leg surgery to improve blood flow in your legs
  4. Have had a heart condition within 60 days prior to screening

Endpoints

Primary and secondary outcome measures (English text)

Primary endpoints 1

  1. Percent Change from Baseline in Maximum Walking Distance On a constant load treadmill test [Time Frame: Baseline, Week 52]

Investigational products

Investigational medicinal products (IMPs), comparators, placebo, auxiliary

Test 6

Orforglipron

PRD12263029 · Product

Active substance
Orforglipron Hemicalcium
Substance synonyms
Orforglipron calcium, Calcium bis{3-[(1S,2S)-1-({2-(4-fluoro-3,5-dimethylphenyl)-3-({3-[3-(4-fluoro-1-methyl-1H-indazol-5-yl)-2-oxo-2,3-dihydro-1H-imidazol-1-yl]-4-methyl-2,4,6,7-tetrahydro-5H-pyrazolo[4,3-c]pyridin-5-yl}carbonyl)-5-[(4S)-2,2-dimethyloxan-4-yl]-1H-indol-1-yl}-2-methylcyclopropyl]-5-oxo-1,2,4-oxadiazol-4(5H)-ide}, LY3502970 hemicalcium
Pharmaceutical form
TABLET
Route of administration
ORAL USE
Max daily dose
0 Other
Max total dose
0 Other
Max treatment duration
52 Week(s)
Authorisation status
Not Authorised
MA holder
ELI LILLY AND COMPANY LIMITED
Paediatric formulation
No
Orphan designation
No

Orforglipron

PRD12263031 · Product

Active substance
Orforglipron Hemicalcium
Substance synonyms
Orforglipron calcium, Calcium bis{3-[(1S,2S)-1-({2-(4-fluoro-3,5-dimethylphenyl)-3-({3-[3-(4-fluoro-1-methyl-1H-indazol-5-yl)-2-oxo-2,3-dihydro-1H-imidazol-1-yl]-4-methyl-2,4,6,7-tetrahydro-5H-pyrazolo[4,3-c]pyridin-5-yl}carbonyl)-5-[(4S)-2,2-dimethyloxan-4-yl]-1H-indol-1-yl}-2-methylcyclopropyl]-5-oxo-1,2,4-oxadiazol-4(5H)-ide}, LY3502970 hemicalcium
Pharmaceutical form
TABLET
Route of administration
ORAL USE
Max daily dose
0 Other
Max total dose
0 Other
Max treatment duration
52 Week(s)
Authorisation status
Not Authorised
MA holder
ELI LILLY AND COMPANY LIMITED
Paediatric formulation
No
Orphan designation
No

Orforglipron

PRD12263027 · Product

Active substance
Orforglipron Hemicalcium
Substance synonyms
Orforglipron calcium, Calcium bis{3-[(1S,2S)-1-({2-(4-fluoro-3,5-dimethylphenyl)-3-({3-[3-(4-fluoro-1-methyl-1H-indazol-5-yl)-2-oxo-2,3-dihydro-1H-imidazol-1-yl]-4-methyl-2,4,6,7-tetrahydro-5H-pyrazolo[4,3-c]pyridin-5-yl}carbonyl)-5-[(4S)-2,2-dimethyloxan-4-yl]-1H-indol-1-yl}-2-methylcyclopropyl]-5-oxo-1,2,4-oxadiazol-4(5H)-ide}, LY3502970 hemicalcium
Pharmaceutical form
TABLET
Route of administration
ORAL USE
Max daily dose
0 Other
Max total dose
0 Other
Max treatment duration
52 Week(s)
Authorisation status
Not Authorised
MA holder
ELI LILLY AND COMPANY LIMITED
Paediatric formulation
No
Orphan designation
No

