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Pilot, Proof-of-Concept Study of Sublingual Tizanidine in Children With Chronic Traumatic Brain Injury (TBI)

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: NCT00287157
Recruitment Status : Completed
First Posted : February 6, 2006
Last Update Posted : January 21, 2009
Information provided by:
Teva GTC

Brief Summary:
Nightly administration of a unique, sublingual (under the tongue) formulation of tizanidine, a known anti-spasticity medication, has been shown in a previous study to improve sleep and next-day functioning in CP (cerebral palsy) patients. It is hypothesized that this improvement in sleep efficiency (i.e.,fewer wake episodes, longer time asleep, etc.) with resulting improvement in quality-of-life (i.e.,improvements in next-day functioning, cognition and movement) may also be seen in a similar patient population, i.e., children with traumatic brain injury (TBI).

Condition or disease Intervention/treatment Phase
Traumatic Brain Injury Drug: Sublingual Tizanidine HCl Phase 1

Detailed Description:

Sublingual tizanidine, a novel test formulation of the known effective antispasticity agent, has been shown to have a unique pharmacokinetic profile [(i.e., nearly twice the bioavailability/AUC), but with little or no increase in peak plasma levels (Cmax), as compared to oral tizanidine (Zanaflex)]. When administered nightly to CP (Cerebral Palsy) patients to more effectively reduce the muscle spasms that disrupt sleep, it was shown to improve sleep efficiency, decrease sleep fragmentation and improve the sleep cycle. This improvement in night-time sleep was translated into a potential improvement in next-day functioning (improvement in next-day measures of spasticity and movement).

It is hypothesized that a similar type of improvement in sleep with consequent positive impact on next day improvement in spasticity, cognition and function, may also be manifest in a similar patient population, children with traumatic brain injury.

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Study Type : Interventional  (Clinical Trial)
Actual Enrollment : 5 participants
Allocation: Randomized
Intervention Model: Crossover Assignment
Masking: Quadruple (Participant, Care Provider, Investigator, Outcomes Assessor)
Primary Purpose: Treatment
Official Title: A Double-Blind, Randomized, Two-Way Crossover, Comparative Study to Evaluate the Clinical Efficacy and Safety of Novel Sublingual Tizanidine HCl Versus Placebo in Children With Chronic Traumatic Brain Injury
Study Start Date : December 2006
Actual Study Completion Date : May 2007

Resource links provided by the National Library of Medicine

Primary Outcome Measures :
  1. Improvement in Spasticity, Cognition and Daily Function [ Time Frame: 4 weeks ]

Secondary Outcome Measures :
  1. Improvement in nighttime actigraphy sleep parameters [ Time Frame: 4 weeks ]

Information from the National Library of Medicine

Choosing to participate in a study is an important personal decision. Talk with your doctor and family members or friends about deciding to join a study. To learn more about this study, you or your doctor may contact the study research staff using the contacts provided below. For general information, Learn About Clinical Studies.

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Ages Eligible for Study:   8 Years to 18 Years   (Child, Adult)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No

Inclusion Criteria:

  • Males/Females 8-18 years of age with documented history of TBI
  • Documented Loss of Consciousness(LOC) for more than 24 H, or initial GCS (Glasgow Coma Score) lower than 8
  • Current Spasticity that interferes with task performance
  • Patient is able to cooperate and understand general explanations

Exclusion Criteria:

  • History of allergy to tizanidine or any inactive component (including lactose intolerance)
  • Use of other hypnotic medication within 3 days of baseline visit and during the study
  • Botox therapy within 6 weeks of baseline, or use of Baclofen pump during the trial
  • Use of CYP1A2 inhibitors (ex. ciprofloxacin or fluvoxamine) for the duration of the study
  • Female patients on oral contraceptives
  • Significant abnormalities in clinical screening laboratory parameters (ALT, AST, Bilirubin>2 x uln; Creatinine>2 mg/dl;WBC <2300/mm3, platelets<80,000/mm3)
  • Taking of other medications that may adversely interfere with the actions of the study medication or outcome variables within 2 weeks of 5 half-lives of the baseline visit

Information from the National Library of Medicine

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.

Please refer to this study by its identifier (NCT number): NCT00287157

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Alyn Hospital Pediatric and Adolescent Rehabilitation Center
Jerusalem, Israel, 01090
Sponsors and Collaborators
Teva GTC
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Principal Investigator: Ido Yatsiv, MD Hadassah Medical Center, Ein Kerem, Jerusalem
Layout table for additonal information Identifier: NCT00287157    
Other Study ID Numbers: Protocol C2/5/TZ-TBI-01
First Posted: February 6, 2006    Key Record Dates
Last Update Posted: January 21, 2009
Last Verified: September 2007
Keywords provided by Teva GTC:
Traumatic Brain Injury
Spasticity, Cognition and Functioning
Additional relevant MeSH terms:
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Brain Injuries
Brain Injuries, Traumatic
Wounds and Injuries
Brain Diseases
Central Nervous System Diseases
Nervous System Diseases
Craniocerebral Trauma
Trauma, Nervous System
Sensory System Agents
Peripheral Nervous System Agents
Physiological Effects of Drugs
Muscle Relaxants, Central
Neuromuscular Agents
Autonomic Agents
Adrenergic alpha-2 Receptor Agonists
Adrenergic alpha-Agonists
Adrenergic Agonists
Adrenergic Agents
Neurotransmitter Agents
Molecular Mechanisms of Pharmacological Action