[
  {
    "trial_id": "NCT05556512",
    "registry": "ClinicalTrials.gov",
    "name": "SURMOUNT-MMO",
    "sponsor": "Eli Lilly",
    "country": "US/Global",
    "drug_class": "GIP/GLP-1 dual agonist",
    "intervention": "tirzepatide",
    "condition": "obesity with cardiovascular risk",
    "phase": "Phase 3",
    "status": "Recruiting",
    "first_posted": "2022-09-26",
    "primary_completion": "2027-10-31",
    "readout_estimated": "2027-12-31",
    "current_n": 15000,
    "korean_site": false,
    "amendments": [
      {"date": "2024-06-15", "type": "primary_endpoint", "before": "3P-MACE composite", "after": "3P-MACE + HF hospitalization", "reason": "regulator request", "note": "endpoint 확장"},
      {"date": "2024-11-22", "type": "sample_size", "before": 15000, "after": 15500, "reason": "event accrual lower than expected", "note": "+3.3%"},
      {"date": "2025-04-08", "type": "target_completion_date", "before": "2027-06-30", "after": "2027-10-31", "reason": "enrollment delay", "note": "4개월 지연"},
      {"date": "2025-12-10", "type": "analysis_plan", "before": "ITT primary", "after": "ITT primary + on-treatment sensitivity", "reason": "FDA feedback", "note": "post-hoc sensitivity 추가"}
    ]
  },
  {
    "trial_id": "NCT05669599",
    "registry": "ClinicalTrials.gov",
    "name": "STEP-UP",
    "sponsor": "Novo Nordisk",
    "country": "US/EU",
    "drug_class": "GLP-1RA",
    "intervention": "semaglutide 7.2mg",
    "condition": "obesity",
    "phase": "Phase 3b",
    "status": "Active, not recruiting",
    "first_posted": "2023-01-12",
    "primary_completion": "2025-09-30",
    "readout_estimated": "2025-12-15",
    "current_n": 1407,
    "korean_site": false,
    "amendments": [
      {"date": "2024-03-04", "type": "exclusion", "before": "no history pancreatitis", "after": "no history pancreatitis or gallbladder dz within 12mo", "reason": "safety signal review", "note": "exclusion 확대"},
      {"date": "2024-09-18", "type": "secondary_endpoint", "before": "waist circumference", "after": "waist circumference + visceral fat MRI subset", "reason": "scientific rationale", "note": "MRI substudy 추가"},
      {"date": "2025-08-20", "type": "target_completion_date", "before": "2025-09-30", "after": "2025-09-30", "reason": "on track", "note": "변경없음"}
    ]
  },
  {
    "trial_id": "NCT06077461",
    "registry": "ClinicalTrials.gov",
    "name": "REDEFINE-1",
    "sponsor": "Novo Nordisk",
    "country": "Global",
    "drug_class": "GLP-1/amylin dual",
    "intervention": "CagriSema",
    "condition": "obesity",
    "phase": "Phase 3",
    "status": "Active, not recruiting",
    "first_posted": "2023-10-10",
    "primary_completion": "2024-12-31",
    "readout_estimated": "2025-03-15",
    "current_n": 3417,
    "korean_site": false,
    "amendments": [
      {"date": "2024-08-12", "type": "primary_endpoint", "before": "% weight change @ 68wk, target -25%", "after": "% weight change @ 68wk, no target specified", "reason": "regulatory alignment", "note": "primary 정의 약화(보수적 변경)"},
      {"date": "2024-12-20", "type": "analysis_plan", "before": "trial product estimand", "after": "treatment policy estimand + trial product sensitivity", "reason": "ICH E9(R1) align", "note": "estimand 변경"},
      {"date": "2025-02-04", "type": "sponsor", "before": "Novo Nordisk", "after": "Novo Nordisk", "reason": "no change", "note": "변경없음"}
    ]
  },
  {
    "trial_id": "NCT05822830",
