← Trials/Trial dossier/NCT00594568

CompletedPhase 3Results posted

Effect of LY450139 on the Long Term Progression of Alzheimer's Disease

Effect of γ-Secretase Inhibition on the Progression of Alzheimer's Disease: LY450139 Versus Placebo

Lead sponsor

Eli Lilly and Company

Asset

Semagacestat

Listed sites

148

Recruiting sites

Enrollment

1,537

actual

Study population

Alzheimer’s disease

Key I/E criteria

•mild-to-moderate AD•MMSE 16-26

Primary endpoints

•ADAS-Cog•ADCS-Activities of Daily Living (ADCS-ADL)

Footprint

Where this trial recruits

Site locations as reported to ClinicalTrials.gov. Site count is not enrollment count; per-site enrollment is not available from source.

Identifiers

Registered as

Org study ID7666

RegistryCTRI/2009/091/000090India

Secondary IDH6L-MC-LFANEli Lilly and Company

NCT IDNCT00594568

Timeline

Milestones

Study first posted2008-01-15estimated

Study start2008-03 (month precision)

Primary completion2011-05actual (month precision)

Study completion2011-05actual (month precision)

Results first posted2014-09-25estimated

Last update posted2015-03-17estimated

Assets

Drug assets

Semagacestat

Study populations

Who this study enrolls

Alzheimer’s disease

Eligibility

Who can enroll

Minimum age55 Years

SexAll

Healthy volunteersNot accepted

Inclusion criteria

•Meets criteria for mild to moderate Alzheimer's disease (AD) with Mini-Mental State Examination (MMSE) score of 16-26 at Visit 1

•Modified Hachinski Ischemia Scale score of less than or equal to 4

•Geriatric Depression Scale score of less than or equal to 6

•A magnetic resonance imaging (MRI) or computerized tomography (CT) scan in the last 2 years with no findings inconsistent with a diagnosis of AD

•If female, must be without menstruation for at least 12 consecutive months or have had both ovaries removed

Exclusion criteria

•Is not capable of swallowing whole oral medication

•Has serious or unstable illnesses

•Does not have a reliable caregiver

•Chronic alcohol or drug abuse within the past 5 years

•Has ever had active vaccination for AD

Endpoints (54)

What's being measured

Protocol endpoints and posted registry outcome measures, grouped into outcome categories. Composite endpoints show their component event types. Standard codes (LOINC, SNOMED CT) are shown where available.

Coverage by outcome category

Memory

Global cognition

Behavior / neuropsychiatric

Amyloid biomarkers

Function / daily living

Tau biomarkers

Neuroimaging

Caregiver / quality of life

Safety / tolerability / PK

Global cognition

8 endpoints

Secondary/protocol endpoint

Change From Baseline in Mini Mental State Examination (MMSE) Score at 76 Weeks

Time frame:Baseline (randomization), 76 weeks

Mini-Mental State Examination (MMSE)

change from baseline, improvement

Secondary/protocol endpoint

Change From Baseline in Clinical Dementia Rating-Sum of Boxes (CDR-SB) Score at 76 Weeks

Time frame:Baseline (randomization), 76 weeks

Clinical Dementia Rating-Sum of Boxes (CDR-SB)

change from baseline, improvement

Secondary/protocol endpoint

Change From Baseline in Clinical Dementia Rating-Sum of Boxes (CDR-SB) Score at 4 Weeks After Cessation of Study Drug

Time frame:Baseline (randomization), 4 weeks following treatment cessation

Clinical Dementia Rating-Sum of Boxes (CDR-SB)

change from baseline, improvement

Secondary/protocol endpoint

Change From Baseline in Mini Mental State Examination (MMSE) Score at 4 Weeks After Cessation of Study Drug

Time frame:Baseline (randomization), 4 weeks following treatment cessation

Mini-Mental State Examination (MMSE)

change from baseline, improvement

Secondary/registry result

Change From Baseline in Mini Mental State Examination (MMSE) Score at 76 Weeks

Time frame:Baseline (randomization), 76 weeks

Mini-Mental State Examination (MMSE)

change from baseline, improvement

Posted result

Group	Value (least_squares_mean), units on a scale	Standard error
Placebon=376 Participants	-2.95	0.26
100 mg LY450139n=289 Participants	-3.14	0.27
140 mg LY450139n=274 Participants	-3.71	0.27

p0.518Mixed Models Analysis

p0.013Mixed Models Analysis

p0.072Mixed Models Analysis

Secondary/registry result

Change From Baseline in Clinical Dementia Rating-Sum of Boxes (CDR-SB) Score at 76 Weeks