Orforglipron

PRD12263028 · Product

Active substance
Orforglipron Hemicalcium
Substance synonyms
Orforglipron calcium, Calcium bis{3-[(1S,2S)-1-({2-(4-fluoro-3,5-dimethylphenyl)-3-({3-[3-(4-fluoro-1-methyl-1H-indazol-5-yl)-2-oxo-2,3-dihydro-1H-imidazol-1-yl]-4-methyl-2,4,6,7-tetrahydro-5H-pyrazolo[4,3-c]pyridin-5-yl}carbonyl)-5-[(4S)-2,2-dimethyloxan-4-yl]-1H-indol-1-yl}-2-methylcyclopropyl]-5-oxo-1,2,4-oxadiazol-4(5H)-ide}, LY3502970 hemicalcium
Pharmaceutical form
TABLET
Route of administration
ORAL USE
Max daily dose
0 Other
Max total dose
0 Other
Max treatment duration
52 Week(s)
Authorisation status
Not Authorised
MA holder
ELI LILLY AND COMPANY LIMITED
Paediatric formulation
No
Orphan designation
No

Orforglipron

PRD12263030 · Product

Active substance
Orforglipron Hemicalcium
Substance synonyms
Orforglipron calcium, Calcium bis{3-[(1S,2S)-1-({2-(4-fluoro-3,5-dimethylphenyl)-3-({3-[3-(4-fluoro-1-methyl-1H-indazol-5-yl)-2-oxo-2,3-dihydro-1H-imidazol-1-yl]-4-methyl-2,4,6,7-tetrahydro-5H-pyrazolo[4,3-c]pyridin-5-yl}carbonyl)-5-[(4S)-2,2-dimethyloxan-4-yl]-1H-indol-1-yl}-2-methylcyclopropyl]-5-oxo-1,2,4-oxadiazol-4(5H)-ide}, LY3502970 hemicalcium
Pharmaceutical form
TABLET
Route of administration
ORAL USE
Max daily dose
0 Other
Max total dose
0 Other
Max treatment duration
52 Week(s)
Authorisation status
Not Authorised
MA holder
ELI LILLY AND COMPANY LIMITED
Paediatric formulation
No
Orphan designation
No

Orforglipron

PRD12263032 · Product

Active substance
Orforglipron Hemicalcium
Substance synonyms
Orforglipron calcium, Calcium bis{3-[(1S,2S)-1-({2-(4-fluoro-3,5-dimethylphenyl)-3-({3-[3-(4-fluoro-1-methyl-1H-indazol-5-yl)-2-oxo-2,3-dihydro-1H-imidazol-1-yl]-4-methyl-2,4,6,7-tetrahydro-5H-pyrazolo[4,3-c]pyridin-5-yl}carbonyl)-5-[(4S)-2,2-dimethyloxan-4-yl]-1H-indol-1-yl}-2-methylcyclopropyl]-5-oxo-1,2,4-oxadiazol-4(5H)-ide}, LY3502970 hemicalcium
Pharmaceutical form
TABLET
Route of administration
ORAL USE
Max daily dose
0 Other
Max total dose
0 Other
Max treatment duration
52 Week(s)
Authorisation status
Not Authorised
MA holder
ELI LILLY AND COMPANY LIMITED
Paediatric formulation
No
Orphan designation
No

Placebo 1

Placebo to match ly

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

Sponsors and contacts

Sponsor organisations, regulatory contacts, third parties

Eli Lilly & Co.

Sponsor organisation
Eli Lilly & Co.
Address
1 Lilly Corporate Center
City
Indianapolis
Postcode
46285-0001
Country
United States