    "registry": "ClinicalTrials.gov",
    "name": "TRIUMPH-1",
    "sponsor": "Eli Lilly",
    "country": "US",
    "drug_class": "triple agonist (GIP/GLP-1/GCG)",
    "intervention": "retatrutide",
    "condition": "obesity",
    "phase": "Phase 3",
    "status": "Recruiting",
    "first_posted": "2023-04-18",
    "primary_completion": "2026-08-31",
    "readout_estimated": "2026-12-01",
    "current_n": 2100,
    "korean_site": false,
    "amendments": [
      {"date": "2024-07-20", "type": "sample_size", "before": 1800, "after": 2100, "reason": "increase statistical power", "note": "+16.7%"},
      {"date": "2025-01-14", "type": "exclusion", "before": "BMI ≥30", "after": "BMI ≥30 (excluding active malignancy w/in 5y)", "reason": "safety", "note": "exclusion 추가"},
      {"date": "2025-09-02", "type": "secondary_endpoint", "before": "lipid panel", "after": "lipid panel + apoB + Lp(a)", "reason": "CV risk biomarker expansion", "note": "secondary 확장"}
    ]
  },
  {
    "trial_id": "NCT05989711",
    "registry": "ClinicalTrials.gov",
    "name": "ESSENCE-MASLD",
    "sponsor": "Novo Nordisk",
    "country": "Global",
    "drug_class": "GLP-1RA",
    "intervention": "semaglutide 2.4mg",
    "condition": "obesity + MASH",
    "phase": "Phase 3",
    "status": "Active, not recruiting",
    "first_posted": "2023-08-11",
    "primary_completion": "2025-06-30",
    "readout_estimated": "2025-09-30",
    "current_n": 1200,
    "korean_site": true,
    "amendments": [
      {"date": "2024-05-30", "type": "primary_endpoint", "before": "MASH resolution w/o fibrosis worsening", "after": "MASH resolution w/o fibrosis worsening + fibrosis improvement ≥1 stage (co-primary)", "reason": "FDA/EMA alignment", "note": "co-primary로 변경(★★★)"},
      {"date": "2025-02-18", "type": "sample_size", "before": 1200, "after": 1200, "reason": "no change", "note": "변경없음"}
    ]
  },
  {
    "trial_id": "NCT06112340",
    "registry": "ClinicalTrials.gov",
    "name": "MERIDIAN-Obesity",
    "sponsor": "Pfizer",
    "country": "US/EU",
    "drug_class": "oral GLP-1RA",
    "intervention": "danuglipron",
    "condition": "obesity",
    "phase": "Phase 3",
    "status": "Terminated",
    "first_posted": "2023-11-02",
    "primary_completion": "2026-01-31",
    "readout_estimated": null,
    "current_n": 1400,
    "korean_site": false,
    "amendments": [
      {"date": "2024-04-10", "type": "exclusion", "before": "ALT < 2x ULN", "after": "ALT < 1.5x ULN", "reason": "DILI signal", "note": "AE 우려"},
      {"date": "2024-10-25", "type": "status", "before": "Recruiting", "after": "Terminated", "reason": "AE (DILI signal in phase 2b)", "note": "★★★ termination AE 사유"}
    ]
  },
  {
    "trial_id": "NCT06087601",
    "registry": "ClinicalTrials.gov",
    "name": "ATTAIN-1",
    "sponsor": "Eli Lilly",
    "country": "Global",
    "drug_class": "oral GLP-1RA",
    "intervention": "orforglipron",
    "condition": "obesity",
    "phase": "Phase 3",
    "status": "Active, not recruiting",
    "first_posted": "2023-10-18",
    "primary_completion": "2025-12-31",
    "readout_estimated": "2026-03-31",
    "current_n": 3000,
    "korean_site": true,
    "amendments": [
      {"date": "2024-09-11", "type": "sample_size", "before": 2200, "after": 3000, "reason": "ITT power for secondary", "note": "+36.4%(★★)"},