Time frame:Baseline (randomization), 76 weeks

Clinical Dementia Rating-Sum of Boxes (CDR-SB)

change from baseline, improvement

Posted result

Group	Value (least_squares_mean), units on a scale	Standard error
Placebon=267 Participants	2.31	0.17
100 mg LY450139n=216 Participants	2.73	0.18
140 mg LY450139n=195 Participants	3.04	0.18

p0.069Mixed Models Analysis

p0.002Mixed Models Analysis

p0.198Mixed Models Analysis

Secondary/registry result

Change From Baseline in Clinical Dementia Rating-Sum of Boxes (CDR-SB) Score at 4 Weeks After Cessation of Study Drug

Time frame:Baseline (randomization), 4 weeks following treatment cessation

Clinical Dementia Rating-Sum of Boxes (CDR-SB)

change from baseline, improvement

Secondary/registry result

Change From Baseline in Mini Mental State Examination (MMSE) Score at 4 Weeks After Cessation of Study Drug

Time frame:Baseline (randomization), 4 weeks following treatment cessation

Mini-Mental State Examination (MMSE)

change from baseline, improvement

Memory

12 endpoints

Primary/protocol endpoint

Change From Baseline in Alzheimer's Disease Assessment Scale-Cognitive Subscale (ADAS-Cog11) Score at 76 Weeks

Time frame:Baseline (randomization), 76 weeks

ADAS-Cog

change from baseline, improvement

Primary/protocol endpoint

Change From Baseline in Alzheimer's Disease Assessment Scale-Cognitive Subscale (ADAS-Cog11) Score at 16 Weeks After Cessation of Study Drug

Time frame:Baseline (randomization), 16 weeks following treatment cessation

ADAS-Cog

change from baseline, improvement

Primary/registry result

Change From Baseline in Alzheimer's Disease Assessment Scale-Cognitive Subscale (ADAS-Cog11) Score at 76 Weeks

Time frame:Baseline (randomization), 76 weeks

ADAS-Cog

change from baseline, improvement

Posted result

Group	Value (least_squares_mean), units on a scale	Standard error
Placebon=270 Participants	6.19	0.54
100 mg LY450139n=216 Participants	7.29	0.57
140 mg LY450139n=199 Participants	7.68	0.59

p0.134Mixed Models Analysis

p0.045Mixed Models Analysis

p0.610Mixed Models Analysis

Primary/registry result

Change From Baseline in Alzheimer's Disease Assessment Scale-Cognitive Subscale (ADAS-Cog11) Score at 16 Weeks After Cessation of Study Drug

Time frame:Baseline (randomization), 16 weeks following treatment cessation

ADAS-Cog

change from baseline, improvement

Posted result

Group	Value (least_squares_mean), units on a scale	Standard error
Placebon=204 Participants	6.59	0.80
100 mg LY450139n=154 Participants	7.57	0.91
140 mg LY450139n=146 Participants	7.90	0.90

p0.296Mixed Models Analysis

p0.172Mixed Models Analysis

p0.746Mixed Models Analysis

Secondary/protocol endpoint

Change From Baseline in Alzheimer's Disease Assessment Scale-Cognitive Subscale (ADAS-Cog12) Score at 76 Weeks

Time frame:Baseline (randomization), 76 weeks

ADAS-Cog

change from baseline, improvement

Secondary/protocol endpoint

Change From Baseline in Alzheimer's Disease Assessment Scale-Cognitive Subscale (ADAS-Cog14) Score at 76 Weeks

Time frame:Baseline (randomization), 76 weeks

ADAS-Cog

change from baseline, improvement

Secondary/protocol endpoint

Change From Baseline in Alzheimer's Disease Assessment Scale-Cognitive Subscale (ADAS-Cog12) Score at 16 Weeks After Cessation of Study Drug

Time frame:Baseline (randomization), 16 weeks following treatment cessation

ADAS-Cog

change from baseline, improvement

Secondary/protocol endpoint

Change From Baseline in Alzheimer's Disease Assessment Scale-Cognitive Subscale (ADAS-Cog14) Score at 16 Weeks After Cessation of Study Drug

