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Alzheimers DiseaseNCT07073066

Deep Cervical Lymphatic Venous Anastomosis in the Treatment of Alzheimer's Disease (CLEAN-AD)

A study of Alzheimers Disease, run by Beijing Tiantan Hospital at 9 sites in China.

Recruiting

Looking for participants now. Contact the study team or a site below to ask about taking part.

Sites and contacts
Official record
Search all trials

Trial summary

This multicenter, prospective, open-label, blinded-endpoint, randomized controlled trial is to evaluate the efficacy and safety of deep cervical lymphatic venous anastomosis (DC-LVA) plus usual care versus usual care in reduing the score of clinical dementia rating-sum of boxes (CDR-SB) at 12 months in patients with… Read more about this study

Who is it for?
Ages 50 to 80 years
Conditions the study is for
Alzheimers Disease
Type of treatment
Surgery or procedure
Could I receive a placebo?
No, everyone receives an active treatment
How many people
376 participants
Where
9 sitesChina
Study dates
13 Mar 2026to 30 Nov 2029
Phase
Interventional
Are there results?
Not yet: the study is under way

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 50 to 80 years
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • Age 50-80 years, male or female.
  • Diagnosed with AD according to NIA-AA criteria.
  • Moderate-to-severe AD dementia, defined as Clinical Dementia Rating Scale Global Score (CDR-GS) ≥1.
  • Mini-Mental State Examination (MMSE) score 10-20.
  • The course of AD more than 6 months.
  • If receiving an approved AD treatment, must be on a stable drug dose for at least 3 months prior to Baseline. AD Treatment-naïve subjects can be entered into the study.
  • Have an identified caregiver (defined as a person able to support the subject for the duration of the study and who spends at least 8 hours per week with the subject). The caregiver must accompany with the participant at all study follow-up visits.
  • Signed informed consent (from the participant or their relative, and the caregiver).

Who cannot join

  • Any neurological condition other than AD that may affect cognitive function, including stroke, Parkinson's disease, epilepsy, intracranial tumors or space-occupying lesions, traumatic brain injury, intracranial infections, metabolic encephalopathy, etc.
  • Other causes of dementia, including vascular dementia, hereditary cerebral small vessel disease, vitamin deficiency, or any other etiology leading to dementia.
  • Previous evidence of severe stenosis (≥70%) in the middle cerebral artery and/or internal carotid artery.
  • Presence of primary psychiatric disorders (such as schizophrenia, schizoaffective disorder, major depressive disorder, or bipolar disorder) rather than psychiatric symptoms caused by AD.
  • Severe neurological deficits in limb movement, language, vision, hearing, or consciousness, or any condition that the investigator determines may prevent the completion of cognitive function assessments.
  • History of drug or alcohol abuse or dependence.
Show all 18Show fewer
  • History of malignant tumors or prior radiotherapy or surgery involving the head and neck.
  • Major surgical procedures or severe head or body trauma within the past 30 days.
  • Presence of other life-threatening conditions with an expected survival time of less than 2 years.
  • Contraindications to head MRI (including cardiac pacemakers/defibrillators, ferromagnetic metal implants, etc.).
  • Severe diseases or functional impairment of the heart, lungs, liver, kidneys, or other solid organs, making the patient unable to tolerate anesthesia or DC-LVA.
  • Severe bleeding tendency (including but not limited to): platelet count <100×10⁹/L; heparin therapy within the last 48 hours with APTT ≥35 seconds; ongoing warfarin use with INR >1.7.
  • Requirement for long-term use of antithrombotic medications, with inability to discontinue them before surgery or potential risks associated with discontinuation.
  • Uncontrolled persistent hypertension (systolic blood pressure >160 mmHg or diastolic blood pressure >95 mmHg).
  • Co-infection with HIV or Treponema pallidum, or any uncontrolled infectious disease.
  • Use of other investigational drugs or devices within 30 days prior to obtaining informed consent, or current participation in other interventional clinical studies.
  • Pregnancy, lactation, potential for pregnancy, or plans for pregnancy during the study period.
  • Immediate family members of the investigator (spouse, parents, children, or siblings), staff of the research institution or third-party organizations, or any other individuals with potential conflicts of interest related to the study.