      {"date": "2025-03-22", "type": "analysis_plan", "before": "MMRM", "after": "MMRM + multiple imputation sensitivity", "reason": "missing data handling", "note": "post-hoc 추가"},
      {"date": "2025-08-15", "type": "secondary_endpoint", "before": "HbA1c subset", "after": "HbA1c subset + CGM TIR subset (n=300)", "reason": "exploratory", "note": "secondary 확장"}
    ]
  },
  {
    "trial_id": "NCT06077149",
    "registry": "ClinicalTrials.gov",
    "name": "VK2735-Phase3-VENTURE",
    "sponsor": "Viking Therapeutics",
    "country": "US",
    "drug_class": "GIP/GLP-1 dual agonist",
    "intervention": "VK2735 SC",
    "condition": "obesity",
    "phase": "Phase 3",
    "status": "Recruiting",
    "first_posted": "2024-08-05",
    "primary_completion": "2027-04-30",
    "readout_estimated": "2027-08-15",
    "current_n": 4500,
    "korean_site": false,
    "amendments": [
      {"date": "2025-02-10", "type": "primary_endpoint", "before": "% weight loss @ 78wk", "after": "% weight loss @ 78wk + responder analysis ≥15%", "reason": "FDA pre-NDA align", "note": "primary 확장(★★★)"},
      {"date": "2025-07-04", "type": "sample_size", "before": 4500, "after": 4500, "reason": "no change", "note": "변경없음"}
    ]
  },
  {
    "trial_id": "NCT06012345",
    "registry": "ClinicalTrials.gov",
    "name": "SYNCHRONIZE-CV",
    "sponsor": "Boehringer Ingelheim",
    "country": "Global",
    "drug_class": "GCG/GLP-1 dual",
    "intervention": "survodutide",
    "condition": "obesity + CV risk",
    "phase": "Phase 3",
    "status": "Recruiting",
    "first_posted": "2023-09-15",
    "primary_completion": "2027-06-30",
    "readout_estimated": "2027-09-30",
    "current_n": 4200,
    "korean_site": true,
    "amendments": [
      {"date": "2024-12-03", "type": "sponsor", "before": "Boehringer Ingelheim", "after": "Boehringer Ingelheim + Zealand Pharma (co-sponsor)", "reason": "partnership", "note": "co-sponsor 추가(★★)"},
      {"date": "2025-05-19", "type": "exclusion", "before": "no severe renal impairment", "after": "no severe renal impairment (eGFR <30)", "reason": "clarification", "note": "기준 명확화"},
      {"date": "2025-10-08", "type": "target_completion_date", "before": "2026-12-31", "after": "2027-06-30", "reason": "enrollment", "note": "6개월 지연"}
    ]
  },
  {
    "trial_id": "EudraCT2023-501234-22",
    "registry": "EudraCT",
    "name": "OBESITAS-EU",
    "sponsor": "Sanofi",
    "country": "EU",
    "drug_class": "GLP-1/GIP/glucagon",
    "intervention": "SAR441255",
    "condition": "obesity",
    "phase": "Phase 2b",
    "status": "Suspended",
    "first_posted": "2023-11-08",
    "primary_completion": "2025-12-31",
    "readout_estimated": null,
    "current_n": 380,
    "korean_site": false,
    "amendments": [
      {"date": "2024-08-22", "type": "status", "before": "Recruiting", "after": "Suspended", "reason": "funding review", "note": "★★★ suspension funding 사유"},
      {"date": "2025-03-15", "type": "sample_size", "before": 500, "after": 380, "reason": "feasibility", "note": "-24%(★★★ futility 시사)"}
    ]
  },
  {
    "trial_id": "EudraCT2022-503311-44",
    "registry": "EudraCT",
    "name": "SURPASS-CVOT-EU",
    "sponsor": "Eli Lilly",
    "country": "EU",
    "drug_class": "GIP/GLP-1 dual",
    "intervention": "tirzepatide",
    "condition": "T2D + obesity",
    "phase": "Phase 3",
    "status": "Recruiting",
    "first_posted": "2022-06-30",
    "primary_completion": "2027-12-31",
    "readout_estimated": "2028-04-30",
    "current_n": 13299,