Time frame:Baseline (randomization), 16 weeks following treatment cessation

ADAS-Cog

change from baseline, improvement

Secondary/registry result

Change From Baseline in Alzheimer's Disease Assessment Scale-Cognitive Subscale (ADAS-Cog12) Score at 76 Weeks

Time frame:Baseline (randomization), 76 weeks

ADAS-Cog

change from baseline, improvement

Posted result

Group	Value (least_squares_mean), units on a scale	Standard error
Placebon=269 Participants	6.52	0.58
100 mg LY450139n=215 Participants	7.98	0.61
140 mg LY450139n=199 Participants	8.33	0.63

p0.062Mixed Models Analysis

p0.022Mixed Models Analysis

p0.669Mixed Models Analysis

Secondary/registry result

Change From Baseline in Alzheimer's Disease Assessment Scale-Cognitive Subscale (ADAS-Cog14) Score at 76 Weeks

Time frame:Baseline (randomization), 76 weeks

ADAS-Cog

change from baseline, improvement

Posted result

Group	Value (least_squares_mean), units on a scale	Standard error
Placebon=270 Participants	7.42	0.63
100 mg LY450139n=216 Participants	8.97	0.67
140 mg LY450139n=198 Participants	9.48	0.69

p0.071Mixed Models Analysis

p0.018Mixed Models Analysis

p0.571Mixed Models Analysis

Secondary/registry result

Change From Baseline in Alzheimer's Disease Assessment Scale-Cognitive Subscale (ADAS-Cog12) Score at 16 Weeks After Cessation of Study Drug

Time frame:Baseline (randomization), 16 weeks following treatment cessation

ADAS-Cog

change from baseline, improvement

Posted result

Group	Value (least_squares_mean), units on a scale	Standard error
Placebon=204 Participants	6.97	0.84
100 mg LY450139n=154 Participants	8.27	0.95
140 mg LY450139n=146 Participants	8.41	0.94

p0.186Mixed Models Analysis

p0.149Mixed Models Analysis

p0.889Mixed Models Analysis

Secondary/registry result

Change From Baseline in Alzheimer's Disease Assessment Scale-Cognitive Subscale (ADAS-Cog14) Score at 16 Weeks After Cessation of Study Drug

Time frame:Baseline (randomization), 16 weeks following treatment cessation

ADAS-Cog

change from baseline, improvement

Posted result

Group	Value (least_squares_mean), units on a scale	Standard error
Placebon=204 Participants	7.90	0.93
100 mg LY450139n=153 Participants	9.30	1.06
140 mg LY450139n=146 Participants	9.89	1.04

p0.202Mixed Models Analysis

p0.075Mixed Models Analysis

p0.616Mixed Models Analysis

Function / daily living

4 endpoints

Primary/protocol endpoint

Change From Baseline in Alzheimer's Disease Cooperative Study Activities of Daily Living (ADCS-ADL) Inventory Score at 76 Weeks

Time frame:Baseline (randomization), 76 weeks

ADCS-Activities of Daily Living (ADCS-ADL)

change from baseline, improvement

Primary/protocol endpoint

Change From Baseline in Alzheimer's Disease Cooperative Study Activities of Daily Living (ADCS-ADL) Inventory Score at 16 Weeks After Cessation of Study Drug

Time frame:Baseline (randomization), 16 weeks following treatment cessation

ADCS-Activities of Daily Living (ADCS-ADL)

change from baseline, improvement

Primary/registry result

Change From Baseline in Alzheimer's Disease Cooperative Study Activities of Daily Living (ADCS-ADL) Inventory Score at 76 Weeks

Time frame:Baseline (randomization), 76 weeks

ADCS-Activities of Daily Living (ADCS-ADL)

change from baseline, improvement

Posted result

Group	Value (least_squares_mean), units on a scale	Standard error
Placebon=266 Participants	-8.76	0.72
100 mg LY450139n=216 Participants	-10.13	0.77
140 mg LY450139n=197 Participants	-12.70	0.79

p0.166Mixed Models Analysis

p<0.001Mixed Models Analysis

p0.014Mixed Models Analysis

Primary/registry result

Change From Baseline in Alzheimer's Disease Cooperative Study Activities of Daily Living (ADCS-ADL) Inventory Score at 16 Weeks After Cessation of Study Drug

