A Study of the Effectiveness and Safety of Tetrabenazine MR in Pediatric Subjects With Tourette's Syndrome (TBZ-MR)

The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. Read our disclaimer for details. Identifier: NCT01133353
Recruitment Status : Withdrawn
First Posted : May 28, 2010
Last Update Posted : November 18, 2010
Information provided by:
Valeant Pharmaceuticals International, Inc.

Brief Summary:
The purpose of this clinical trial is to study the therapeutic effect of tetrabenazine MR in children with Tourette's Syndrome, as measured by the improvement in total tic score of the Yale Global Tic Severity Scale (YGTSS).

Condition or disease Intervention/treatment Phase
Tourette's Syndrome Drug: Tetrabenazine MR Drug: Placebo Phase 2

Detailed Description:
Tourette's Syndrome (TS) is typically diagnosed in early childhood (6-7 years) or before the age of 21 years and is characterized by chronic, intermittent motor and phonic tics. There is a body of evidence, mostly from the clinical experience data, suggesting the efficacy of tetrabenazine in TS patients with tics, including patients who were unresponsive to other treatment options. These publications consistently report the usefulness of tetrabenazine as an alternative to conventional neuroleptics for the treatment of TS.

Study Type : Interventional  (Clinical Trial)
Estimated Enrollment : 160 participants
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Quadruple (Participant, Care Provider, Investigator, Outcomes Assessor)
Primary Purpose: Treatment
Official Title: A Randomized, Double-Blind, Placebo-Controlled Study to Evaluate the Efficacy and Safety of Tetrabenazine MR in Subjects Aged 5 up to 17 Years With Tourette's Syndrome
Study Start Date : March 2011
Estimated Primary Completion Date : November 2011
Estimated Study Completion Date : December 2011

Resource links provided by the National Library of Medicine

Arm Intervention/treatment
Experimental: Tetrabenazine MR Drug: Tetrabenazine MR
Modified-Release (MR) tablets containing 15 mg or 30 mg tetrabenazine, dose-escalating up to a maximum of 150 mg depending on weight, once per day for 12 weeks

Placebo Comparator: Placebo Drug: Placebo
1 to 5 tablets once per day depending on weight for 12 weeks

Primary Outcome Measures :
  1. Improvement in total tic score as measured by the Yale Global Tic Severity Score (YGTSS) [ Time Frame: Days 0 to 84 ]

Secondary Outcome Measures :
  1. To evaluate the safety and tolerability of tetrabenazine using cognitive measures [ Time Frame: Days 0 and 84 ]
  2. To evaluate the safety and tolerability of tetrabenazine using an assessment of depression [ Time Frame: Days 0 to 84 ]
  3. To evaluate the safety and tolerability of tetrabenazine using an assessment of suicidality [ Time Frame: Days 0 to 91 ]
  4. To explore the therapeutic effects of tetrabenazine using the full YGTSS [ Time Frame: Days 0 to 84 ]
  5. To explore the therapeutic effects of tetrabenazine using the Patient Global Impression of Change scale (PGI-C) [ Time Frame: Days 0 to 84 ]
  6. To explore the therapeutic effects of tetrabenazine using the Clinical Global Impression of Severity scale (CGI-S) [ Time Frame: Days 0 to 84 ]

Information from the National Library of Medicine

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Ages Eligible for Study:   5 Years to 16 Years   (Child)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No

Inclusion Criteria:

Subjects must meet all of the following criteria:

  1. Children aged 5 to up to 17 years
  2. Subjects must be capable of providing informed consent or assent, if applicable, and parents/legal guardian must be capable of providing informed consent/permission and complying with study procedures
  3. Subject and parents/legal guardian must be able to communicate effectively with Investigator and study coordinator
  4. Diagnosed with Tourette's Syndrome, according to DSM-IV-TR and using K-SADS-PL to aid diagnosis, and requiring drug therapy
  5. Total tic score ≥ 22 as measured by YGTSS at screening and baseline
  6. Total body weight ≥ 15 kg (33 lbs.)
  7. Tics are causing distress or impairment, as determined by parent/legal guardian or subject and by the Investigator, despite current treatment regimen
  8. Able to swallow whole tablets without difficulty
  9. Non-pregnant status:

    • All female subjects must be non-pregnant (as demonstrated by negative serum β-HCG test), non-breastfeeding, and must avoid pregnancy from at least 10 days before signing the informed consent/assent and up until 1 month after the end of the study by abstaining from sexual activity or using two (2) medically acceptable methods of contraception, such as: a non-hormonal IUD with spermicide, female condom with spermicide, contraceptive sponge with spermicide, an intravaginal system, diaphragm with spermicide, cervical cap with spermicide, a male sexual partner who agrees to use a male condom with spermicide, a sterile sexual partner.
    • Male subjects must abstain from sexual activity from the time they sign the informed consent/assent and up until 1 month after the end of the study or use a condom with spermicide.
    • For all females of child bearing potential, a serum pregnancy test result must be negative at Screening and urine pregnancy test must be negative at Baseline

Exclusion Criteria:

Subjects are not eligible if any of the following criteria are met:

  1. Subjects with history or current major depressive disorder
  2. Prior treatment with > 7 doses of tetrabenazine
  3. Prior treatment with reserpine
  4. Subjects with impaired renal function (defined as having a creatinine level of ≥ 1.5 times the upper limit of age-appropriate normal value)
  5. Subjects with current or any history of suicidal ideation
  6. Participation in an investigational medication trial within the 3 months prior to the Screening visit, except for study BVF-018-102
  7. Use of Botox® (botulinum toxin) within the 4 months prior to the Screening visit
  8. Immediate families of site Investigators or sponsor employees
  9. Excluding conditions related directly to the disease under study, subject has a history or presence of clinically significant cardiovascular, pulmonary, hepatic, renal, hematologic, gastrointestinal, endocrine, immunologic, dermatologic, neurologic, or oncologic or any other condition that, in the opinion of the Investigator, would jeopardize the safety of the subject or the validity of the study results.
  10. Subjects with clinically important thyroid dysfunction requiring medication
  11. Subjects with impaired hepatic function (defined as having SGOT/SGPT levels ≥ 1.5 times the upper limit of age-appropriate normal values)
  12. Subjects with a Children's Depression Rating Scale-Revised (CDRS-R) total score of > 65
  13. Male subjects with QTc > 450 msec; female subjects with QTc > 470 msec based on Bazzett's correction formula
  14. Organic brain disease, for example, traumatic brain injury residua or toxic delirium
  15. Any subject at immediate risk of requiring hospitalization
  16. Physical examination, electrocardiography, or laboratory values that are clinically important in the opinion of the Investigator
  17. Autistic spectrum disorder
  18. Schizophrenia
  19. Other psychotic disorder
  20. Subjects with Bipolar I Disorder
  21. Subjects with one or more first-degree relatives with Bipolar I Disorder
  22. Subjects who are unable to complete a washout period of 4 weeks for fluoxetine and 3 weeks for MAOIs, respectively, prior to Baseline visit and who require fluoxetine and MAOIs during the Treatment Period
  23. Inability to washout of strong inhibitors or inducers of CYP2D6 within 7 days of the Baseline visit
  24. Positive findings on urine drug screen at the Screening Visit
  25. Allergies to tetrabenazine or its excipients

Responsible Party: Diane Anderson, Biovail Laboratories International SRL Identifier: NCT01133353     History of Changes
Other Study ID Numbers: BVF-018-201
First Posted: May 28, 2010    Key Record Dates
Last Update Posted: November 18, 2010
Last Verified: November 2010

Additional relevant MeSH terms:
Tourette Syndrome
Pathologic Processes
Basal Ganglia Diseases
Brain Diseases
Central Nervous System Diseases
Nervous System Diseases
Tic Disorders
Movement Disorders
Heredodegenerative Disorders, Nervous System
Neurodegenerative Diseases
Genetic Diseases, Inborn
Neurodevelopmental Disorders
Mental Disorders
Adrenergic Uptake Inhibitors
Neurotransmitter Uptake Inhibitors
Membrane Transport Modulators
Molecular Mechanisms of Pharmacological Action
Adrenergic Agents
Neurotransmitter Agents
Physiological Effects of Drugs