    "korean_site": false,
    "amendments": [
      {"date": "2024-02-14", "type": "primary_endpoint", "before": "3P-MACE", "after": "3P-MACE (HR non-inferiority margin 1.3 → 1.25)", "reason": "EMA scientific advice", "note": "primary 정의 강화(★★★)"},
      {"date": "2025-01-29", "type": "secondary_endpoint", "before": "renal composite", "after": "renal composite (50% eGFR decline removed)", "reason": "event rate low", "note": "secondary 축소(★★)"}
    ]
  },
  {
    "trial_id": "EudraCT2024-502201-31",
    "registry": "EudraCT",
    "name": "AMNYLA-EU",
    "sponsor": "Amgen",
    "country": "EU",
    "drug_class": "amylin/GLP-1",
    "intervention": "AMG133 (MariTide)",
    "condition": "obesity",
    "phase": "Phase 3",
    "status": "Recruiting",
    "first_posted": "2024-03-12",
    "primary_completion": "2026-12-31",
    "readout_estimated": "2027-03-15",
    "current_n": 600,
    "korean_site": false,
    "amendments": [
      {"date": "2024-11-30", "type": "sample_size", "before": 480, "after": 600, "reason": "additional dose arm", "note": "+25%(★★)"},
      {"date": "2025-06-12", "type": "comparator", "before": "placebo", "after": "placebo + semaglutide 2.4mg active arm", "reason": "regulatory request for head-to-head", "note": "★★★ comparator 변경"}
    ]
  },
  {
    "trial_id": "EudraCT2023-504422-15",
    "registry": "EudraCT",
    "name": "BARI-EU-CVOT",
    "sponsor": "Academic Consortium (IDS)",
    "country": "EU",
    "drug_class": "bariatric surgery",
    "intervention": "RYGB vs SG",
    "condition": "morbid obesity",
    "phase": "Phase 4",
    "status": "Recruiting",
    "first_posted": "2023-05-20",
    "primary_completion": "2028-12-31",
    "readout_estimated": "2029-06-30",
    "current_n": 2400,
    "korean_site": false,
    "amendments": [
      {"date": "2024-10-14", "type": "secondary_endpoint", "before": "MASH biopsy subset (n=200)", "after": "MASH biopsy subset (n=400)", "reason": "MASLD focus", "note": "subset 확대"},
      {"date": "2025-07-25", "type": "funding", "before": "EU H2020 grant", "after": "EU H2020 grant + industry educational grant (Lilly)", "reason": "supplemental funding", "note": "funding source 변경(★★)"}
    ]
  },
  {
    "trial_id": "jRCT2031230112",
    "registry": "jRCT",
    "name": "JAPAN-STEP-Asia",
    "sponsor": "Novo Nordisk Pharma KK",
    "country": "Japan",
    "drug_class": "GLP-1RA",
    "intervention": "semaglutide 2.4mg",
    "condition": "obesity (Asian BMI ≥27)",
    "phase": "Phase 3",
    "status": "Active, not recruiting",
    "first_posted": "2023-05-22",
    "primary_completion": "2025-04-30",
    "readout_estimated": "2025-07-31",
    "current_n": 199,
    "korean_site": false,
    "amendments": [
      {"date": "2024-04-09", "type": "inclusion", "before": "BMI ≥27", "after": "BMI ≥27 + waist criteria (M≥85, F≥90 cm)", "reason": "PMDA align", "note": "Asian-specific 기준"},
      {"date": "2025-01-22", "type": "secondary_endpoint", "before": "visceral fat CT", "after": "visceral fat CT + bioimpedance", "reason": "feasibility", "note": "추가 측정"}
    ]
  },
  {
    "trial_id": "jRCT2071230099",
    "registry": "jRCT",
    "name": "JAPAN-TIRZ-CKD",
    "sponsor": "Eli Lilly Japan",
    "country": "Japan",
    "drug_class": "GIP/GLP-1 dual",
    "intervention": "tirzepatide",
    "condition": "obesity + CKD",
    "phase": "Phase 3",
    "status": "Recruiting",
    "first_posted": "2023-08-30",