Time frame:Baseline (randomization), 16 weeks following treatment cessation

ADCS-Activities of Daily Living (ADCS-ADL)

change from baseline, improvement

Posted result

Group	Value (least_squares_mean), units on a scale	Standard error
Placebon=198 Participants	-9.26	1.14
100 mg LY450139n=153 Participants	-9.15	1.28
140 mg LY450139n=147 Participants	-11.73	1.26

p0.935Mixed Models Analysis

p0.068Mixed Models Analysis

p0.070Mixed Models Analysis

Behavior / neuropsychiatric

8 endpoints

Secondary/protocol endpoint

Change From Baseline in Neuropsychiatric Inventory (NPI) Score at 76 Weeks

Time frame:Baseline (randomization), 76 weeks

Neuropsychiatric Inventory (NPI)

change from baseline, improvement

Secondary/protocol endpoint

Change From Baseline in EuroQol 5-Dimensional Health-Related Quality of Life Scale Proxy Version (EQ-5D Proxy) Visual Analog Scale (VAS) Score at 76 Weeks

Time frame:Baseline (randomization), 76 weeks

change from baseline, improvement

Secondary/protocol endpoint

Change From Baseline in Neuropsychiatric Inventory (NPI) Score at 4 Weeks After Cessation of Study Drug

Time frame:Baseline (randomization), 4 weeks following treatment cessation

Neuropsychiatric Inventory (NPI)

change from baseline, improvement

Secondary/protocol endpoint

Change From Baseline in EuroQol 5-Dimensional Health-Related Quality of Life Scale Proxy Version (EQ-5D Proxy) Visual Analog Scale (VAS) Score at 4 Weeks After Cessation of Study Drug

Time frame:Baseline (randomization), 4 weeks following treatment cessation

change from baseline, improvement

Secondary/registry result

Change From Baseline in Neuropsychiatric Inventory (NPI) Score at 76 Weeks

Time frame:Baseline (randomization), 76 weeks

Neuropsychiatric Inventory (NPI)

change from baseline, improvement

Posted result

Group	Value (least_squares_mean), units on a scale	Standard error
Placebon=369 Participants	1.92	0.75
100 mg LY450139n=298 Participants	3.31	0.79
140 mg LY450139n=271 Participants	4.15	0.81

p0.127Mixed Models Analysis

p0.016Mixed Models Analysis

p0.381Mixed Models Analysis

Secondary/registry result

Change From Baseline in EuroQol 5-Dimensional Health-Related Quality of Life Scale Proxy Version (EQ-5D Proxy) Visual Analog Scale (VAS) Score at 76 Weeks

Time frame:Baseline (randomization), 76 weeks

change from baseline, improvement

Posted result

Group	Value (least_squares_mean), units on a scale	Standard error
Placebon=374 Participants	-1.41	1.11
100 mg LY450139n=300 Participants	-7.49	1.20
140 mg LY450139n=275 Participants	-5.33	1.22

p<0.001Mixed Models Analysis

p0.005Mixed Models Analysis

p0.141Mixed Models Analysis

Secondary/registry result

Change From Baseline in Neuropsychiatric Inventory (NPI) Score at 4 Weeks After Cessation of Study Drug

Time frame:Baseline (randomization), 4 weeks following treatment cessation

Neuropsychiatric Inventory (NPI)

change from baseline, improvement

Secondary/registry result

Change From Baseline in EuroQol 5-Dimensional Health-Related Quality of Life Scale Proxy Version (EQ-5D Proxy) Visual Analog Scale (VAS) Score at 4 Weeks After Cessation of Study Drug

Time frame:Baseline (randomization), 4 weeks following treatment cessation

change from baseline, improvement

Amyloid biomarkers

6 endpoints

Secondary/protocol endpoint

Percent Change From Baseline in Amyloid Beta (Aβ) 1-42 Plasma Concentration at 52 Weeks

Time frame:Baseline (randomization), 52 weeks

percent change from baseline, improvement

Secondary/protocol endpoint

Change From Baseline in Amyloid Imaging Positron Emission Tomography (AV-45 PET) up to 76 Weeks