Scientific contact point

Organisation
Eli Lilly & Co.
Contact name
Lilly Clinical Trials information desk

Public contact point

Organisation
Eli Lilly & Co.
Contact name
Lilly Clinical Trials information desk

Third parties 19

OrganisationCity, countryDuties
Inventus Group Limited
ORL-000015947
Wokingham, United Kingdom Code 14
Syneos Health Inc.
ORG-100008382
Morrisville, United States Code 11
Lionbridge Technologies Inc
ORL-000015975
Waltham, United States Other
Tier 1 Impact Pbc Inc.
ORG-100050163
Covington, United States Other
IQVIA Limited
ORG-100008655
Livingston, United Kingdom Laboratory analysis
Q2 Solutions LLC
ORG-100017000
Ithaca, United States Laboratory analysis
Zoom
ORL-000012319
San Jose, United States Other
Icon Public Limited Company
ORG-100042517
Dublin 18, Ireland Code 8
The Hibbert Co.
ORG-100047639
Trenton, United States Other
Colorado Prevention Center
ORG-100046058
Aurora, United States Code 14
Cleveland Clinic Foundation
ORG-100028017
Cleveland, United States Code 13
Clinical Trial Media Inc.
ORG-100046339
Hauppauge, United States Other
Veeva Systems Inc.
ORG-100006053
Pleasanton, United States E-data capture
Clinical Ink Inc.
ORG-100042433
Winston Salem, United States Data management
Greenphire LLC
ORG-100041621
King Of Prussia, United States Code 2
RWS Life Sciences Inc.
ORG-100042348
East Hartford, United States Other
Iqvia Inc.
ORQ-110192931
Durham, United States On site monitoring
Florence
ORL-000012320
Atlanta, United States Other
Reify Health Inc.
ORG-100049669
Boston, United States Code 2

Locations

4 EU/EEA countries · 17 investigational sites

By country

CountryMS statusPlanned subjectsSites
France Ongoing, recruiting 60 7
Netherlands Authorised, recruitment pending 50 3
Poland Ongoing, recruiting 50 5
Slovakia Ongoing, recruiting 25 2
Rest of world
Brazil, Taiwan, United Kingdom, Canada, Argentina, United States, Australia, India, Japan, Korea, Republic of, China
1,065

Investigational sites

France

7 sites · Ongoing, recruiting
Hôpital Européen Georges Pompidou
Service de médecine vasculaire ,7e Pôle C, 20 Rue Leblanc,, 75015, Paris
Groupe hospitalier Paris saint Joseph
Services de Chirurgie Vasculaire, 185, Rue Raymond Losserand, Losserand
Centre Hospitalier Universitaire d'Angers
Médecine Vasculaire, 4 rue Larrey, Angers, Angers
Hôpital Saint Philibert
Chirurgie et medecine vasculaire, Rue du Grand But, Lomme, Lomme
Centre Hospitalier Universitaire De Nice
Chirurgie et Médecine Vasculaire, 30 Voie Romaine, 06000, Nice
Centre Hospitalier Universitaire de Rennes , Hôpital Pontchaillou
Centre d'Investigation Clinique CIC1414, 2 Rue Henri Le Guilloux, RENNES, RENNES
CHRU Troussau
Cardiologie, Avenue de la République, Chambray Les Tours, Chambray Les Tours

Netherlands

3 sites · Authorised, recruitment pending
Catharina Ziekenhuis Stichting
Vascular Surgery, Michelangelolaan 2, 5623 EJ, Eindhoven
Albert Schweitzer Ziekenhuis
Interne Geneeskunde, Albert Schweitzerplaats 25, 3318 AT, Dordrecht
Radboud UMC
Vascular Surgery, Geert Grooteplein-Zuid 10, 6500 HB Nijmegen, HB Nijmegen

Poland

5 sites · Ongoing, recruiting
Centrum Medyczne Intercor Sp. z o.o.
Badania Kliniczne, Ul. Kasztanowa 57, 85-605, Bydgoszcz
Przychodnie Grudziadz Sp. z o.o.
N/A, Ul. Legionow 21/23, 86-300, Grudziadz
Serce Sp. z o.o.
Poradnia Specjalistyczna, Ul. Fabryczna 15, 64-100, Leszno
Niepubliczny Zaklad Opieki Zdrowotnej Twoje Zdrowie El Sp. z o.o.
Poradnia Kardiologiczna, Ul. Robotnicza 79, 82-300, Elblag
Centrum Medyczne Komorniki Sp. z o.o.
Poradnia Kardiologiczna, Ul. Stawna 7, 62-052, Komorniki