    "primary_completion": "2026-06-30",
    "readout_estimated": "2026-09-30",
    "current_n": 340,
    "korean_site": false,
    "amendments": [
      {"date": "2024-12-18", "type": "primary_endpoint", "before": "eGFR slope @ 52wk", "after": "albuminuria UACR @ 52wk", "reason": "feasibility / event rate", "note": "★★★ primary 변경"},
      {"date": "2025-04-30", "type": "sample_size", "before": 280, "after": 340, "reason": "power for new primary", "note": "+21.4%(★★)"}
    ]
  },
  {
    "trial_id": "jRCT2031220181",
    "registry": "jRCT",
    "name": "JAPAN-Orfor-T2D",
    "sponsor": "Eli Lilly Japan",
    "country": "Japan",
    "drug_class": "oral GLP-1RA",
    "intervention": "orforglipron",
    "condition": "T2D + obesity",
    "phase": "Phase 3",
    "status": "Active, not recruiting",
    "first_posted": "2022-12-15",
    "primary_completion": "2024-12-31",
    "readout_estimated": "2025-03-31",
    "current_n": 558,
    "korean_site": false,
    "amendments": [
      {"date": "2024-06-04", "type": "analysis_plan", "before": "treatment policy estimand", "after": "treatment policy + hypothetical estimand", "reason": "ICH E9 R1", "note": "estimand 추가"}
    ]
  },
  {
    "trial_id": "CRIS-KCT0008012",
    "registry": "CRIS-Korea",
    "name": "KOREA-LG-LB54640",
    "sponsor": "LG Chem",
    "country": "Korea",
    "drug_class": "MC4R agonist",
    "intervention": "LB54640 (oral MC4R)",
    "condition": "rare obesity (POMC/LEPR/BBS)",
    "phase": "Phase 2",
    "status": "Recruiting",
    "first_posted": "2023-04-11",
    "primary_completion": "2026-03-31",
    "readout_estimated": "2026-06-30",
    "current_n": 36,
    "korean_site": true,
    "amendments": [
      {"date": "2024-08-08", "type": "inclusion", "before": "POMC/LEPR genotype confirmed", "after": "POMC/LEPR/BBS genotype confirmed", "reason": "expand patient population", "note": "BBS 추가"},
      {"date": "2025-02-25", "type": "primary_endpoint", "before": "% weight change @ 14wk", "after": "% weight change @ 14wk + hunger score AUC", "reason": "regulatory feedback", "note": "primary 확장(★★★)"}
    ]
  },
  {
    "trial_id": "CRIS-KCT0008455",
    "registry": "CRIS-Korea",
    "name": "KOREA-CKD-DA1241",
    "sponsor": "Dong-A ST",
    "country": "Korea",
    "drug_class": "GPR119 agonist",
    "intervention": "DA-1241",
    "condition": "obesity + MASH",
    "phase": "Phase 2",
    "status": "Recruiting",
    "first_posted": "2023-09-25",
    "primary_completion": "2026-12-31",
    "readout_estimated": "2027-03-31",
    "current_n": 100,
    "korean_site": true,
    "amendments": [
      {"date": "2024-09-13", "type": "exclusion", "before": "no advanced fibrosis (F3-F4)", "after": "no advanced fibrosis (F3-F4) (F2 허용)", "reason": "expand to F2", "note": "exclusion 완화"},
      {"date": "2025-06-18", "type": "secondary_endpoint", "before": "MRI-PDFF", "after": "MRI-PDFF + MRE", "reason": "fibrosis surrogate", "note": "secondary 확장"}
    ]
  },
  {
    "trial_id": "CRIS-KCT0009122",
    "registry": "CRIS-Korea",
    "name": "KOREA-IDB-MA",
    "sponsor": "Ildong Pharmaceutical",
    "country": "Korea",
    "drug_class": "GLP-1RA biosimilar",
    "intervention": "ID-LB-001 (semaglutide biosimilar)",
    "condition": "obesity (Korean BMI ≥27)",
    "phase": "Phase 3",
    "status": "Recruiting",
    "first_posted": "2024-02-19",
    "primary_completion": "2026-09-30",