Time frame:Baseline (randomization), up to 76 weeks

change from baseline, improvement

Secondary/protocol endpoint

Change From Baseline in Amyloid Beta (Aβ) 1-42 Concentration in Spinal Fluid up to 76 Weeks

Time frame:Baseline (randomization), up to 76 weeks

change from baseline, improvement

Secondary/registry result

Percent Change From Baseline in Amyloid Beta (Aβ) 1-42 Plasma Concentration at 52 Weeks

Time frame:Baseline (randomization), 52 weeks

percent change from baseline, improvement

Posted result

Group	Value (least_squares_mean), picogram per milliliter (pg/mL)	Standard error
Placebon=309 Participants	3.86	2.32
100 mg LY450139n=265 Participants	-5.97	2.50
140 mg LY450139n=245 Participants	-19.95	2.58

p0.002ANCOVA

p<0.001ANCOVA

Secondary/registry result

Change From Baseline in Amyloid Imaging Positron Emission Tomography (AV-45 PET) up to 76 Weeks

Time frame:Baseline (randomization), up to 76 weeks

change from baseline, improvement

Posted result

Group	Value (least_squares_mean), ratio	Standard error
Placebon=18 Participants	0.08	0.06
100 mg LY450139n=23 Participants	0.06	0.06
140 mg LY450139n=18 Participants	0.09	0.07

p0.784ANCOVA

p0.931ANCOVA

p0.718ANCOVA

Secondary/registry result

Change From Baseline in Amyloid Beta (Aβ) 1-42 Concentration in Spinal Fluid up to 76 Weeks

Time frame:Baseline (randomization), up to 76 weeks

change from baseline, improvement

Posted result

Group	Value (least_squares_mean), picogram per milliliter (pg/mL)	Standard error
Placebon=10 Participants	-86.16	50.89
100 mg LY450139n=19 Participants	23.27	34.55
140 mg LY450139n=18 Participants	-40.51	31.68

Tau biomarkers

4 endpoints

Secondary/protocol endpoint

Change From Baseline in Tau Concentration in Spinal Fluid up to 76 Weeks

Time frame:Baseline (randomization), up to 76 weeks

change from baseline, improvement

Secondary/protocol endpoint

Change From Baseline in Phosphorylated-Tau (P-Tau) Concentration in Spinal Fluid

Time frame:Baseline (randomization), up to 76 weeks

change from baseline, improvement

Secondary/registry result

Change From Baseline in Tau Concentration in Spinal Fluid up to 76 Weeks

Time frame:Baseline (randomization), up to 76 weeks

change from baseline, improvement

Posted result

Group	Value (least_squares_mean), picogram per milliliter (pg/mL)	Standard error
Placebon=10 Participants	75.11	92.02
100 mg LY450139n=17 Participants	20.50	69.54
140 mg LY450139n=18 Participants	61.00	59.07

p0.634ANCOVA

p0.901ANCOVA

p0.659ANCOVA

Secondary/registry result

Change From Baseline in Phosphorylated-Tau (P-Tau) Concentration in Spinal Fluid

Time frame:Baseline (randomization), up to 76 weeks

change from baseline, improvement

Posted result

Group	Value (least_squares_mean), picogram per milliliter (pg/mL)	Standard error
Placebon=10 Participants	9.75	7.67
100 mg LY450139n=19 Participants	-6.26	5.46
140 mg LY450139n=18 Participants	-5.13	5.04

Neuroimaging

4 endpoints

Secondary/protocol endpoint

Change From Baseline in Positron Emission Tomography (PET) Using Fluorine-18 Fluorodeoxyglucose (18F-FDG) at 76 Weeks

Time frame:Baseline (randomization), 76 weeks

change from baseline, improvement

Secondary/protocol endpoint

Change From Baseline in Hippocampal Volume Using Volumetric Magnetic Resonance Imaging (vMRI) up to 76 Weeks

Time frame:Baseline (randomization), up to 76 weeks

change from baseline, improvement

Secondary/registry result

Change From Baseline in Positron Emission Tomography (PET) Using Fluorine-18 Fluorodeoxyglucose (18F-FDG) at 76 Weeks

