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Evaluation of Whether Deferiprone Affects QT Interval in Healthy Subjects

A Double-Blind, Randomized, Crossover, Thorough QT/QTc Trial to Evaluate the Potential of Deferiprone to Prolong the QT Interval in Healthy Subjects

Status
Completed
Phases
Phase 4
Study type
Interventional
Source
ClinicalTrials.gov
Registry ID
NCT01860703
Enrollment
50
Registered
2013-05-23
Start date
2012-11-30
Completion date
2013-07-31
Last updated
2014-11-12

For informational purposes only — not medical advice. Sourced from public registries and may not reflect the latest updates. Terms

Conditions

Prolonged QTc Interval

Keywords

Ferriprox®, LI, DFP, Deferiprone, Healthy Volunteers

Brief summary

Randomized, single-dose, double-blind, placebo and active controlled, four-period crossover study to evaluate the effect of deferiprone on QTc prolongation after administration of a single therapeutic (33 mg/kg) and supratherapeutic(50 mg/kg) oral doses of deferiprone in healthy volunteers as compared to placebo treatment.

Detailed description

Post-marketing study to evaluate the effect of deferiprone and deferiprone 3-O-glucuronide on QTc prolongation in healthy volunteers after administration of a single therapeutic (33 mg/kg) and supratherapeutic (50 mg/kg) oral dose of deferiprone and moxifloxacin (Avelox®).

Interventions

DRUGDeferiprone

Ferriprox 500 mg tablets

DRUGdeferiprone matching placebo tablets

deferiprone matching placebo tablets

DRUGmoxifloxacin

Active control

DRUGplacebo

moxifloxacin-matching placebo

Sponsors

ApoPharma
Lead SponsorINDUSTRY

Study design

Allocation
RANDOMIZED
Intervention model
CROSSOVER
Primary purpose
TREATMENT
Masking
TRIPLE (Subject, Investigator, Outcomes Assessor)

Eligibility

Sex/Gender
ALL
Age
18 Years to 45 Years
Healthy volunteers
Yes

Inclusion criteria

Main Inclusion Criteria: 1. Healthy adult males or females, 18 - 45 years of age (inclusive). 2. Body weight ≥ 50 kg. 3. Body mass index (BMI) ≥ 19 and ≤ 32 kg/m2. 4. Medically healthy with clinically insignificant screening results (e.g., laboratory profiles, medical history, vital signs, physical examination). 5. Absolute neutrophil count (ANC) of \>1.5x109/L. 6. 12-lead ECGs which have no clinically significant findings as judged by the Principal Investigator (PI) or the PI's designee at screening and check-in of each study period,including: 1. Normal sinus rhythm (heart rate between 45 and 100 bpm); 2. QTcF interval ≤ 450 msec; 3. QRS interval ≤ 110 msec; and 4. PR interval ≤ 220 msec. 7. Subject must be capable of providing written informed consent, and must voluntarily consent to participate in the study. 8. Willing to answer inclusion and

Exclusion criteria

questionnaire at check-in. Main

Design outcomes

Primary

MeasureTime frameDescription
Maximum Difference in Change From Baseline in ddQTcF Following a Single Dose of 33 mg/kg Deferiprone24-hour intervalChange from baseline in QTcF interval was measured by looking at the post-dose difference in change from baseline in Fridericia's QT corrected heart rate (dQTcF) between treatment and placebo (ddQTcF) at each time interval. ECG recordings were obtained within a 5-minute time window at Hours -0.75, -0.5, and -0.25 (prior to dosing) and Hours 0.25, 0.5, 0.75, 1, 1.25, 1.5, 2, 3, 4, 6, 8, 10, and 24 post-dose.
Maximum Difference in Change From Baseline in ddQTcF Following a Single Dose of 50 mg/kg Deferiprone24-hour intervalChange from baseline in QTcF interval was measured by looking at the post-dose difference in change from baseline in Fridericia's QT corrected heart rate (dQTcF) between treatment and placebo (ddQTcF) at each time interval. ECG recordings were obtained within a 5-minute time window at Hours -0.75, -0.5, and -0.25 (prior to dosing) and Hours 0.25, 0.5, 0.75, 1, 1.25, 1.5, 2, 3, 4, 6, 8, 10, and 24 post-dose.
Maximum Postdose QT/QTc Interval24-hour intervalThe maximum post-dose QT/QTc interval for deferiprone and placebo. ECG recordings were obtained within a 5-minute time window at Hours -0.75, -0.5, and -0.25 (prior to dosing) and Hours 0.25, 0.5, 0.75, 1, 1.25, 1.5, 2, 3, 4, 6, 8, 10, and 24 post-dose.
Maximum Change From Baseline (dQT/dQTc)24-hour intervalMaximum Change From Baseline (dQT/dQTc) for deferiprone and placebo. ECG recordings were obtained within a 5-minute time window at Hours -0.75, -0.5, and -0.25 (prior to dosing) and Hours 0.25, 0.5, 0.75, 1, 1.25, 1.5, 2, 3, 4, 6, 8, 10, and 24 post-dose.