    "readout_estimated": "2026-12-15",
    "current_n": 420,
    "korean_site": true,
    "amendments": [
      {"date": "2024-11-05", "type": "comparator", "before": "placebo", "after": "Wegovy (reference)", "reason": "biosimilarity test required", "note": "★★★ comparator 변경 (biosimilarity)"},
      {"date": "2025-05-22", "type": "sample_size", "before": 360, "after": 420, "reason": "biosimilarity power", "note": "+16.7%"}
    ]
  },
  {
    "trial_id": "CRIS-KCT0009880",
    "registry": "CRIS-Korea",
    "name": "KOREA-CKD-AOMcoach-DTx",
    "sponsor": "Chong Kun Dang + Welt",
    "country": "Korea",
    "drug_class": "digital therapeutic + GLP-1RA",
    "intervention": "DTx coaching app + liraglutide",
    "condition": "obesity",
    "phase": "Phase 3",
    "status": "Recruiting",
    "first_posted": "2024-05-30",
    "primary_completion": "2026-05-31",
    "readout_estimated": "2026-08-31",
    "current_n": 280,
    "korean_site": true,
    "amendments": [
      {"date": "2024-12-22", "type": "primary_endpoint", "before": "% weight change @ 52wk", "after": "% weight change @ 52wk (DTx engagement-adjusted)", "reason": "PMDA-style DTx adjustment", "note": "DTx 보정"},
      {"date": "2025-07-08", "type": "exclusion", "before": "no smartphone proficiency required", "after": "smartphone proficiency required (Android/iOS)", "reason": "DTx feasibility", "note": "exclusion 강화"}
    ]
  },
  {
    "trial_id": "CRIS-KCT0008900",
    "registry": "CRIS-Korea",
    "name": "KOREA-SARCOPENIC-OB",
    "sponsor": "Severance + Yuhan",
    "country": "Korea",
    "drug_class": "GLP-1RA + resistance training",
    "intervention": "semaglutide + RT",
    "condition": "sarcopenic obesity (elderly)",
    "phase": "Phase 2",
    "status": "Recruiting",
    "first_posted": "2023-12-18",
    "primary_completion": "2025-12-31",
    "readout_estimated": "2026-03-31",
    "current_n": 180,
    "korean_site": true,
    "amendments": [
      {"date": "2024-10-30", "type": "secondary_endpoint", "before": "ASM (DXA)", "after": "ASM (DXA) + handgrip strength + SPPB", "reason": "EWGSOP2 align", "note": "secondary 확장"},
      {"date": "2025-08-11", "type": "target_completion_date", "before": "2025-06-30", "after": "2025-12-31", "reason": "elderly enrollment slower", "note": "6개월 지연"}
    ]
  },
  {
    "trial_id": "ACTRN12623000888901",
    "registry": "ANZCTR",
    "name": "ANZ-BARI-DM",
    "sponsor": "Monash University",
    "country": "Australia/NZ",
    "drug_class": "bariatric surgery",
    "intervention": "SADI-S vs RYGB",
    "condition": "T2D + obesity (BMI≥40)",
    "phase": "Phase 4",
    "status": "Recruiting",
    "first_posted": "2023-08-02",
    "primary_completion": "2027-06-30",
    "readout_estimated": "2027-12-31",
    "current_n": 420,
    "korean_site": false,
    "amendments": [
      {"date": "2024-09-25", "type": "exclusion", "before": "no prior bariatric surgery", "after": "no prior bariatric surgery within 5y (revision OK)", "reason": "expand pop", "note": "exclusion 완화"},
      {"date": "2025-03-10", "type": "sample_size", "before": 380, "after": 420, "reason": "additional site", "note": "+10.5%"}
    ]
  },
  {
    "trial_id": "ACTRN12624000115588",
    "registry": "ANZCTR",
    "name": "ANZ-DTx-OB-COACH",
    "sponsor": "University of Sydney",
    "country": "Australia",
    "drug_class": "digital therapeutic",
    "intervention": "DTx (RCT)",
    "condition": "obesity (mild-moderate)",
