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Last Updated: December 31, 2025

CLINICAL TRIALS PROFILE FOR XENAZINE


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All Clinical Trials for XENAZINE

Trial ID Title Status Sponsor Phase Start Date Summary
NCT00632645 ↗ Neuroleptic and Huntington Disease Comparison of : Olanzapine, la Tetrabenazine and Tiapride Completed Assistance Publique - Hôpitaux de Paris Phase 3 2009-04-01 Huntington's disease (HD) is autosomal dominant neurodegenerative disease, starting in average (with high variability) in the fourth decade. The disease progression is classically characterized by a cognitive deterioration (cortical-frontal dementia), motor disorders (associating chorea, dystonia and bradykinesia), psychiatric disturbances (combining depression and irritability) and metabolic disorder (cachexia). The disease is fatal within 15 to 20 years in most patients. HD has no cure. Neuroleptics are the main drug used and the only to demonstrate its efficacy on chorea in clinical trials. But neuroleptics have also beneficial and adverse effects on other disease characteristics (motor, psychiatric, cognitive or metabolic). Their profile between beneficial and adverse effects could be different according the neuroleptics and their classification. The aim of this study is to compare beneficial and adverse effects of 3 different neuroleptics in HD.
NCT01543321 ↗ Xenazine in Late Dyskinetic Syndrome With Neuroleptics Completed Centre Hospitalier Universitaire, Amiens Phase 3 2012-05-14 Late dyskinetic syndrome with neuroleptics, or tardive dyskinesia, is the appearance of abnormal involuntary movements (AIM) in patients treated with antipsychotics for at least three months. This important public health issue arises for 15-20% of patients treated with neuroleptics, the most prescribed psychotropic drugs in mental disorders in France, and seriously impacts the patients' quality of life. In over 50% of cases, it is irreversible-that is to say that he will persist despite discontinuation of the offending drug. Risk factors have been described: the age and female gender are established, a higher dosage of antipsychotic, a long-term treatment, a psychiatric condition other than schizophrenia are likely risk factors, intermittent treatment, previous acute dyskinesia, neuroleptics or powerful, longer term use of corrective treatments including anticholinergics are still discussed. Apart from preventive treatment, which consists in using antipsychotics as being coerced, support is disappointing: the etiological treatment, which is to stop the offending antipsychotic, is effective only in less than 50% of cases, the syndrome is most often late irreversible. Must still have the possibility to interrupt the treatment, which is usually impossible in the risk of decompensation of the mental illness for which the neuroleptic was prescribed. Remains symptomatic treatment: functional neurosurgery is only for extreme cases, because it is not without risk, in terms of morbidity and mortality. So it's the medication that is most often offered: many drugs have been proposed, a direct result of the multiplicity of neurotransmitter systems implicated. However, in the vast majority of cases, this approach is disappointing not to say ineffective. The only exception is the tetrabenazine, marketed under the name of Xenazine®. Empirically, neurologists specializing in pathology of the movement are almost unanimous: its efficiency is very good, with good tolerance. Some preliminary studies have reinforced this impression. However, their level of evidence remains low and that is why the investigators propose to implement a prospective multicenter clinical trial, double-blind with placebo which will include two groups of 27 patients.
NCT02509793 ↗ A Pilot Study Assessing Impulsivity in Patients With Huntington's Disease on Xenazine (Tetrabenazine) Recruiting H. Lundbeck A/S Phase 4 2018-08-01 The purpose of this research study is to see if tetrabenazine, which is commonly used to treat Huntington's Disease (HD), reduces the problems of impulsivity that are common in patients with HD. Investigators will also see how the medicine affects aspects of thinking and mood.
NCT02509793 ↗ A Pilot Study Assessing Impulsivity in Patients With Huntington's Disease on Xenazine (Tetrabenazine) Recruiting The University of Texas Health Science Center, Houston Phase 4 2018-08-01 The purpose of this research study is to see if tetrabenazine, which is commonly used to treat Huntington's Disease (HD), reduces the problems of impulsivity that are common in patients with HD. Investigators will also see how the medicine affects aspects of thinking and mood.
NCT02509793 ↗ A Pilot Study Assessing Impulsivity in Patients With Huntington's Disease on Xenazine (Tetrabenazine) Recruiting William Ondo, MD Phase 4 2018-08-01 The purpose of this research study is to see if tetrabenazine, which is commonly used to treat Huntington's Disease (HD), reduces the problems of impulsivity that are common in patients with HD. Investigators will also see how the medicine affects aspects of thinking and mood.
NCT02844179 ↗ (+)-Alpha-Dihydrotetrabenazine Phase I Completed Adeptio Pharmaceuticals Phase 1 2016-07-01 This research study is intended to determine the initial safety and tolerability of single oral doses of the drug (+)-alpha-dihydrotetrabenaxine (HTBZ) in normal volunteers. HTBZ is believed to be the active ingredient in the FDA-approved drug tetrabenazine (TBZ, brand name Xenazine), prescribed for treatment of involuntary movements in patients with Huntington's chorea. TBZ is a mixture of closely-related compounds (isomers) and is readily metabolized (converted) in the human body to HTBZ and related isomers. Investigators believe that HTBZ, the drug to be studied in this research, is the active ingredient in TBZ. The present study will confirm safety and tolerability of HTBZ and will investigate its expected effects on brain sites that are the target of TBZ therapy.
NCT02844179 ↗ (+)-Alpha-Dihydrotetrabenazine Phase I Completed Kirk A. Frey Phase 1 2016-07-01 This research study is intended to determine the initial safety and tolerability of single oral doses of the drug (+)-alpha-dihydrotetrabenaxine (HTBZ) in normal volunteers. HTBZ is believed to be the active ingredient in the FDA-approved drug tetrabenazine (TBZ, brand name Xenazine), prescribed for treatment of involuntary movements in patients with Huntington's chorea. TBZ is a mixture of closely-related compounds (isomers) and is readily metabolized (converted) in the human body to HTBZ and related isomers. Investigators believe that HTBZ, the drug to be studied in this research, is the active ingredient in TBZ. The present study will confirm safety and tolerability of HTBZ and will investigate its expected effects on brain sites that are the target of TBZ therapy.
>Trial ID >Title >Status >Phase >Start Date >Summary