Secondary

MeasureTime frameDescription
T1/2 for Serum Deferiprone and Deferiprone 3-O-glucuronide24-hour intervalT1/2 was assessed over a 24-hour interval for analyses of deferiprone and its 3-O-glucuronide metabolite in healthy volunteers. Serial blood samples were collected prior to dosing and within 5 minutes following completion of each scheduled post-dose ECG at Hours 0.25, 0.5, 0.75, 1, 1.25, 1.5, 2, 3, 4, 6, 8, 10, and 24 post-dose.
Tmax of Deferiprone and Deferiprone 3-O-glucuronide24-hour intervalTo evaluate the Tmax of deferiprone and deferiprone 3-O-glucuronide following administration of single doses of 33 and 50 mg/kg deferiprone in healthy volunteers. Serial blood samples were collected prior to dosing and within 5 minutes following completion of each scheduled post-dose ECG at Hours 0.25, 0.5, 0.75, 1, 1.25, 1.5, 2, 3, 4, 6, 8, 10, and 24 post-dose.
Maximum Difference in Change From Baseline in ddQTcF Following a Single Dose of Moxifloxacin24-hour intervalChange from baseline in QTcF interval was measured by looking at the post-dose difference in change from baseline in Fridericia's QT corrected heart rate (dQTcF) between treatment and placebo (ddQTcF) at each time interval. ECG recordings were obtained within a 5-minute time window at Hours -0.75, -0.5, and -0.25 (prior to dosing) and Hours 0.25, 0.5, 0.75, 1, 1.25, 1.5, 2, 3, 4, 6, 8, 10, and 24 post-dose.
Number of Participants With Adverse EventsFrom administration of the first dose until 7 days +/- 1 day following the final doseNumber of participants with adverse events following therapeutic and supratherapeutic doses of deferiprone
Cmax of Deferiprone and Deferiprone 3-O Glucuronide24-hour intervalTo evaluate the Cmax of deferiprone and deferiprone 3-O-glucuronide following administration of single doses of 33 and 50 mg/kg deferiprone in healthy volunteers. Serial blood samples were collected prior to dosing and within 5 minutes following completion of each scheduled post-dose ECG at Hours 0.25, 0.5, 0.75, 1, 1.25, 1.5, 2, 3, 4, 6, 8, 10, and 24 post-dose.
AUC0-infinity for Serum Deferiprone and Deferiprone 3-O-glucuronide24-hour intervalAUC0-infinity was assessed over a 24-hour interval for analyses of deferiprone and its 3-O-glucuronide metabolite in healthy volunteers. Serial blood samples were collected prior to dosing and within 5 minutes following completion of each scheduled post-dose ECG at Hours 0.25, 0.5, 0.75, 1, 1.25, 1.5, 2, 3, 4, 6, 8, 10, and 24 post-dose.

Countries

United States

Participant flow

Recruitment details

First subject enrolled: 17 November 2012 Last subject completed: 19 December 2012 The study was carried out at Celerion, a research facility used for conducting clinical trials.