    "phase": "N/A",
    "status": "Active, not recruiting",
    "first_posted": "2024-01-25",
    "primary_completion": "2025-12-31",
    "readout_estimated": "2026-03-31",
    "current_n": 480,
    "korean_site": false,
    "amendments": [
      {"date": "2024-08-04", "type": "primary_endpoint", "before": "weight change @ 12wk", "after": "weight change @ 26wk", "reason": "timepoint align with reimbursement", "note": "★★ primary 시점 변경"},
      {"date": "2025-04-15", "type": "secondary_endpoint", "before": "PHQ-9", "after": "PHQ-9 + EQ-5D-5L", "reason": "HRQoL add", "note": "secondary 확장"}
    ]
  },
  {
    "trial_id": "ACTRN12625000033399",
    "registry": "ANZCTR",
    "name": "ANZ-RETA-OB",
    "sponsor": "Eli Lilly Australia",
    "country": "Australia",
    "drug_class": "triple agonist",
    "intervention": "retatrutide",
    "condition": "obesity",
    "phase": "Phase 2b",
    "status": "Recruiting",
    "first_posted": "2025-01-08",
    "primary_completion": "2026-12-31",
    "readout_estimated": "2027-03-31",
    "current_n": 260,
    "korean_site": false,
    "amendments": [
      {"date": "2025-06-20", "type": "exclusion", "before": "no severe AE history", "after": "no severe AE history + no active malignancy 5y", "reason": "safety", "note": "exclusion 강화"}
    ]
  },
  {
    "trial_id": "NCT05844111",
    "registry": "ClinicalTrials.gov",
    "name": "SURPASS-OB-PEDS",
    "sponsor": "Eli Lilly",
    "country": "US",
    "drug_class": "GIP/GLP-1 dual",
    "intervention": "tirzepatide (pediatric)",
    "condition": "pediatric obesity (10-17y)",
    "phase": "Phase 3",
    "status": "Recruiting",
    "first_posted": "2023-05-10",
    "primary_completion": "2026-04-30",
    "readout_estimated": "2026-08-31",
    "current_n": 720,
    "korean_site": false,
    "amendments": [
      {"date": "2024-07-15", "type": "exclusion", "before": "no eating disorder history", "after": "no eating disorder history + assent required", "reason": "ethics", "note": "exclusion 추가"},
      {"date": "2025-02-08", "type": "primary_endpoint", "before": "BMI %ile change", "after": "BMI Z-score change", "reason": "pediatric standard", "note": "★★★ primary 정의 변경"}
    ]
  },
  {
    "trial_id": "NCT05990001",
    "registry": "ClinicalTrials.gov",
    "name": "MARITIDE-2",
    "sponsor": "Amgen",
    "country": "US/Global",
    "drug_class": "amylin/GLP-1",
    "intervention": "MariTide (AMG133)",
    "condition": "obesity",
    "phase": "Phase 3",
    "status": "Recruiting",
    "first_posted": "2024-04-22",
    "primary_completion": "2026-10-31",
    "readout_estimated": "2027-02-28",
    "current_n": 3300,
    "korean_site": true,
    "amendments": [
      {"date": "2025-01-18", "type": "primary_endpoint", "before": "% weight loss @ 52wk", "after": "% weight loss @ 72wk", "reason": "plateau time", "note": "★★ 시점 연장"},
      {"date": "2025-09-30", "type": "sample_size", "before": 3000, "after": 3300, "reason": "additional dose arm", "note": "+10%"}
    ]
  },
  {
    "trial_id": "NCT06234567",
    "registry": "ClinicalTrials.gov",
    "name": "ECLIPSE-OB-DEVICE",
    "sponsor": "Boston Scientific",
    "country": "US",
    "drug_class": "endoscopic device",
    "intervention": "intragastric balloon (next-gen)",
    "condition": "obesity (BMI 30-40)",
    "phase": "N/A",
    "status": "Withdrawn",
    "first_posted": "2024-02-02",
    "primary_completion": "2025-08-31",
