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Enrolling by invitation NCT06801886

Silymarin's Advantage on Graft Effectiveness

Phase III Interventional Posttransplant Diabetes Mellitus Acute Graft Rejection Biopsy Proven Acute Rejection Antibody Mediated Rejection of Kidney Transplant

For patients and families

In plain language

An automatic summary of structured registry data. It is an orientation aid, not a substitute for the official protocol or a physician assessment.

What is being studied
The protocol lists: Silymarine supplementation, Placebo Supplementation.
Who it may be relevant to
Registry conditions: Posttransplant Diabetes Mellitus, Acute Graft Rejection, Biopsy Proven Acute Rejection, Antibody Mediated Rejection of Kidney Transplant. Basic parameters: No limits · All.
What needs checking
Age, condition and sex are only basic indicators. Prior treatment, laboratory values and other mandatory requirements appear in the eligibility criteria below.
Where it takes place
Slovakia
Next step
Save the trial, show it to the treating physician, and confirm current recruitment with the study center. Costs, documents and travel →
Official title

Effect of Silymarin Supplementation on Graft Function and Early Post-transplant Complications

Overview

The study examines the impact of silymarin supplementation during the early post-transplant period, administering 900 g daily for 30 days under standard treatment. Subsequently, the investigators investigate its impact on graft function, as measured by eGFR (CKD-EPI equation), UACR or UPCR, the development of dnDSA, rejection changes, and histological changes in the 3-month biopsy protocol. At the same time, investigators will investigate the effect of silymarin on metabolic complications-PTDM, DLP, disorders of calcium-phosphate metabolism, and arterial hypertension in the post-transplant period-in comparison with the placebo group. At the same time, investigators will investigate the safety and tolerance of silymarin.

Interventions

  • Drug Silymarine supplementation
    900 mg of silymarin supplementation daily during the early post-transplant period, (for 30 days) under standard treatment.
  • Other Placebo Supplementation
    Placebo supplementation during the early post-transplant period (30 days) under standard treatment

Primary outcome measures

  • eGFR improvement [Time frame: 3 months]
  • Inicidence of biopsy proven acute rejection [Time frame: 6 months]
Secondary outcome measures (3)
  • Incidence of PTDM [Time frame: 6 months]
  • Incidence of dyslipidemia [Time frame: 6 months]
  • Improved graft function in participatns with delayed graft function [Time frame: 6 months]

Eligibility criteria

Inclusion criteria

  • First or second kidney transplant recipient
  • Deceased or living donor kidney transplant
  • Patients receiving standard immunosuppression regimen:
  • Tacrolimus or cyclosporine + Mycophenolate mofetil + Corticosteroids
  • Body Mass Index (BMI) 18-35 kg/m²
  • Willingness to provide informed consent
  • Ability to understand and comply with study procedures
  • Stable medical condition without significant comorbidities

Exclusion criteria

  • Multi-organ transplant recipients
  • Recipients of ABO-incompatible or highly sensitized transplants
  • Active infectious complications at the time of transplantation: HIV, Active hepatitis B or C, Active cytomegalovirus (CMV) infection
  • Patients with known liver disease: Cirrhosis, Active hepatitis, ALT or AST > 2.5 times the upper limit of normal
  • Significant cardiovascular disease: Recent myocardial infarction (within 6 months), Unstable angina, Severe heart failure (NYHA Class III or IV)
  • Malignancy within the past 5 years (except successfully treated non-melanoma skin cancer)
  • Current or recent (within 30 days) participation in another clinical trial
  • Pregnancy or planned pregnancy during the study period
  • Known allergy or hypersensitivity to silymarin or milk thistle
  • Patients taking medications with significant interactions with silymarin:

Anticoagulants, Cytochrome P450 enzyme modulators

  • Psychiatric conditions that may interfere with study compliance
  • Uncontrolled diabetes mellitus (HbA1c > 8.5%)
  • History of non-compliance with medical treatment
  • Patients with known genetic disorders affecting drug metabolism

Criteria are shown verbatim from the registry (in English). Final eligibility is always assessed by the study center.

Healthy volunteers: No

Study design

Allocation
Randomized
Model
Parallel assignment
Masking
Single blind
Primary purpose
Prevention

Study locations

Slovakia · 1 center
  • University Hospital Martin — Martin

Publications

  • Goli F, Karimi J, Khodadadi I, Tayebinia H, Kheiripour N, Hashemnia M, Rahimi R. Silymarin Attenuates ELMO-1 and KIM-1 Expression and Oxidative Stress in the Kidney of Rats with Type 2 Diabetes. Indian J Clin Biochem. 2019 Apr;34(2):172-179. doi: 10.1007/s12291-018-0735-0. Epub 2018 Feb 6. PMID 31092990
  • Kaur G, Athar M, Alam MS. Dietary supplementation of silymarin protects against chemically induced nephrotoxicity, inflammation and renal tumor promotion response. Invest New Drugs. 2010 Oct;28(5):703-13. doi: 10.1007/s10637-009-9289-6. Epub 2009 Jul 10. PMID 19590824
  • Mohammadi H, Hadi A, Arab A, Moradi S, Rouhani MH. Effects of silymarin supplementation on blood lipids: A systematic review and meta-analysis of clinical trials. Phytother Res. 2019 Apr;33(4):871-880. doi: 10.1002/ptr.6287. Epub 2019 Mar 5. PMID 30834633
  • Voroneanu L, Nistor I, Dumea R, Apetrii M, Covic A. Silymarin in Type 2 Diabetes Mellitus: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. J Diabetes Res. 2016;2016:5147468. doi: 10.1155/2016/5147468. Epub 2016 Jun 1. PMID 27340676

Identifiers

NCT: NCT06801886 · TNO_UNM

Primary sources (government registries)

View this study on ClinicalTrials.gov ↗