Participants by arm

ArmCount
All Subjects
Subjects in this cross-over study all received one dose of each the following: A) a maximum therapeutic dose of 33 mg deferiprone, B) a supratherapeutic dose of 50 mg/kg deferiprone, C) placebo, and D) moxifloxacin (active control). They were randomized to receive these products in different orders: ABCD, BDAC, CADB, or DCBA. Treatments were separated by a 7-day washout period.
50
Total50

Withdrawals & dropouts

PeriodReasonFG000FG001FG002FG003
Overall StudyAdverse Event1402
Overall StudyPersonal reason1010
Overall StudyWithdrawal by Subject0100

Baseline characteristics

CharacteristicAll Subjects
Age, Categorical
<=18 years
0 Participants
Age, Categorical
>=65 years
0 Participants
Age, Categorical
Between 18 and 65 years
50 Participants
Ethnicity (NIH/OMB)
Hispanic or Latino
46 Participants
Ethnicity (NIH/OMB)
Not Hispanic or Latino
4 Participants
Ethnicity (NIH/OMB)
Unknown or Not Reported
0 Participants
Race (NIH/OMB)
American Indian or Alaska Native
0 Participants
Race (NIH/OMB)
Asian
0 Participants
Race (NIH/OMB)
Black or African American
1 Participants
Race (NIH/OMB)
More than one race
0 Participants
Race (NIH/OMB)
Native Hawaiian or Other Pacific Islander
0 Participants
Race (NIH/OMB)
Unknown or Not Reported
0 Participants
Race (NIH/OMB)
White
49 Participants
Region of Enrollment
United States
50 participants
Sex: Female, Male
Female
29 Participants
Sex: Female, Male
Male
21 Participants

Adverse events

Event typeEG000
affected / at risk
EG001
affected / at risk
EG002
affected / at risk
EG003
affected / at risk
deaths
Total, all-cause mortality
— / —— / —— / —— / —
other
Total, other adverse events
12 / 4635 / 4810 / 455 / 46
serious
Total, serious adverse events
0 / 460 / 480 / 450 / 46

Outcome results

Primary

Maximum Change From Baseline (dQT/dQTc)

Maximum Change From Baseline (dQT/dQTc) for deferiprone and placebo. ECG recordings were obtained within a 5-minute time window at Hours -0.75, -0.5, and -0.25 (prior to dosing) and Hours 0.25, 0.5, 0.75, 1, 1.25, 1.5, 2, 3, 4, 6, 8, 10, and 24 post-dose.

Time frame: 24-hour interval

Population: The Cardiodynamic Analysis Set consisted of all randomized subjects who received at least 1 dose of study medication and who had valid Day 1 QT/QTc interval measurements (predose and at least one postdose measurement).

ArmMeasureGroupValue (NUMBER)
33 mg/kg DeferiproneMaximum Change From Baseline (dQT/dQTc)QTcF ≤ 30 msec100 percentage of participants
33 mg/kg DeferiproneMaximum Change From Baseline (dQT/dQTc)QTcF >60 msec0 percentage of participants
33 mg/kg DeferiproneMaximum Change From Baseline (dQT/dQTc)QTcF >30 but ≤ 60 msec0 percentage of participants
Placebo ControlMaximum Change From Baseline (dQT/dQTc)QTcF ≤ 30 msec100 percentage of participants
Placebo ControlMaximum Change From Baseline (dQT/dQTc)QTcF >60 msec0 percentage of participants
Placebo ControlMaximum Change From Baseline (dQT/dQTc)QTcF >30 but ≤ 60 msec0 percentage of participants
Arm C - Placebo ControlMaximum Change From Baseline (dQT/dQTc)QTcF >30 but ≤ 60 msec0 percentage of participants
Arm C - Placebo ControlMaximum Change From Baseline (dQT/dQTc)QTcF ≤ 30 msec100 percentage of participants
Arm C - Placebo ControlMaximum Change From Baseline (dQT/dQTc)QTcF >60 msec0 percentage of participants
Arm D - Positive ControlMaximum Change From Baseline (dQT/dQTc)QTcF ≤ 30 msec96 percentage of participants
Arm D - Positive ControlMaximum Change From Baseline (dQT/dQTc)QTcF >60 msec0 percentage of participants
Arm D - Positive ControlMaximum Change From Baseline (dQT/dQTc)QTcF >30 but ≤ 60 msec4 percentage of participants
Primary

Maximum Difference in Change From Baseline in ddQTcF Following a Single Dose of 33 mg/kg Deferiprone

Change from baseline in QTcF interval was measured by looking at the post-dose difference in change from baseline in Fridericia's QT corrected heart rate (dQTcF) between treatment and placebo (ddQTcF) at each time interval. ECG recordings were obtained within a 5-minute time window at Hours -0.75, -0.5, and -0.25 (prior to dosing) and Hours 0.25, 0.5, 0.75, 1, 1.25, 1.5, 2, 3, 4, 6, 8, 10, and 24 post-dose.