Slovakia

2 sites · Ongoing, recruiting
Medivasa s.r.o.
N/A, Vojtecha Spanyola 8187, 010 01, Zilina
Alian s.r.o.
NA, Sv. Jakuba 33, 085 01, Bardejov

Country notifications

Trial-start, recruitment-start, end and early-termination notifications submitted per Member State

Country Trial startTrial end Recruitment startRecruitment end Early termination
France 2026-02-17 2026-04-07
Poland 2026-02-22 2026-04-10
Slovakia 2026-05-08 2026-05-18

Results and documents

Annex IV summary of results, Annex V layperson summary, and all documents registered in CTIS for this trial

Documents 97 files

Public protocol annexes, IB summaries, regulatory submissions and post-authorisation documents registered in CTIS.

TypeTitleVersion
Protocol (for publication) D1_Protocol 2025-523283-21-00_Redacted a
Protocol (for publication) D4_Patient Documents Copyright 1
Protocol (for publication) D4_Patient facing document_PGIS-PAD Walking Ability_eCOA_PL 2
Recruitment arrangements (for publication) K1_Recruitment and Informed consent procedure 2.0
Recruitment arrangements (for publication) K1_Recruitment Arrangements 1.0
Recruitment arrangements (for publication) K1_Recruitment arrangements 1.3
Recruitment arrangements (for publication) K1_Recruitment arrangements_FRA 1.0
Recruitment arrangements (for publication) K1_Recruitment arrangements_Redacted 1.2
Recruitment arrangements (for publication) K1_Recruitment arrangments_PL 1
Recruitment arrangements (for publication) K2_Document additionnel_Redacted 1.0
Recruitment arrangements (for publication) K2_Recruitment Material_Appreciation Items 1.0
Recruitment arrangements (for publication) K2_Recruitment Material_Brochure_FRA_Redacted 1.1
Recruitment arrangements (for publication) K2_Recruitment material_Brochure_Master_PL_redacted 1
Recruitment arrangements (for publication) K2_Recruitment material_Brochure_Redacted 1.0
Recruitment arrangements (for publication) K2_Recruitment material_CC_Script_Secondary_Master_PL_Redacted 1
Recruitment arrangements (for publication) K2_Recruitment material_Database_and_Patient_Messaging_Master_PL 1
Recruitment arrangements (for publication) K2_Recruitment material_Digital_Ad_Copy_Master_PL 1
Recruitment arrangements (for publication) K2_Recruitment material_Digital_Ad_Visuals_Master_PL 1
Recruitment arrangements (for publication) K2_Recruitment Material_Doctor Referral Letter TC_FRA_Redacted 2.0
Recruitment arrangements (for publication) K2_Recruitment Material_Doctor Referral Letter_FRA_Redacted 2.0
Recruitment arrangements (for publication) K2_Recruitment Material_Flyer_FRA_Redacted 1.1
Recruitment arrangements (for publication) K2_Recruitment material_Flyer_Master_PL_Redacted 1
Recruitment arrangements (for publication) K2_Recruitment material_Letter-Doctor-Referral_Master_PL_Redacted 1
Recruitment arrangements (for publication) K2_Recruitment material_Letter-Doctor-to-Patient_Master_PL_Redacted 1
Recruitment arrangements (for publication) K2_Recruitment material_List of sites_Redacted 1.1
Recruitment arrangements (for publication) K2_Recruitment Material_LITES Survey Participant Invitation Email_FRA 1.0
Recruitment arrangements (for publication) K2_Recruitment Material_Poster_FRA_Redacted 1.1
Recruitment arrangements (for publication) K2_Recruitment material_Poster_Master_PL_Redacted 1
Recruitment arrangements (for publication) K2_Recruitment material_Screener_Secondary_Master_PL_Redacted 1
Recruitment arrangements (for publication) K2_Recruitment material_Social_Media_Video_Script_1_Master_PL 1
Recruitment arrangements (for publication) K2_Recruitment material_WS_Script_Secondary_Master_PL 1
Recruitment arrangements (for publication) K2_Recruitment Materials_Brochure_Redacted 1.2
Recruitment arrangements (for publication) K2_Recruitment Materials_Doctor to Patient Letter_Redacted 1.2
Recruitment arrangements (for publication) K2_Recruitment Materials_Flyer_Redacted 1.1
Recruitment arrangements (for publication) K2_Recruitment Materials_Poster_Redacted 1.2
Recruitment arrangements (for publication) K2_Recruitment_Materials_Flyer_Redacted 1.2
Recruitment arrangements (for publication) K2_Recruitment_Materials_Poster_Redacted 1.1
