History
# Registration date Revision Id
3 2026-04-06, 1405/01/17 378900
2 2025-07-01, 1404/04/10 346018
1 2021-09-13, 1400/06/22 197551
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  • Protocol summary

    Eligibles enter the study by signing informed consent. The intervention is performed on patients two months after transplantation (receiving Prograf in the first two months). The investigator assigns participants into two groups of Suprotac or Prograf, using a randomization series (1:1 allocation) according to the entry order. Patients in the suprotac group receive one milligram of Suprotac in exchange for each milligram of Prograf they have received pre-enrollment. The appropriate dose will be adjusted if needed to reach the desired trough level.
    Eligible patients are randomized into two groups of Suprotac® or Prograf®. Tacrolimus in both groups is administered at a dose of 0.1–0.15 mg/kg orally on the first day post-transplant. Then, dose will be adjusted if needed to reach the desired trough level.
    بیماران واجد شرایط پس از دریافت توضیح طرح با امضای رضایتنامه آگاهانه وارد مطالعه میشوند. مداخله بر روی بیماران تحت پیوند کبد بعد از گذشت دو ماه از جراحی (که در دو ماه ابتدایی پروگراف گرفته اند) انجام میشود. پزشک محقق با استفاده از سری تصادفی‌سازی به نسبت یک به یک و بر اساس ترتیب ورود، بیمار را در یکی از دو بازوی ساپروتاک یا پروگرف وارد مینماید. بیماران بازوی ساپروتاک به ازای هر میلیگرم پروگراف دریافتی قبل از ورود به مطالعه، ساپروتاک دریافت خواهند کرد و دوز مربوطه در صورت نیاز برای رسیدن به سطح trough مورد نظر تنظیم خواهد شد.
    بیماران واجد شرایط به صورت تصادفی در دو گروه ساپروتاک® یا پروگرف® قرار می گیرند. تاکرولیموس در هر دو گروه با دوز 0.1 تا 0.15 میلی گرم به ازای هر کیلوگرم وزن بدن به صورت خوراکی در روز اول پس از پیوند تجویز می شود. پس از آن و در صورت نیاز، تنظیم دوز جهت رسیدن به سطح خونی مطلوب انجام میشود.
    Inclusion criteria: Patients aged between 18 to 70; two months past the liver transplantation Exclusion criteria: Receiving any investigational products within the last 30 days; contraindication for tacrolimus; Experience of liver transplant rejection in the first two months after transplantation; Glomerular Filtration Rate greater than 30
    Inclusion criteria: Patients aged between 18 to 70 Exclusion criteria: Receiving any investigational products within the last 30 days; contraindication for tacrolimus; Glomerular Filtration Rate greater than 30
    شرایط ورود: بیماران ۱۸ تا 70 ساله؛ گذشت دو ماه از پیوند کبد شرایط عدم ورود: مصرف داروهای تحقیقاتی در 30 روز اخیر؛ منع مصرف تاکرولیموس؛ بیماران با رخداد رد پیوند طی دو ماه ابتدایی پیوند قبل از ورود به مطالعه؛ بیماران با شاخص فیلتراسیون گلومرولی بیش از 30
    شرایط ورود: بیماران ۱۸ تا 70 ساله شرایط عدم ورود: مصرف داروهای تحقیقاتی در 30 روز اخیر؛ منع مصرف تاکرولیموس؛ بیماران با شاخص فیلتراسیون گلومرولی بیش از 30
    Intervention: Patients will receive Suprotac® (Nanoalvand Tacrolimus) from two months after transplantation surgery until one year after liver transplantation surgery, and the effectiveness and safety of this drug will be compared to the control group. Control: Patients will continue receiving Prograf® (Astellas Tacrolimus) from two months after transplantation surgery until one year after liver transplantation surgery.
    Group 1: Suprotac® (Nanoalvand) Group 2: Prograf® (Astellas) Tacrolimus in both groups is administered at a dose of 0.1–0.15 mg/kg orally on the first day post-transplant. Then, dose will be adjusted if needed to reach the desired trough level. Treatment is continued for one year.
    مداخله: بیماران داروی ساپروتاک® (تاکرولیموس نانوالوند) به صورت خوراکی، با دوز برابر با تاکرولیموس استفاده‌شده قبل از ورود به مطالعه برای رسیدن به سطح تراف هدف تاکرولیموس، به صورت منقسم در دو دوز 12 ساعته در روز را برای طول مدت مطالعه تا یک سال بعد از پیوند دریافت میکنند. کنترل: بیماران داروی پروگراف® (تاکرولیموس آستلاس) به صورت خوراکی، با دوز برابر با تاکرولیموس استفاده‌شده قبل از ورود به مطالعه برای رسیدن به سطح تراف هدف تاکرولیموس، به صورت منقسم در دو دوز 12 ساعته در روز را برای طول مدت مطالعه تا یک سال بعد از پیوند دریافت میکنند.
    گروه 1: ساپروتاک® (نانوالوند) گروه 2: پروگرف® (آستلاس) تاکرولیموس در هر دو گروه با دوز 0.1 تا 0.15 میلی گرم به ازای هر کیلوگرم وزن بدن به صورت خوراکی در روز اول پس از پیوند تجویز می شود. پس از آن و در صورت نیاز، تنظیم دوز جهت رسیدن به سطح خونی مطلوب انجام میشود. درمان تا یک سال ادامه میابد.
  • General information