Trial locations and contacts

9 sites in 1 country. Contact the study team or a site near you to ask about taking part.

9 sites in 1 country

China9 sites, 8 recruiting
  • Beijing Tiantan Hopital, Capital Medical University

    Beijing, 100070

    Yijia Guo, phD, 0086-010-59975029, guoyijia_cmu@163.com

    Yuesong Pan, phD, 0086-010-59975029, yuesongpan@aliyun.com

    Recruiting
  • Dongguan Chashan Hospital

    Dongguan, Guangdong

    Haiwen Wang, 0086-13609048317, shizetianv@163.com

    Recruiting
  • Guangdong Second People's Hospital

    Guangdong, Guangzhou, 510000

    Ping Luan, 13612992682, luanping@szu.edu.cn

    Recruiting
  • First Affiliated Hospital of Shandong First Medical University

    Jinan, Shandong, 250000

    Active, not recruiting
  • Shandong Provincial Public Health Clinical Center

    Jinan, Shandong, 250000

    Qinghua Zhang, 0086-15168863112, zhang.qinghua@outlook.com

    Recruiting
  • Shandong Provincial Third Hospital

    Jinan, Shandong, 250000

    Tingzhong Wang, 0086-18900912311, wangtingzhong@126.com

    Tingzhong Wang

    Recruiting
  • Jining First People's Hospital

    Jining, Shandong, 272000

    Lei Feng, 0086-13181326326, flneuro@163.com

    Lei Feng

    Recruiting
  • The First Affiliated Hospital of Ningbo University

    Ningbo, Zhejiang, 315000

    Xiang Gao, 0086-18888611859, yehand120@163.com

    Zhaohui Ye

    Recruiting
  • Zhengzhou Central Hospital

    Zhengzhou, Henan, 450000

    Xiwen Ma, 0086-13623805170, zmydocument@163.com

    Recruiting

Other trials in China

About this study

Official title: Deep Cervical Lymphatic Venous Anastomosis in the Treatment of Alzheimer's Disease: A Multicenter, Prospective, Open-label, Blinded-Endpoint, Randomized Controlled Trial (CLEAN-AD)

This multicenter, prospective, open-label, blinded-endpoint, randomized controlled trial is to evaluate the efficacy and safety of deep cervical lymphatic venous anastomosis (DC-LVA) plus usual care versus usual care in reduing the score of clinical dementia rating-sum of boxes (CDR-SB) at 12 months in patients with moderate-to-severe Alzheimer's Disease (AD).

Read the detailed description

Alzheimer's Disease (AD) is a common neurodegenerative disorder affecting the elderly population. Global health data estimates that there are 50 million AD patients worldwide, and this number may triple to 150 million cases by 2050. Anti-amyloid β (Aβ) monoclonal antibodies have emerged as disease-modifying therapies for preclinical or mild AD, but the majority of candidate agents have failed to demonstrate clinical efficacy. For patients with moderate-to-severe AD, who comprise approximately 50% of the existing AD population, there are limitied treatment options in clinical practice. A series of case studies has suggested the efficacy of deep cervical lymphatic venous anastomosis (DC-LVA) in AD patients, however, there is currently no evidence from randomized controlled clinical trials.

The primary purpose of this study is to evaluate the efficacy and safety of deep cervical lymphatic venous anastomosis (DC-LVA) plus usual care versus usual care in reduing the score of clinical dementia rating-sum of boxes (CDR-SB) at 12 months in patients with moderate-to-severe Alzheimer's Disease (AD). This study also aims to assess the efficacy and safety of DC-LVA in reducing AD biomarker levels of brain Aβ PET imaging.

