Neurocognitive Function and Tacrolimus in Older Kidney Transplant Recipients

This study is looking at how different forms of tacrolimus, a medicine used after kidney transplants, might affect thinking and memory (neurocognitive function) in older adults. If you're an older kidney transplant recipient, this study compares two types of tacrolimus: immediate-release tacrolimus (Prograf®) and extended-release tacrolimus (Envarsus XR). Researchers want to see if switching to Envarsus XR changes your thinking and memory compared to staying on Prograf®. The study aims to enroll 92 participants and will measure changes in neurocognitive function over 12 months. To join, you must be at least 65 years old, have had your kidney transplant at least a year ago, and be taking immediate-release tacrolimus with stable kidney function and drug levels.

Study design
This is a randomized controlled study, meaning participants will be assigned by chance to one of two groups. It plans to enroll 92 participants.
What's involved
Not specified in the trial record.
Compensation
Not stated in the trial record.
Follow-up
Neurocognitive function will be measured at 12 months to see changes over an intermediate term.

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NCT06751992

Neurocognitive Function Changes With Extended-Release Tacrolimus Among Older Kidney Transplant Recipients

Recruiting
PHASE4Ages 65+InterventionalPrevention
Massachusetts General Hospital
~92 participants
Updated 2026-05-28 on ClinicalTrials.gov
What's tested:Conversion to extended-release tacrolimusMaintenance of immediate-release tacrolimus

At a glance

Recruiting sites
1 of 1 listed site is recruiting right now
RecruitingSuspended, closed, or not yet open
What they're measuring
The difference in changes of neurocognitive function in intermediate-term (Total cognition composite, standard score)
Measured over 12 month
+5 more outcomes measured
Kidney Transplant Recipients
Old Age
1 sites across 1 states
Massachusetts1
  • Leonardo V. Riella, MD, PhD · PRINCIPAL_INVESTIGATOR · Massachusetts General Hospital

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Eligibility criteria

Inclusion

Able to give informed consent for participation in the study
Patients who have regular outpatient follow-up at the Massachusetts General Hospital (MGH) transplant center
≥1 year since the latest kidney transplantation
On IR tacrolimus as maintenance therapy
At a stable therapeutic tacrolimus level (5-10 ng/ml) over the last ≥3 months
Stable kidney function \[\<20% variability between the last two estimated glomerular filtration rate (eGFR)\]
Utilizing English or Spanish as the primary language

Exclusion

Dual organ transplantation
Rejection within the last three months
History of moderate to severe dementia (defined by Dementia Severity Rating Scale ≥19)
History of Parkinson's disease
Decompensated liver disease
Active cancer
Uncontrolled depression or anxiety
Blindness
Deafness
Intellectual disabilities
Pregnancy
eGFR \<15 mL/min/1.73 m2 at the time of enrollment
Total bilirubin \>3.0 mg/dL
  • The difference in changes of neurocognitive function in intermediate-term (Total cognition composite, standard score)12 month

    Neurocognitive functions will be assessed across multiple cognitive domains using the NIH toolbox-Cognitive battery (NIHTB-CB) version 3. The NIHTB-CB version 3 encompasses seven tests to assess attention, executive function, language, memory, and processing speed. The total cognition composite will be derived by averaging normalized scores. The results will be reported in Standard Scores \[SS; mean of 100, standard deviation (SD) of 15\] adjusting the age of the subject. The investigators will compare the changes in standard score from baseline between the two intervention groups.

  • The difference in changes of neurocognitive function in intermediate-term (Fluid composite, standard score)12 month

    The fluid composite score will be obtained using the NIH toolbox-Cognitive battery (NIHTB-CB) version 3, similarly as described above. The fluid cognition composite will be derived by averaging normalized scores. The results will be reported in Standard Scores \[SS; mean of 100, standard deviation (SD) of 15\] adjusting the age of the subject. The investigators will compare the changes in standard score from baseline between the two intervention groups.

  • The difference in changes of neurocognitive function in intermediate-term (Crystallized composite, standard score)12 month

    The crystallized composite score will be obtained using the NIH toolbox-Cognitive battery (NIHTB-CB) version 3, similarly as described above. The crystallized cognition composite will be derived by averaging normalized scores. The results will be reported in Standard Scores \[SS; mean of 100, standard deviation (SD) of 15\] adjusting the age of the subject. The investigators will compare the changes in standard score from baseline between the two intervention groups.

  • The difference in changes of neurocognitive function in intermediate-term (Total cognition composite, T score)12 month

    The total composite score will be obtained using the NIH toolbox-Cognitive battery (NIHTB-CB) version 3, similarly as described above. The total cognition composite will be derived by averaging normalized scores. The results will be reported in T scores (mean of 50 and SD of 10) with adjustments for age, gender, education, and race/ethnicity. The investigators will compare the changes in T score from baseline between the two intervention groups.

  • The difference in changes of neurocognitive function in intermediate-term (Fluid composite, T score)12 month

    The fluid composite score will be obtained using the NIH toolbox-Cognitive battery (NIHTB-CB) version 3, similarly as described above. The fluid cognition composite will be derived by averaging normalized scores. The results will be reported in T scores (mean of 50 and SD of 10) with adjustments for age, gender, education, and race/ethnicity. The investigators will compare the changes in T score from baseline between the two intervention groups.

  • The difference in changes of neurocognitive function in intermediate-term (Crystallized composite, T score)12 month

    The crystallized composite score will be obtained using the NIH toolbox-Cognitive battery (NIHTB-CB) version 3, similarly as described above. The crystallized cognition composite will be derived by averaging normalized scores. The results will be reported in T scores (mean of 50 and SD of 10) with adjustments for age, gender, education, and race/ethnicity. The investigators will compare the changes in T score from baseline between the two intervention groups.