Time frame: 24-hour interval

Population: Cardiodynamic Analysis Set : all randomized subjects who received at least 1 dose of study medication and who had valid Day 1 QT/QTc interval measurements (predose and at least one postdose measurement).

ArmMeasureValue (LEAST_SQUARES_MEAN)Dispersion
33 mg/kg DeferiproneMaximum Difference in Change From Baseline in ddQTcF Following a Single Dose of 33 mg/kg Deferiprone1.4 millisecondsStandard Deviation 4.92
Placebo ControlMaximum Difference in Change From Baseline in ddQTcF Following a Single Dose of 33 mg/kg Deferiprone-1.6 millisecondsStandard Deviation 4.72
90% CI: [1.02, 5.01]
Primary

Maximum Difference in Change From Baseline in ddQTcF Following a Single Dose of 50 mg/kg Deferiprone

Change from baseline in QTcF interval was measured by looking at the post-dose difference in change from baseline in Fridericia's QT corrected heart rate (dQTcF) between treatment and placebo (ddQTcF) at each time interval. ECG recordings were obtained within a 5-minute time window at Hours -0.75, -0.5, and -0.25 (prior to dosing) and Hours 0.25, 0.5, 0.75, 1, 1.25, 1.5, 2, 3, 4, 6, 8, 10, and 24 post-dose.

Time frame: 24-hour interval

Population: Cardiodynamic Analysis Set : all randomized subjects who received at least 1 dose of study medication and who had valid Day 1 QT/QTc interval measurements (predose and at least one postdose measurement).

ArmMeasureValue (LEAST_SQUARES_MEAN)Dispersion
33 mg/kg DeferiproneMaximum Difference in Change From Baseline in ddQTcF Following a Single Dose of 50 mg/kg Deferiprone3.5 millisecondsStandard Deviation 5.28
Placebo ControlMaximum Difference in Change From Baseline in ddQTcF Following a Single Dose of 50 mg/kg Deferiprone-1.7 millisecondsStandard Deviation 6.36
90% CI: [3.26, 7.19]
Primary

Maximum Postdose QT/QTc Interval

The maximum post-dose QT/QTc interval for deferiprone and placebo. ECG recordings were obtained within a 5-minute time window at Hours -0.75, -0.5, and -0.25 (prior to dosing) and Hours 0.25, 0.5, 0.75, 1, 1.25, 1.5, 2, 3, 4, 6, 8, 10, and 24 post-dose.

Time frame: 24-hour interval

Population: The Cardiodynamic Analysis Set consisted of all randomized subjects who received at least 1 dose of study medication and who had valid Day 1 QT/QTc interval measurements (predose and at least one postdose measurement).

ArmMeasureGroupValue (NUMBER)
33 mg/kg DeferiproneMaximum Postdose QT/QTc IntervalQTcF ≤ 450 msec100 percentage of participants
33 mg/kg DeferiproneMaximum Postdose QT/QTc IntervalQTcF > 450 to ≤ 480 msec0 percentage of participants
33 mg/kg DeferiproneMaximum Postdose QT/QTc IntervalQTcF > 480 to ≤ 500 msec0 percentage of participants
33 mg/kg DeferiproneMaximum Postdose QT/QTc IntervalQTcF > 500 msec0 percentage of participants
Placebo ControlMaximum Postdose QT/QTc IntervalQTcF > 450 to ≤ 480 msec4 percentage of participants
Placebo ControlMaximum Postdose QT/QTc IntervalQTcF > 480 to ≤ 500 msec0 percentage of participants
Placebo ControlMaximum Postdose QT/QTc IntervalQTcF > 500 msec0 percentage of participants
Placebo ControlMaximum Postdose QT/QTc IntervalQTcF ≤ 450 msec96 percentage of participants
Arm C - Placebo ControlMaximum Postdose QT/QTc IntervalQTcF > 480 to ≤ 500 msec0 percentage of participants
Arm C - Placebo ControlMaximum Postdose QT/QTc IntervalQTcF > 450 to ≤ 480 msec2 percentage of participants
Arm C - Placebo ControlMaximum Postdose QT/QTc IntervalQTcF > 500 msec0 percentage of participants
Arm C - Placebo ControlMaximum Postdose QT/QTc IntervalQTcF ≤ 450 msec98 percentage of participants
Arm D - Positive ControlMaximum Postdose QT/QTc IntervalQTcF > 500 msec0 percentage of participants
Arm D - Positive ControlMaximum Postdose QT/QTc IntervalQTcF > 450 to ≤ 480 msec11 percentage of participants
Arm D - Positive ControlMaximum Postdose QT/QTc IntervalQTcF ≤ 450 msec89 percentage of participants
Arm D - Positive ControlMaximum Postdose QT/QTc IntervalQTcF > 480 to ≤ 500 msec0 percentage of participants
Secondary