This trial is a multicenter, prospective, open-label, blinded-endpoint, randomized controlled trial. A total of 754 patients in 20 centers from China will be enrolled. Patients will be randomly assigned into DC-LVA plus usual care or usual care according to the ratio of 1:1. Face to face interviews will be made at baseline, 7 days (or hospital discharge), 3th months ± 7 days, 6th months ± 15 days, 9th months ± 15 days and 12th month ± 15 days after randomization. After 12 months, there will be 12 months open-label extension of follow-up, participants in the control group can choose to conduct DC-LVA. During the open-label extension phase, follow-up visits will be conducted every 3 months until 24th months after randomization.

Primary outcome is defined as the change of CDR-SB score at 12th months after randomization. The changes of CDR-SB score will be analyzed using a repeated measures mixed-effects model. Least squares means will be used to estimate the levels at each time point, and the mean difference with 95% confidence intervals will be calculated. Safety outcomes in the DC-LVA treatment group will be summarized using counts/percentages. Adverse events and serious adverse events will be summarized.

In exploratory outcome measures, the investigators will analyse the AD associated biomarkers in lymphatic tissue in the intervetnon group during the surgery, and analyse the change of fluid biomarkers ( AD associated biomarkers in peripheral blood, saliva, urine, and cerebrospinal fluid), the change of MRI brain volumes (total brain volume, hippocampal volume, lateral ventricle volume), the change of glymphatic function index(DTI-ALPS), the change of MRS metabolic markers (N-Acetylaspartate, Creatine, Choline, Lactate, Glutamate and Glutamine, myo-Inositol), and the change of artificial intelligence-assisted oculomotor/gait measurements during 12 months of follow-up.

Being tested
DC-LVA treatment plus usual care, Usual care
Keywords
Alzheimers disease, Cervical Lymphatic Venous Anastomosis, Randomized Controlled Trial
Medical subject headings
Alzheimer Disease

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • DC-LVA treatment plus usual careProcedure or surgery

    Also called LVA

    Through cervical incision, the deep cervical lymphatic tissue is anatomically dissected and anastomosed with the venous system of the neck. Under indocyanine green (ICG) navigation, the flow of lymphatic fluid into the vein could be observed via ICG tracing fluorescence after surgery.

  • Usual careOther

    The usual care group includes patients who were not using or were currently using medications for improving cognitive function.

Study groups in NCT07073066
Study groupRoleWhat they receive
DC-LVA treatment plus usual careExperimentalThe intervention requires to perform bilateral deep cervical lymphatic venous anastomosis (DC-LVA). The usual care includes patients who were not using or were currently using medications for improving cognitive function.
Receives: Procedure: DC-LVA treatment plus usual care
Usual careActive comparatorThe usual care group includes patients who were not using or were currently using medications for improving cognitive function.
Receives: Other: Usual care

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. The change of Clinical Dementia Rating-Sum of Boxes score at 12th months after randomization

    The change of Clinical Dementia Rating-Sum of Boxes score (CDR-SB, 0-18 score, higher scores mean a worse outcome)

    Measured: From baseline to 12th months after randomization

Secondary outcomes (15)
  1. The Change of Clinician's Interview-Based Impression of Change plus caregiver input score

    Clinician's Interview-Based Impression of Change plus caregiver input score (CIBIC-plus, 1-7 score, higher scores mean a worse outcome)

    Measured: From baseline to 12th months after randomization

  2. The Change of Neuropsychiatric Inventory Score

    Neuropsychiatric Inventory Score (NPI, 0-144 score, higher scores mean a worse outcome)

    Measured: From baseline to 12th months after randomization

  3. The Change of Aβ PET-CT Centiloid value

    The change of Aβ PET-CT Centiloid value at 12 months

    Measured: From baseline to 12th months after randomization

  4. The Change of Zarit Caregiver Interview of Alzheimer's Disease Score

    Zarit Caregiver Interview of Alzheimer's Disease Score (ZCI-AD, 0-88 score, higher scores mean a worse outcome)

    Measured: From baseline to 12th months after randomization

  5. The Change of Alzheimer's Disease Assessment Scale-Activity of Daily Living score

    Alzheimer's Disease Assessment Scale-Activity of Daily Living score (ADCS-ADL, 0-78 score, higher scores mean a better outcome)