Time frame:Baseline (randomization), 76 weeks

change from baseline, improvement

Posted result

Group	Value (least_squares_mean), ratio	Standard error
Placebon=40 Participants	-0.08	0.01
100 mg LY450139n=42 Participants	-0.12	0.01
140 mg LY450139n=43 Participants	-0.11	0.02

p0.038ANCOVA

p0.147ANCOVA

p0.604ANCOVA

Secondary/registry result

Change From Baseline in Hippocampal Volume Using Volumetric Magnetic Resonance Imaging (vMRI) up to 76 Weeks

Time frame:Baseline (randomization), up to 76 weeks

change from baseline, improvement

Posted result

Group	Value (least_squares_mean), cubic millimeter (mm^3)	Standard error
PlaceboLeft Hippocampal Volumen=75 Participants	-96.54	10.73
Right Hippocampal Volumen=75 Participants	-108.69	11.56
100 mg LY450139Left Hippocampal Volumen=69 Participants	-75.34	11.06
Right Hippocampal Volumen=69 Participants	-93.89	12.19
140 mg LY450139Left Hippocampal Volumen=64 Participants	-107.62	11.38
Right Hippocampal Volumen=64 Participants	-112.40	12.52

p0.143ANCOVA

p0.464ANCOVA

p0.025ANCOVA

p0.347ANCOVA

p0.820ANCOVA

p0.243ANCOVA

Caregiver / quality of life

4 endpoints

Secondary/protocol endpoint

Change From Baseline in Resource Utilization in Dementia-Lite (RUD-Lite) Score (Number of Hospitalizations) up to 76 Weeks

Time frame:Baseline (randomization), up to 76 weeks

change from baseline, improvement

Secondary/protocol endpoint

Change From Baseline in Resource Utilization in Dementia-Lite (RUD-Lite) Score (Number of Hospitalizations) at 4 Weeks After Cessation of Study Drug

Time frame:Baseline (randomization), 4 weeks following treatment cessation

change from baseline, improvement

Secondary/registry result

Change From Baseline in Resource Utilization in Dementia-Lite (RUD-Lite) Score (Number of Hospitalizations) up to 76 Weeks

Time frame:Baseline (randomization), up to 76 weeks

change from baseline, improvement

Posted result

Group	Value (least_squares_mean), hospitalizations/participant	Standard error
Placebon=82 Participants	0.55	0.09
100 mg LY450139n=98 Participants	0.66	0.07
140 mg LY450139n=94 Participants	0.83	0.08

p0.337ANCOVA

p0.018ANCOVA

p0.157ANCOVA

Secondary/registry result

Change From Baseline in Resource Utilization in Dementia-Lite (RUD-Lite) Score (Number of Hospitalizations) at 4 Weeks After Cessation of Study Drug

Time frame:Baseline (randomization), 4 weeks following treatment cessation

change from baseline, improvement

Safety / tolerability / PK

4 endpoints

Secondary/protocol endpoint

LY450139 Population Pharmacokinetics: Clearance of LY450139

Time frame:6 weeks, 12 weeks, and 52 weeks

descriptive

Secondary/protocol endpoint

LY450139 Population Pharmacokinetics: Volume of Distribution of LY450139

Time frame:6 weeks, 12 weeks, and 52 weeks

descriptive

Secondary/registry result

LY450139 Population Pharmacokinetics: Clearance of LY450139

Time frame:6 weeks, 12 weeks, and 52 weeks

descriptive

Posted result

Group	Value (geometric_mean), liter per hour (L/h)	Geometric coefficient of variation
LY450139n=974 Participants	18.8	26.8

Secondary/registry result

LY450139 Population Pharmacokinetics: Volume of Distribution of LY450139

Time frame:6 weeks, 12 weeks, and 52 weeks

descriptive

Posted result

Group	Value (geometric_mean), liter (L)	Geometric coefficient of variation
LY450139n=974 Participants	66.8	26.1

Publications (4)

Bibliography

Records linked to this trial through ClinicalTrials.gov references, PubMed NCT search, and curated study seeds. 'Canonical' marks design/result papers; others are registry references or candidates.

Registry references + supporting bibliography

Provenance

Sources

Trial identity, design, statusClinicalTrials.gov API v2

Snapshot dateJuly 21, 2026

Endpoint classificationDelfa ADRD endpoint taxonomy

Results tableClinicalTrials.gov results section

Trial facts come from public ClinicalTrials.gov records. Endpoint categories are Delfa's classification of those records, not a ClinicalTrials.gov field. All figures reflect the July 21, 2026 snapshot.