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    The following items have been removed from the inclusion criteria section: - Two months past the liver transplantation - Patient who has received a stable dose of tacrolimus (prograf®) in the last 14 days before enrolment The following item also has been removed from the exclusion criteria section: - Experience of liver transplant rejection in the first two months after transplantation Changes have also been made to the following sections: Intervention Groups Protocol Summary (Inclusion and Exclusion Criteria, Intervention Groups, and Settings and Conduct)
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    در قسمت General information موارد زیر از بخش معیارهای ورود حذف شدند: - گذشت دو ماه از پیوند کبد - بیمارانی که طی 14 روز قبل از ورود به مطالعه، دوز ثابتی از تاکرولیموس (پروگرف®) را دریافت کرده باشند همچنین مورد "بیماران با رخداد رد پیوند طی دو ماه ابتدایی پیوند قبل از ورود به مطالعه " از بخش معیارهای عدم ورود حذف شد. همچنین تغییراتی در بخش های Intervention groups، Protocol summary (Inclusion and exclusion criteria , Intervention groups and Settings and conduct ) اعمال شد.
    Patient aged between 18 to 70 years
    Patient who has passed two months from transplantation surgery
    Patient who has received a stable dose of tacrolimus (prograf®) in the last 14 days before enrolment
    Ability to comprehend and willing to sign the informed consent form for this study
    Patient aged between 18 to 70 years
    Ability to comprehend and willing to sign the informed consent form for this study
    بیمار 18 تا 70 ساله
    بیمارانی که دو ماه از جراحی پیوند کبد در ایشان گذشته باشد
    بیمارانی که طی 14 روز قبل از ورود به مطالعه، دوز ثابتی از تاکرولیموس (پروگراف®) را دریافت کرده باشند
    بیمارانی که توانایی فهم و تمایل به امضای فرم رضایتنامه این مطالعه را داشته باشند
    بیمار 18 تا 70 ساله
    بیمارانی که توانایی فهم و تمایل به امضای فرم رضایتنامه این مطالعه را داشته باشند
    Use of other investigational drugs at the time or within 30 days of enrolment, or within five half-lives of those drugs, whichever is longer (except for dialysis-related drugs which are not expected to interact with the study regimens)
    Patients with contraindication for tacrolimus or any other ingredients of the formulation
    Patients who underwent liver transplant rejection in the first two months after liver transplantation
    Patients with Glomerular Filtration Rate greater than 30 at the time of enrolment to the study (two months after liver transplantation)
    Use of other investigational drugs at the time or within 30 days of enrolment, or within five half-lives of those drugs, whichever is longer (except for dialysis-related drugs which are not expected to interact with the study regimens)
    Patients with contraindication for tacrolimus or any other ingredients of the formulation
    Patients with Glomerular Filtration Rate greater than 30 at the time of enrolment to the study (two months after liver transplantation)
    استفاده از سایر داروهای تحقیقاتی در زمان ورود به مطالعه و طی 30 روز قبل از ورود به مطالعه (یا طی فاصله زمانی معادل 5 نیمه عمر داروی تحقیقاتی استفاده شده در صورتی که بیشتر از 30 روز باشد قبل از ورود به مطالعه)
    بیمارانی که منع مصرف داروی تاکرولیموس را دارند شامل حساسیت به تاکرولیموس یا سایر اجزای فرمولاسیون دارو
    بیمارانی که طی دو ماه ابتدایی پیوند قبل از ورود به مطالعه رد پیوند برای ایشان رخ داده است
    بیمارانی که در زمان ورود به مطالعه (پایان ماه دوم بعد از پیوند) شاخص نرخ فیلتراسیون گلومرولی بیشتر از 30 داشته باشند
    استفاده از سایر داروهای تحقیقاتی در زمان ورود به مطالعه و طی 30 روز قبل از ورود به مطالعه (یا طی فاصله زمانی معادل 5 نیمه عمر داروی تحقیقاتی استفاده شده در صورتی که بیشتر از 30 روز باشد قبل از ورود به مطالعه)
    بیمارانی که منع مصرف داروی تاکرولیموس را دارند شامل حساسیت به تاکرولیموس یا سایر اجزای فرمولاسیون دارو
    بیمارانی که در زمان ورود به مطالعه (پایان ماه دوم بعد از پیوند) شاخص نرخ فیلتراسیون گلومرولی بیشتر از 30 داشته باشند
  • Intervention groups