Subject information and informed consent form (for publication) L1_ SIS and ICF_GZPR_Main TC_FR_Redacted 1.1
Subject information and informed consent form (for publication) L1_ SIS and ICF_GZPR_Main_FR_Redacted 1.1
Subject information and informed consent form (for publication) L1_SIS and ICF_Data Privacy Addendum 1.1
Subject information and informed consent form (for publication) L1_SIS and ICF_Main ICF_Redacted 1.2
Subject information and informed consent form (for publication) L1_SIS and ICF_Main ICF_Redacted 1.6
Subject information and informed consent form (for publication) L1_SIS and ICF_PL_Redacted 1.2
Subject information and informed consent form (for publication) L1_SIS and ICF_Pregnant partner 1.1
Subject information and informed consent form (for publication) L2_Other subject information material_Confidentiality Notice_Netherlands_Redacted 2.0
Subject information and informed consent form (for publication) L2_Other subject information material_eConsent - Participant-Facing Screenshots_Redacted 1.4
Subject information and informed consent form (for publication) L2_Other subject information material_eConsent Security and Privacy Quick Reference Guide_Redacted 1.5
Subject information and informed consent form (for publication) L2_Other subject information material_eConsent Submission Letter 1.0
Subject information and informed consent form (for publication) L2_Other subject information material_eSignature In-Person Consent Quick Reference Guide 1.2
Subject information and informed consent form (for publication) L2_Other subject information material_GI-AE Brochure 1.0
Subject information and informed consent form (for publication) L2_Other subject information material_Hypo Awareness Brochure 2.0
Subject information and informed consent form (for publication) L2_Other subject information material_IQVIA E2E Privacy Policy 2
Subject information and informed consent form (for publication) L2_Other subject information material_IQVIA Getting Started Patient-facing landing page_Redacted 1.1
Subject information and informed consent form (for publication) L2_Other subject information material_Lilly In Trial Experience Survey LITES Ethics Cover Letter 1
Subject information and informed consent form (for publication) L2_Other subject information material_Lilly In-Trial Experience Survey LITES Privacy Policy 1
Subject information and informed consent form (for publication) L2_Other subject information material_Lilly In-Trial Experience Survey LITES Study Specific Form 1
Subject information and informed consent form (for publication) L2_Other subject information material_Lilly In-Trial Experience Survey LITES Terms of Use 2
Subject information and informed consent form (for publication) L2_Other subject information material_LITES Participant Invitation Email 1
Subject information and informed consent form (for publication) L2_Other subject information material_LITES Study Participant and Study Partner Survey 1
Subject information and informed consent form (for publication) L2_Other subject information material_LITES_Ethics Cover Letter_Template 1
Subject information and informed consent form (for publication) L2_Other subject information material_LITES_Participant Invitation Email_Template_PL 1
Subject information and informed consent form (for publication) L2_Other subject information material_LITES_Privacy Policy_Master_PL 1
Subject information and informed consent form (for publication) L2_Other subject information material_LITES_Study Participant and Study Partner Survey_Master_PL 1
Subject information and informed consent form (for publication) L2_Other subject information material_LITES_Study Participant_Study Partner Survey_Screenshots_PL 1
Subject information and informed consent form (for publication) L2_Other subject information material_LITES_Study Specific Form 1
Subject information and informed consent form (for publication) L2_Other subject information material_LITES_Terms of Use_Master_PL 2
Subject information and informed consent form (for publication) L2_Other subject information material_Participant Postcard Anytime 1
Subject information and informed consent form (for publication) L2_Other subject information material_Participant Postcard During study 1