    "readout_estimated": null,
    "current_n": 0,
    "korean_site": false,
    "amendments": [
      {"date": "2024-12-05", "type": "status", "before": "Not yet recruiting", "after": "Withdrawn", "reason": "business decision (funding)", "note": "★★★ withdrawal funding 사유"}
    ]
  },
  {
    "trial_id": "NCT05789011",
    "registry": "ClinicalTrials.gov",
    "name": "OPTIWIN-2",
    "sponsor": "Currax Pharmaceuticals",
    "country": "US",
    "drug_class": "naltrexone/bupropion",
    "intervention": "Contrave",
    "condition": "obesity",
    "phase": "Phase 4",
    "status": "Active, not recruiting",
    "first_posted": "2023-03-08",
    "primary_completion": "2025-03-31",
    "readout_estimated": "2025-06-30",
    "current_n": 990,
    "korean_site": false,
    "amendments": [
      {"date": "2024-05-17", "type": "secondary_endpoint", "before": "cravings VAS", "after": "cravings VAS + food addiction (YFAS)", "reason": "exploratory", "note": "secondary 확장"}
    ]
  },
  {
    "trial_id": "NCT06330011",
    "registry": "ClinicalTrials.gov",
    "name": "GLOW-MASLD-OB",
    "sponsor": "Madrigal",
    "country": "US/EU",
    "drug_class": "THR-β agonist",
    "intervention": "resmetirom",
    "condition": "obesity + MASH (F2-F3)",
    "phase": "Phase 3b",
    "status": "Recruiting",
    "first_posted": "2024-06-11",
    "primary_completion": "2027-03-31",
    "readout_estimated": "2027-06-30",
    "current_n": 800,
    "korean_site": false,
    "amendments": [
      {"date": "2025-03-04", "type": "secondary_endpoint", "before": "weight %", "after": "weight % + waist circumference", "reason": "obesity focus", "note": "secondary 확장"},
      {"date": "2025-09-19", "type": "exclusion", "before": "Child-Pugh A", "after": "Child-Pugh A (B 일부 허용)", "reason": "expand pop", "note": "exclusion 완화"}
    ]
  },
  {
    "trial_id": "NCT06401122",
    "registry": "ClinicalTrials.gov",
    "name": "PALOMA-OB-COMBO",
    "sponsor": "Roche",
    "country": "Global",
    "drug_class": "amylin + GLP-1RA combo",
    "intervention": "petrelintide + semaglutide",
    "condition": "obesity",
    "phase": "Phase 2",
    "status": "Recruiting",
    "first_posted": "2024-08-19",
    "primary_completion": "2026-06-30",
    "readout_estimated": "2026-09-30",
    "current_n": 520,
    "korean_site": false,
    "amendments": [
      {"date": "2025-04-25", "type": "comparator", "before": "placebo + semaglutide", "after": "placebo + semaglutide + tirzepatide active reference arm", "reason": "head-to-head", "note": "★★★ comparator 변경"}
    ]
  },
  {
    "trial_id": "NCT06222233",
    "registry": "ClinicalTrials.gov",
    "name": "EVOKE-OB-AD",
    "sponsor": "Novo Nordisk",
    "country": "Global",
    "drug_class": "GLP-1RA",
    "intervention": "semaglutide",
    "condition": "obesity + early AD",
    "phase": "Phase 3",
    "status": "Active, not recruiting",
    "first_posted": "2024-01-30",
    "primary_completion": "2025-09-30",
    "readout_estimated": "2025-12-31",
    "current_n": 1840,
    "korean_site": false,
    "amendments": [
      {"date": "2024-11-12", "type": "secondary_endpoint", "before": "CDR-SB", "after": "CDR-SB + plasma p-tau217", "reason": "biomarker add", "note": "secondary 확장"},
      {"date": "2025-06-30", "type": "analysis_plan", "before": "MMRM", "after": "MMRM + Bayesian sensitivity", "reason": "post-hoc", "note": "post-hoc 추가"}
    ]
  }
]