    #1
    Intervention group: Patients will receive Suprotac® (Tacrolimus produced by Nano Alvand Co.) with mycophenolic acid and prednisolone until one year after liver transplantation surgery. Suprotac® dose in these patients will be equivalent to dose they’ve received of prograf® (Tacrolimus produced by Astellas Pharma) before enrolment (two months after transplantation surgery) which had been adjusted to achieve target trough concentration of tacrolimus. Daily dose of Suprotac® will be administered in two divided doses, given every 12 hours.
    Intervention group: Suprotac® (Nanoalvand) is administered at a dose of 0.1–0.15 mg/kg orally on the first day post-transplant. Then, dose will be adjusted if needed to reach the desired trough level. Treatment is continued for one year.
    گروه مداخله: بیماران تا یک سال پس از جراحی پیوند کبد، داروی ساپروتاک® (تاکرولیموس تولیدشده توسط شرکت نانوالوند) را به همراه مایکوفنولیک اسید و پردنیزولون دریافت خواهند کرد. دوز روزانه دریافت ساپروتاک® در این بیماران، معادل دوز مورد مصرف از داروی پروگراف® (تاکرولیموس تولید شرکت Astellas Pharma) پیش از ورود به مطالعه (دو ماه پس از جراحی پیوند) خواهد بود که برای رسیدن به سطح تراف خونی مد نظر از تاکرولیموس تنظیم شده بوده است. بیماران دوز روزانه مد نظر برای دریافت ساپروتاک® را به صورت منقسم در دو دوز با فاصله 12 ساعت دریافت خواهند کرد.
    گروه مداخله: داروی ساپروتاک® (تاکرولیموس تولیدشده توسط شرکت نانوالوند) با دوز 0.1 تا 0.15 میلی گرم به ازای هر کیلوگرم وزن بدن به صورت خوراکی در روز اول پس از پیوند تجویز می شود. پس از آن و در صورت نیاز، تنظیم دوز جهت رسیدن به سطح خونی مطلوب انجام میشود. درمان تا یک سال ادامه میابد.
    #2
    Control group: Patients will continue receiving Prograf® (Tacrolimus produced by Astellas Pharma) with mycophenolic acid and prednisolone until one year after liver transplantation surgery. Daily dose of Prograf® which has been adjusted to achieve target trough concentration will be administered in two divided doses, given every 12 hours.
    Control group: Prograf® (Tacrolimus produced by Astellas Pharma) is administered at a dose of 0.1–0.15 mg/kg orally on the first day post-transplant. Then, dose will be adjusted if needed to reach the desired trough level. Treatment is continued for one year.
    گروه کنترل: بیماران تا یک سال پس از جراحی پیوند کبد، داروی پروگراف® (تاکرولیموس تولیدشده توسط شرکت Astellas Pharma) را به همراه مایکوفنولیک اسید و پردنیزولون ادامه خواهند داد. بیماران دوز روزانه مد نظر برای دریافت پروگراف® را که برای رسیدن به سطح تراف خونی مد نظر از تاکرولیموس تنظیم شده است، به صورت منقسم در دو دوز با فاصله 12 ساعت دریافت خواهند کرد.
    گروه کنترل: ، داروی پروگراف® (تاکرولیموس تولیدشده توسط شرکت آستلاس) با دوز 0.1 تا 0.15 میلی گرم به ازای هر کیلوگرم وزن بدن به صورت خوراکی در روز اول پس از پیوند تجویز می شود. پس از آن و در صورت نیاز، تنظیم دوز جهت رسیدن به سطح خونی مطلوب انجام میشود. درمان تا یک سال ادامه میابد.