    Measured: From baseline to 12th months after randomization

  6. The Change of Mini-Mental State Examination Score

    Mini-Mental State Examination Score (MMSE, 0-30 score, higher scores mean a better outcome)

    Measured: From baseline to 12th months after randomization

  7. The Change of Clinical Dementia Rating-Sum of Boxes score

    Clinical Dementia Rating-Sum of Boxes score (CDR-SB, 0-18 score, higher scores mean a worse outcome

    Measured: From baseline to 3th, 6th, 9th months after randomization

  8. The Change of Clinician's Interview-Based Impression of Change plus caregiver input score

    Clinician's Interview-Based Impression of Change plus caregiver input score (CIBIC-plus, 1-7 score, higher scores mean a worse outcome)

    Measured: From baseline to 3th, 6th, 9th months after randomization

  9. The Change of Neuropsychiatric Inventory Score

    Neuropsychiatric Inventory Score (NPI, 0-144 score, higher scores mean a worse outcome)

    Measured: From baseline to 3th, 6th, 9th months after randomization

  10. The Change of Zarit Caregiver Interview of Alzheimer's Disease Score

    Zarit Caregiver Interview of Alzheimer's Disease Score (ZCI-AD, 0-88 score, higher scores mean a worse outcome)

    Measured: From baseline to 3th, 6th, 9th months after randomization

  11. The Change of Alzheimer's Disease Assessment Scale-Activity of Daily Living score

    Alzheimer's Disease Assessment Scale-Activity of Daily Living score (ADCS-ADL, 0-78 score, higher scores mean a better outcome)

    Measured: From baseline to 3th, 6th, 9th months after randomization

  12. The Change of Mini-Mental State Examination Score

    Mini-Mental State Examination Score (MMSE, 0-30 score, higher scores mean a better outcome

    Measured: From baseline to 3th, 6th, 9th months after randomization

  13. The Change of Alzheimer's Disease Assessment Scale Cognitive Score

    Alzheimer's Disease Assessment Scale Cognitive score (ADCS-Cog-13, 0-85 score, higher scores mean a worse outcome)

    Measured: From baseline to 3th, 6th, 9th, 12th months after randomization

  14. The Change of Severe Impairment Batterty Score

    Severe Impairment Batterty Score (SIB, 0-100 score, higher scores mean a worse outcome)

    Measured: From baseline to 3th, 6th, 9th, 12th months after randomization

  15. The Change of Alzheimer's Disease Composite Score

    Alzheimer's Disease Composite Score (ADCOMS, 0-1.97 score, higher scores mean a worse outcome) is calculated by a weighted items from three scales including ADCS-Cog, MMSE, and CDR-SB.

    Measured: From baseline to 3th, 6th, 9th, 12th months after randomization

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted18 Jul 2025
  2. Study start13 Mar 2026
  3. Primary completion30 Nov 2028 (estimated)
  4. Study completion30 Nov 2029 (estimated)

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase N/A
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Model description
This multicenter, prospective, open-label, blinded-endpoint, randomized controlled trial
Masking
Single blind
Who is masked
Outcomes assessor
Enrolment
376 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT07073066
Sponsor's protocol ID
KY2025-089-02
Status last verified
May 2026
First submitted
11 May 2025
Last updated
12 May 2026
Results posted
No
Data monitoring committee
Yes
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
No

Questions about this trial

What is this clinical trial studying?

A study of Alzheimers Disease, run by Beijing Tiantan Hospital at 9 sites in China.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 8 inclusion and 18 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: looking for participants now, as of the sponsor's last update on 12 May 2026. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 9 sites in China. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

This study is still under way. Results are not available in the source record yet.

How can a doctor refer a patient or contact the research team?

Contact Yuesong Pan (0086-010-59975807, yuesongpan@aliyun.com), or a site near the patient. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

The change of Clinical Dementia Rating-Sum of Boxes score at 12th months after randomization (time frame: From baseline to 12th months after randomization). It is what the study was designed to measure, not a finding.

Where can I read the original study information?
Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 12 May 2026.

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