AUC0-infinity for Serum Deferiprone and Deferiprone 3-O-glucuronide

AUC0-infinity was assessed over a 24-hour interval for analyses of deferiprone and its 3-O-glucuronide metabolite in healthy volunteers. Serial blood samples were collected prior to dosing and within 5 minutes following completion of each scheduled post-dose ECG at Hours 0.25, 0.5, 0.75, 1, 1.25, 1.5, 2, 3, 4, 6, 8, 10, and 24 post-dose.

Time frame: 24-hour interval

Population: The PK population consisted of all subjects who had taken study medication and had at least 1 PK sample collected.

ArmMeasureGroupValue (MEAN)Dispersion
33 mg/kg DeferiproneAUC0-infinity for Serum Deferiprone and Deferiprone 3-O-glucuronideAUC0-infinity for serum deferiprone95.4 μg *hr/mLStandard Deviation 18.03
33 mg/kg DeferiproneAUC0-infinity for Serum Deferiprone and Deferiprone 3-O-glucuronideAUC0-infinity for serum deferiprone -O-glucuronide205.5 μg *hr/mLStandard Deviation 42.8
Placebo ControlAUC0-infinity for Serum Deferiprone and Deferiprone 3-O-glucuronideAUC0-infinity for serum deferiprone152.1 μg *hr/mLStandard Deviation 22.2
Placebo ControlAUC0-infinity for Serum Deferiprone and Deferiprone 3-O-glucuronideAUC0-infinity for serum deferiprone -O-glucuronide331.2 μg *hr/mLStandard Deviation 74.7
Secondary

Cmax of Deferiprone and Deferiprone 3-O Glucuronide

To evaluate the Cmax of deferiprone and deferiprone 3-O-glucuronide following administration of single doses of 33 and 50 mg/kg deferiprone in healthy volunteers. Serial blood samples were collected prior to dosing and within 5 minutes following completion of each scheduled post-dose ECG at Hours 0.25, 0.5, 0.75, 1, 1.25, 1.5, 2, 3, 4, 6, 8, 10, and 24 post-dose.

Time frame: 24-hour interval

Population: The PK population consisted of all subjects who had taken study medication and had at least 1 PK sample collected.

ArmMeasureGroupValue (MEAN)Dispersion
33 mg/kg DeferiproneCmax of Deferiprone and Deferiprone 3-O GlucuronideCmax of serum deferiprone34.1 μg/mLStandard Deviation 8.9
33 mg/kg DeferiproneCmax of Deferiprone and Deferiprone 3-O GlucuronideCmax of serum deferiprone 3-O-glucuronide35.2 μg/mLStandard Deviation 8.5
Placebo ControlCmax of Deferiprone and Deferiprone 3-O GlucuronideCmax of serum deferiprone54.4 μg/mLStandard Deviation 16.4
Placebo ControlCmax of Deferiprone and Deferiprone 3-O GlucuronideCmax of serum deferiprone 3-O-glucuronide51.4 μg/mLStandard Deviation 13.4
Secondary

Maximum Difference in Change From Baseline in ddQTcF Following a Single Dose of Moxifloxacin

Change from baseline in QTcF interval was measured by looking at the post-dose difference in change from baseline in Fridericia's QT corrected heart rate (dQTcF) between treatment and placebo (ddQTcF) at each time interval. ECG recordings were obtained within a 5-minute time window at Hours -0.75, -0.5, and -0.25 (prior to dosing) and Hours 0.25, 0.5, 0.75, 1, 1.25, 1.5, 2, 3, 4, 6, 8, 10, and 24 post-dose.