Protocol summary

Study aim
Investigation of the efficacy and safety of Suprotac® compared with Prograf® in liver transplant patients in Iran
Design
Randomized Clinical Trial; Two arms in parallel; Open-label; Phase 4 with 196 patients
Settings and conduct
Eligible patients are randomized into two groups of Suprotac® or Prograf®. Tacrolimus in both groups is administered at a dose of 0.1–0.15 mg/kg orally on the first day post-transplant. Then, dose will be adjusted if needed to reach the desired trough level.
Participants/Inclusion and exclusion criteria
Inclusion criteria: Patients aged between 18 to 70 Exclusion criteria: Receiving any investigational products within the last 30 days; contraindication for tacrolimus; Glomerular Filtration Rate greater than 30
Intervention groups
Group 1: Suprotac® (Nanoalvand) Group 2: Prograf® (Astellas) Tacrolimus in both groups is administered at a dose of 0.1–0.15 mg/kg orally on the first day post-transplant. Then, dose will be adjusted if needed to reach the desired trough level. Treatment is continued for one year.
Main outcome variables
Percentage of rejection-free patients between two groups (until one year after transplantation); Comparing the percentage of patient survival, graft survival, and mean trough concentration/dose of tacrolimus between two groups; Adverse events

General information

Reason for update
The following items have been removed from the inclusion criteria section: - Two months past the liver transplantation - Patient who has received a stable dose of tacrolimus (prograf®) in the last 14 days before enrolment The following item also has been removed from the exclusion criteria section: - Experience of liver transplant rejection in the first two months after transplantation Changes have also been made to the following sections: Intervention Groups Protocol Summary (Inclusion and Exclusion Criteria, Intervention Groups, and Settings and Conduct)
Acronym
IRCT registration information
IRCT registration number: IRCT20150303021315N25
Registration date: 2021-09-13, 1400/06/22
Registration timing: registered_while_recruiting

Last update: 2025-07-03, 1404/04/12
Update count: 2
Registration date
2021-09-13, 1400/06/22
Registrant information
Name
Nassim Anjidani
Name of organization / entity
Orchid Pharmed
Country
Iran (Islamic Republic of)
Phone
+98 21 4347 3000
Email address
amini@orchidpharmed.com
Recruitment status
Recruitment complete
Funding source
Expected recruitment start date
2021-09-06, 1400/06/15
Expected recruitment end date
2023-09-06, 1402/06/15
Actual recruitment start date
empty
Actual recruitment end date
empty
Trial completion date
empty
Scientific title
Open-label, randomized study to evaluate efficacy and safety of Suprotac® in comparison with Prograf® in liver transplant patients in Iran
Public title
Efficacy and safety evaluation of Suprotac® in comparison with Prograf® in prevention of liver transplant rejection
Purpose
Treatment
Inclusion/Exclusion criteria
Inclusion criteria:
Patient aged between 18 to 70 years Ability to comprehend and willing to sign the informed consent form for this study
Exclusion criteria:
Use of other investigational drugs at the time or within 30 days of enrolment, or within five half-lives of those drugs, whichever is longer (except for dialysis-related drugs which are not expected to interact with the study regimens) Patients with contraindication for tacrolimus or any other ingredients of the formulation Patients with Glomerular Filtration Rate greater than 30 at the time of enrolment to the study (two months after liver transplantation)
Age
From 18 years old to 70 years old
Gender
Both
Phase
4
Groups that have been masked
No information
Sample size
Target sample size: 196
Randomization (investigator's opinion)
Randomized
Randomization description
Eligible patients will be assigned to treatment using stratified block randomization with blocks of size 2 or 4. Randomization will be stratified according to living or deceased donors. The patients will be carried out using R-CRAN software version 3.6.3. Blocks will be made using permuted block randomization for a total of 196 patients (1:1 allocation ratio). The random series Excel will be placed in the patient recruitment center and a person will be responsible for assigning a random code by the investigator. This code will be assigned in order of entry and based on the stratification in which the patient's donor is living or deceased.
Blinding (investigator's opinion)
Not blinded
Blinding description
Placebo
Not used
Assignment
Parallel
Other design features

Secondary Ids

empty

Ethics committees

1

Ethics committee
Name of ethics committee
Research Ethics Committees of Shiraz University of Medical Sciences
Street address
Zand Street
City
Shiraz
Province
Fars
Postal code
7134814336
Approval date
2021-07-03, 1400/04/12
Ethics committee reference number
IR.SUMS.REC.1400.308

Health conditions studied

1

Description of health condition studied
Liver transplant
ICD-10 code
Z94.4
ICD-10 code description
Liver transplant status

Primary outcomes

1

Description
Transplantation rejection
Timepoint
All along the study duration until one year after transplantation surgery
Method of measurement
Liver transplant rejection approved by biopsy or clinical symptoms and laboratory tests (enhancement in alanine aminotransferase or aspartate aminotransferase liver enzymes)