Subject information and informed consent form (for publication) L2_Other subject information material_Participant Postcard End of study 1
Subject information and informed consent form (for publication) L2_Other subject information material_Participant Postcard Start of study 1
Subject information and informed consent form (for publication) L2_Other subject information material_Patient Card 1.0
Subject information and informed consent form (for publication) L2_Other subject information material_Patient Information Card 2
Subject information and informed consent form (for publication) L2_Other subject information material_Study Connect Participant 1.0
Subject information and informed consent form (for publication) L2_Other subject information material_Study Guide_Redacted 1.0
Subject information and informed consent form (for publication) L2_Other subject information material_Supportive Partner Guide 1.0
Subject information and informed consent form (for publication) L2_Other subject information material_Survey_Participant_Postcard Anytime_Master_PL 1
Subject information and informed consent form (for publication) L2_Other subject information material_Survey_Participant_Postcard During study_Master_PL 1
Subject information and informed consent form (for publication) L2_Other subject information material_Survey_Participant_Postcard End of study_Master_PL 1
Subject information and informed consent form (for publication) L2_Other subject information material_Survey_Participant_Postcard Start of study_Master_PL 1
Subject information and informed consent form (for publication) L2_Other subject information material_Visit Card 1.0
Subject information and informed consent form (for publication) L2_Other Subject Information_LITES Survey Participant Invitation Email_FRA 1.0
Subject information and informed consent form (for publication) L2_Other Subject Information_LITES Survey Participant Postcard Anytime_FRA 1.0
Subject information and informed consent form (for publication) L2_Other Subject Information_LITES Survey Participant Postcard During Study_FRA 1.0
Subject information and informed consent form (for publication) L2_Other Subject Information_LITES Survey Participant Postcard End of Study_FRA 1.1
Subject information and informed consent form (for publication) L2_Other Subject Information_LITES Survey Participant Postcard Start of Study_FRA 1.0
Subject information and informed consent form (for publication) L2_Other Subject Information_LITES Survey Privacy Policy_FRA 1.0
Subject information and informed consent form (for publication) L2_Other Subject Information_LITES Survey Screenshots_FRA 1.0
Subject information and informed consent form (for publication) L2_Other Subject Information_LITES Survey Study-Specific Form 1.0
Subject information and informed consent form (for publication) L2_Other Subject Information_LITES Survey Terms of Use_FRA 2.0
Subject information and informed consent form (for publication) L2_Other Subject Information_LITES Survey_FRA 1.0
Subject information and informed consent form (for publication) L3_Recruitment arrangements_Informed consent and patient recruitment procedure_PL 2
Subject information and informed consent form (for publication) L4_Info Re insurance Conditions for Patient 1
Synopsis of the protocol (for publication) D1_Protocol synopsis_2025-523283-21-00_FR_Redacted 1.0
Synopsis of the protocol (for publication) D1_Protocol Synopsis_2025-523283-21-00_PL_Redacted 1
Synopsis of the protocol (for publication) D1_Protocol Synopsis_NL_2025-523283-21-00_Redacted 1.0
Synopsis of the protocol (for publication) D1_Protocol Synopsis_Redacted 1
Synopsis of the protocol (for publication) D1_Protocol Synopsis_SK_2025-523283-21-00_Redacted initial

Application history

5 submissions — initial application plus substantial / non-substantial modifications

#TypeCodeSubmittedReference MSConclusionDecision date
1 INITIAL IN 2025-10-15 Netherlands Acceptable
2026-02-16
2026-02-17
2 SUBSTANTIAL MODIFICATION SM-1 2026-03-04 Acceptable 2026-06-01
3 SUBSTANTIAL MODIFICATION SM-4 2026-03-06 Acceptable 2026-04-16
4 SUBSTANTIAL MODIFICATION SM-2 2026-03-10 Acceptable 2026-04-29
5 SUBSTANTIAL MODIFICATION SM-3 2026-03-10 Netherlands Acceptable 2026-05-22