Clear-Brain: stimulating amyloid clearance in cerebral amyloid angiopathy

2023-506128-10-00 Therapeutic exploratory (Phase II) Ongoing, recruiting

Start 27 Mar 2025 · Status Ongoing, recruiting · 1 EU/EEA countries · 1 sites

Overview

Sponsor-declared trial summary

Phase Therapeutic exploratory (Phase II)
Status Ongoing, recruiting
Participants planned 60
Countries 1
Sites 1

Cerebral amyloid angiopathy

To assess whether treatment with non-invasive vagus nerve stimulation (nVNS), low-sodium oxybate (LXB) or both interventions will increase the clearance of amyloid-beta (aβ) from the cerebral blood vessels, compared to pre-treatment, in patients with cerebral amyloid angiopathy (CAA) by stimulating the glymphatic syste…

Key facts

Sponsor
Academisch Ziekenhuis Leiden
Participant type
Patients
Age range
18-64 years, 65+ years
Gender
Male and Female
Therapeutic area
Diseases [C] - Nervous System Diseases [C10], Phenomena and Processes [G] - Physiological processes [G07]
Trial duration
27 Mar 2025 → ongoing
Decision date (initial)
2024-04-08
Transition trial
No
Low-intervention
No
Rare-disease indication
No
Vulnerable population
No

External identifiers

EU CT number
2023-506128-10-00
WHO UTN
U1111-1295-1113
ClinicalTrials.gov
NCT06421532

Trial design

CTIS Part I — objectives, methods, condition coding

Main objective

Scope: Therapy, Others

To assess whether treatment with non-invasive vagus nerve stimulation (nVNS), low-sodium oxybate (LXB) or both interventions will increase the clearance of amyloid-beta (aβ) from the cerebral blood vessels, compared to pre-treatment, in patients with cerebral amyloid angiopathy (CAA) by stimulating the glymphatic system.

Conditions and MedDRA coding

Cerebral amyloid angiopathy

Eligibility criteria

Principal inclusion / exclusion criteria as submitted by sponsor

Inclusion criteria 4

  1. Patients with D-CAA with a proven APP mutation or a history of ≥1 lobar ICH and a positive family history for D-CAA in ≥1 first degree relative • Age ≥30 years old • ≤ 2 symptomatic ICH (occurrence of ICH at least > 1 year ago) or presence of ≥ 1 haemorrhagic marker (cortical superficial siderosis, cortical microbleeds) or non-haemorrhagic marker (white matter hyperintensities, microinfarcts, enlarged perivascular spaces, lobar lacunes). • When presymptomatic, patients are aware that they have D-CAA
  2. Probable sCAA according to the Modified Boston criteria 2.0 • Age ≥50 years old • ≤ 2 symptomatic ICH (occurrence of ICH at least > 1 year ago)
  3. Provisional CAA when the criteria for probable sCAA are not met due to presence of deep haemorrhagic lesions but there are mostly lobar MB and cSS present or a ratio of 10 times more lobar MB than deep MB without cSS. • Age ≥50 years old • ≤ 2 symptomatic ICH (occurrence of ICH at least > 1 year ago)
  4. Written informed consent

Exclusion criteria 7

  1. Modified Rankin Score ≥ 4
  2. A life expectancy of less than six months
  3. Pregnancy/breast feeding
  4. Contraindications for lumbar puncture
  5. Unwillingness to refrain from consuming ≤ 1 alcohol unit per day and not later than 8 pm.
  6. Contraindications for LXB and nVNS
  7. Contraindications for MRI 7T

Endpoints

Primary and secondary outcome measures (English text)

Primary endpoints 1

  1. The primary endpoint will be the morning Aβ 40 and 42 levels in CSF before and after treatment. CSF will be obtained through a lumbar puncture before the intervention at 3 months and after the intervention at 6 months.

Investigational products

Investigational medicinal products (IMPs), comparators, placebo, auxiliary

Test 1

Sodium Oxybate

SUB14731MIG · Substance

Active substance
Sodium Oxybate
Pharmaceutical form
ORAL SOLUTION
Route of administration
ORAL
Max daily dose
9.00
Max total dose
756
Max treatment duration
12 Week(s)
Authorisation status
Authorised
ATC code
- — -
Marketing authorisation
-
Paediatric formulation
No
Orphan designation
No
Modified vs. Marketing Authorisation
No

Sponsors and contacts

Sponsor organisations, regulatory contacts, third parties

Academisch Ziekenhuis Leiden

Sponsor organisation
Academisch Ziekenhuis Leiden
Address
Albinusdreef 2
City
Leiden
Postcode
2333 ZA
Country
Netherlands

Scientific contact point

Organisation
Academisch Ziekenhuis Leiden
Contact name
S.E. Schriemer

Public contact point

Organisation
Academisch Ziekenhuis Leiden
Contact name
S.E. Schriemer

Locations

1 EU/EEA country · 1 investigational sites

By country

CountryMS statusPlanned subjectsSites
Netherlands Ongoing, recruiting 60 1
Rest of world 0

Investigational sites

Netherlands

1 site · Ongoing, recruiting
Academisch Ziekenhuis Leiden
Neurology, Albinusdreef 2, 2333 ZA, Leiden

Country notifications

Trial-start, recruitment-start, end and early-termination notifications submitted per Member State

Country Trial startTrial end Recruitment startRecruitment end Early termination
Netherlands 2025-03-27 2025-03-27

Results and documents

Annex IV summary of results, Annex V layperson summary, and all documents registered in CTIS for this trial

Documents 10 files

Public protocol annexes, IB summaries, regulatory submissions and post-authorisation documents registered in CTIS.

TypeTitleVersion
Protocol (for publication) D1_Onderzoeksprotocol 2023-506128-10-00_redacted 4
Recruitment arrangements (for publication) K1_ Recruitment arrangements 1
Recruitment arrangements (for publication) K2_Recruitment material for advertising 1
Subject information and informed consent form (for publication) L1_SIS and ICF adults 1
Subject information and informed consent form (for publication) L2_Other subject information Clear-Brain and Cappricorn 2
Subject information and informed consent form (for publication) L2_Other subject information material gammaCore Sapphire 1
Subject information and informed consent form (for publication) L2_Other subject information material lumbar puncture 1
Subject information and informed consent form (for publication) L2_Other subject information material XYWAV 1
Summary of Product Characteristics (SmPC) (for publication) G2_SmPC XYWAV 1
Synopsis of the protocol (for publication) D1_Protocol synopsis 2023-506128-10-00 for NL 1

Application history

4 submissions — initial application plus substantial / non-substantial modifications

#TypeCodeSubmittedReference MSConclusionDecision date
1 INITIAL IN 2023-12-08 Netherlands Acceptable
2024-04-02
2024-04-08
2 NON SUBSTANTIAL MODIFICATION NSM-1 2024-12-17 Netherlands Acceptable
2024-04-02
2024-12-17
3 NON SUBSTANTIAL MODIFICATION NSM-3 2025-08-20 Netherlands Acceptable
2024-04-02
2025-08-20
4 SUBSTANTIAL MODIFICATION SM-4 2025-12-15 Netherlands Acceptable
2026-01-27
2026-01-30