Secondary outcomes

1

Description
Death
Timepoint
All along the study duration until one year after transplantation surgery
Method of measurement
Incidence of death written in the adverse event’s section of the case report form

2

Description
Graft loss
Timepoint
All along the study duration until one year after transplantation surgery
Method of measurement
Transplant rejection not responsive to the treatment according to the biopsy or clinical symptoms and laboratory tests (enhancement in alanine aminotransferase or aspartate aminotransferase liver enzymes)

3

Description
Mean trough concentration per dose of tacrolimus
Timepoint
Baseline, months 2, 4, 6 and 10
Method of measurement
Dividing trough concentration to the consumed daily dose

4

Description
Adverse events
Timepoint
Baseline, months 2, 4, 6 and 10
Method of measurement
All adverse events are assessed through patient reporting, physician diagnosis, or laboratory abnormalities, and are then classified by severity (based on Common Terminology Criteria for Adverse Events (CTCAE)), seriousness, relationship to the study drug, action taken, and outcome.

Intervention groups

1

Description
Intervention group: Suprotac® (Nanoalvand) is administered at a dose of 0.1–0.15 mg/kg orally on the first day post-transplant. Then, dose will be adjusted if needed to reach the desired trough level. Treatment is continued for one year.
Category
Treatment - Drugs

2

Description
Control group: Prograf® (Tacrolimus produced by Astellas Pharma) is administered at a dose of 0.1–0.15 mg/kg orally on the first day post-transplant. Then, dose will be adjusted if needed to reach the desired trough level. Treatment is continued for one year.
Category
Treatment - Drugs

Recruitment centers

1

Recruitment center
Name of recruitment center
Abu-Ali Sina Hospital
Full name of responsible person
Dr Saman Nik-Eghbalian
Street address
2nd Phase, Sadra
City
Shiraz
Province
Fars
Postal code
7199467985
Phone
+98 71 3344 0000
Email
Nikeghbalian@gmail.com

Sponsors / Funding sources

1

Sponsor
Name of organization / entity
Nanoalvand Company
Full name of responsible person
Dr Nima Sepehri
Street address
No. 485, between 63th and 65th Ave., Yousef Abad
City
Tehran
Province
Tehran
Postal code
1439955991
Phone
+98 21 8802 0579
Email
info@nanoalvand.com
Grant name
Grant code / Reference number
Is the source of funding the same sponsor organization/entity?
Yes
Title of funding source
Nanoalvand Company
Proportion provided by this source
100
Public or private sector
Private
Domestic or foreign origin
Domestic
Category of foreign source of funding
empty
Country of origin
Type of organization providing the funding
Industry

Person responsible for general inquiries

Contact
Name of organization / entity
Orchid Pharmed
Full name of responsible person
Nassim Anjidani
Position
Medical Manager
Latest degree
Medical doctor
Other areas of specialty/work
Medical Pharmacy
Street address
No 42, Attar Neyshaboori St., Vanak Sq., Tehran
City
Tehran
Province
Tehran
Postal code
1994766411
Phone
+98 21 4347 3000
Fax
Email
anjidani.n@orchidpharmed.com

Person responsible for scientific inquiries

Contact
Name of organization / entity
Orchid Pharmed
Full name of responsible person
Nassim Anjidani
Position
Medical Manager
Latest degree
Medical doctor
Other areas of specialty/work
Medical Pharmacy
Street address
No 42, Attar Neyshaboori St., Vanak Sq., Tehran
City
Tehran
Province
Tehran
Postal code
1994766411
Phone
+98 21 4347 3000
Fax
Email
anjidani.n@orchidpharmed.com

Person responsible for updating data

Contact
Name of organization / entity
Orchid Pharmed
Full name of responsible person
Nassim Anjidani
Position
Medical Manager
Latest degree
Medical doctor
Other areas of specialty/work
Medical Pharmacy
Street address
No 42, Attar Neyshaboori St., Vanak Sq., Tehran
City
Tehran
Province
Tehran
Postal code
1994766411
Phone
+98 21 4347 3000
Fax
Email
anjidani.n@orchidpharmed.com

Sharing plan

Deidentified Individual Participant Data Set (IPD)
Undecided - It is not yet known if there will be a plan to make this available
Study Protocol
No - There is not a plan to make this available
Statistical Analysis Plan
No - There is not a plan to make this available
Informed Consent Form
No - There is not a plan to make this available
Clinical Study Report
Undecided - It is not yet known if there will be a plan to make this available
Analytic Code
No - There is not a plan to make this available
Data Dictionary
No - There is not a plan to make this available
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