Time frame: 24-hour interval

Population: Cardiodynamic Analysis Set : all randomized subjects who received at least 1 dose of study medication and who had valid Day 1 QT/QTc interval measurements (predose and at least one postdose measurement).

ArmMeasureValue (LEAST_SQUARES_MEAN)Dispersion
33 mg/kg DeferiproneMaximum Difference in Change From Baseline in ddQTcF Following a Single Dose of Moxifloxacin14.7 millisecondsStandard Deviation 6.38
Placebo ControlMaximum Difference in Change From Baseline in ddQTcF Following a Single Dose of Moxifloxacin1.2 millisecondsStandard Deviation 6.46
90% CI: [11.1, 15.75]
Secondary

Number of Participants With Adverse Events

Number of participants with adverse events following therapeutic and supratherapeutic doses of deferiprone

Time frame: From administration of the first dose until 7 days +/- 1 day following the final dose

Population: The Safety Analysis Set consisted of all subjects who received at least 1 dose of study medication and had at least 1 safety assessment.

ArmMeasureValue (NUMBER)
33 mg/kg DeferiproneNumber of Participants With Adverse Events12 participants
Placebo ControlNumber of Participants With Adverse Events35 participants
Arm C - Placebo ControlNumber of Participants With Adverse Events10 participants
Arm D - Positive ControlNumber of Participants With Adverse Events5 participants
Secondary

T1/2 for Serum Deferiprone and Deferiprone 3-O-glucuronide

T1/2 was assessed over a 24-hour interval for analyses of deferiprone and its 3-O-glucuronide metabolite in healthy volunteers. Serial blood samples were collected prior to dosing and within 5 minutes following completion of each scheduled post-dose ECG at Hours 0.25, 0.5, 0.75, 1, 1.25, 1.5, 2, 3, 4, 6, 8, 10, and 24 post-dose.

Time frame: 24-hour interval

Population: The PK population consisted of all subjects who had taken study medication and had at least 1 PK sample collected.

ArmMeasureGroupValue (MEAN)Dispersion
33 mg/kg DeferiproneT1/2 for Serum Deferiprone and Deferiprone 3-O-glucuronideT1/2 for serum deferiprone1.8 hourStandard Deviation 0.3
33 mg/kg DeferiproneT1/2 for Serum Deferiprone and Deferiprone 3-O-glucuronideT1/2 for serum deferiprone 3-O-glucuronide2.5 hourStandard Deviation 0.5
Placebo ControlT1/2 for Serum Deferiprone and Deferiprone 3-O-glucuronideT1/2 for serum deferiprone1.8 hourStandard Deviation 0.3
Placebo ControlT1/2 for Serum Deferiprone and Deferiprone 3-O-glucuronideT1/2 for serum deferiprone 3-O-glucuronide2.6 hourStandard Deviation 0.2
Secondary

Tmax of Deferiprone and Deferiprone 3-O-glucuronide

To evaluate the Tmax of deferiprone and deferiprone 3-O-glucuronide following administration of single doses of 33 and 50 mg/kg deferiprone in healthy volunteers. Serial blood samples were collected prior to dosing and within 5 minutes following completion of each scheduled post-dose ECG at Hours 0.25, 0.5, 0.75, 1, 1.25, 1.5, 2, 3, 4, 6, 8, 10, and 24 post-dose.

Time frame: 24-hour interval

Population: The PK population consisted of all subjects who had taken study medication and had at least 1 PK sample collected.

ArmMeasureGroupValue (MEDIAN)Dispersion
33 mg/kg DeferiproneTmax of Deferiprone and Deferiprone 3-O-glucuronideTmax of serum deferiprone0.8185 hourFull Range 0.6
33 mg/kg DeferiproneTmax of Deferiprone and Deferiprone 3-O-glucuronideTmax of serum deferiprone -O-glucuronide3.066 hourFull Range 0.7
Placebo ControlTmax of Deferiprone and Deferiprone 3-O-glucuronideTmax of serum deferiprone0.8175 hourFull Range 0.9
Placebo ControlTmax of Deferiprone and Deferiprone 3-O-glucuronideTmax of serum deferiprone -O-glucuronide3.071 hourFull Range 0.7

Source: ClinicalTrials.gov · Data processed: Feb 4, 2026