A study of chorea after tetrabenazine withdrawal in patients with Huntington disease.
OBJECTIVE
To assess tetrabenazine (TBZ) efficacy by evaluating the change in Huntington disease-associated chorea resulting from TBZ treatment withdrawal.


METHODS
Thirty patients treated in the long term were randomized to 1 of 3 groups assigned to withdraw from TBZ in a double-blind, staggered fashion during a 5-day period.


RESULTS
The chorea scores of subjects withdrawn from TBZ treatment increased by 5.3 units from days 1 to 3, whereas the scores of the group with partial or no withdrawal of TBZ treatment increased by 3.0 units (P = 0.0773). A post hoc analysis of the linear trend was positive for reemergent chorea (P = 0.0486). No serious adverse events were reported after abrupt withdrawal of TBZ treatment.


CONCLUSIONS
The trend for reemergence of chorea in patients with Huntington disease who were withdrawn from TBZ treatment is consistent with the findings from previous studies, thus showing the effectiveness of TBZ in reducing chorea.
Department of Neurology, Boston University School of Medicine, Boston, MA, USA. samfrank@bu.edu
Samuel
S
Frank
William
W
Ondo
Stanley
S
Fahn
Christine
C
Hunter
David
D
Oakes
Sandra
S
Plumb
Frederick
F
Marshall
Ira
I
Shoulson
Shirley
S
Eberly
Francis
F
Walker
Stewart
S
Factor
Vicki
V
Hunt
Aileen
A
Shinaman
Joseph
J
Jankovic
D018759:Adrenergic Uptake Inhibitors / Q000627:therapeutic use*; D000328:Adult; D000368:Aged; D002819:Chorea / Q000188:drug therapy* / Q000503:physiopathology; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D006816:Huntington Disease / Q000188:drug therapy* / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D012720:Severity of Illness Index; D013747:Tetrabenazine / Q000627:therapeutic use*; D016896:Treatment Outcome; D028761:Withholding Treatment
D018759:Adrenergic Uptake Inhibitors; D013747:Tetrabenazine