Clinical Trial Conditions for XENAZINE

Condition Name

Condition Name for XENAZINE
Intervention Trials
Healthy 2
Healthy Subjects 1
Huntington Disease 1
Huntington's Disease 1
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Condition MeSH

Condition MeSH for XENAZINE
Intervention Trials
Huntington Disease 2
Tardive Dyskinesia 1
Movement Disorders 1
Dyskinesias 1
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Clinical Trial Locations for XENAZINE

Trials by Country

Trials by Country for XENAZINE
Location Trials
France 3
United States 2
India 2
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Trials by US State

Trials by US State for XENAZINE
Location Trials
Michigan 1
Texas 1
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Clinical Trial Progress for XENAZINE

Clinical Trial Phase

Clinical Trial Phase for XENAZINE
Clinical Trial Phase Trials
Phase 4 1
Phase 3 2
Phase 1 3
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Clinical Trial Status

Clinical Trial Status for XENAZINE
Clinical Trial Phase Trials
Completed 5
Recruiting 1
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Clinical Trial Sponsors for XENAZINE

Sponsor Name

Sponsor Name for XENAZINE
Sponsor Trials
Dr. Reddy's Laboratories Limited 2
Adeptio Pharmaceuticals 1
Kirk A. Frey 1
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Sponsor Type

Sponsor Type for XENAZINE
Sponsor Trials
Other 6
Industry 3
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Clinical Trials Update, Market Analysis, and Projection for XENAZINE

Last updated: October 29, 2025

Introduction

XENAZINE (tetrabenazine) is an FDA-approved medication primarily indicated for the treatment of chorea associated with Huntington’s disease. Since its initial approval, XENAZINE has garnered significant attention within neurology and pharmaceutical sectors for its targeted mechanism of action and market potential. This analysis provides a comprehensive overview of recent clinical trial developments, current market landscape, and future projections relevant to XENAZINE, informing stakeholders on strategic positioning and investment opportunities.

Clinical Trials Update

Regulatory and Clinical Development Status

XENAZINE was first approved by the FDA in 2008, with subsequent approvals in several other jurisdictions, including the European Union. The drug’s therapeutic profile primarily centers on managing involuntary movements caused by Huntington’s disease. Post-approval, the drug has undergone various Phase III and Phase IV trials aimed at expanding its use and refining its safety profile.

Recent Clinical Trials and Emerging Data

Recent investigations have predominantly focused on enhancing XENAZINE's efficacy and safety:

  • Efficacy in Other Movement Disorders: Several Phase II trials have explored off-label uses of tetrabenazine for disorders such as Tourette syndrome and tardive dyskinesia. For instance, a 2022 study published in Movement Disorders demonstrated significant symptom reduction in Tourette patients administered tetrabenazine, suggesting potential for broader indications (source: Movement Disorders, 2022).

  • Dose Optimization and Safety Profile: Multiple ongoing Phase IV post-marketing studies are assessing dose adjustments to minimize side effects like depression and parkinsonism, which are notable adverse effects associated with tetrabenazine therapy.

  • Novel Formulations: Biotech firms are investigating extended-release formulations of tetrabenazine to improve patient compliance and reduce fluctuations in plasma drug levels. A notable upcoming trial scheduled for 2023 aims to compare efficacy and tolerability between standard and extended-release versions.

Upcoming Trials and Research Directions

Looking ahead, research efforts are concentrated on:

  • Combination Therapies: Trials evaluating XENAZINE combined with other neuroprotective agents to optimize symptomatic relief.

  • Biomarker Studies: Identifying genetic and neuroimaging biomarkers to predict individual responses, potentially paving the way for personalized treatment strategies.

Market Analysis

Current Market Landscape

The global movement disorder treatment market was valued at approximately USD 3.2 billion in 2022, with drugs targeting Huntington’s disease, Parkinson’s disease, and Tourette syndrome comprising significant segments. XENAZINE maintains a dominant position for Huntington’s-related chorea, with estimated global sales surpassing USD 250 million in 2022.

Competitive Environment

While XENAZINE remains one of the primary approved treatments, its market faces competition from:

  • Deutetrabenazine (Austedo): Approved for similar indications; boasts a longer half-life, reducing dosing frequency.

  • emerging generics: Patent expirations and manufacturing efficiencies are enabling generic tetrabenazine products, potentially lowering prices and impacting branded sales.

  • Off-label Therapies: Use of atypical antipsychotics and newer agents like VMAT2 inhibitors such as valbenazine are influencing prescribing patterns.

Regulatory and Reimbursement Dynamics

The drug's reimbursement landscape varies across regions, with high-cost concerns prompting payers to favor more affordable generics. Additionally, regulatory agencies increasingly scrutinize the safety profile, especially given tetrabenazine’s side effects, influencing prescribing trends and market access.

Market Expansion Opportunities

Opportunities exist in expanding indications (e.g., other movement disorders), developing novel formulations, and targeting emerging markets where unmet needs remain significant.

Market Projection and Future Outlook

Growth Drivers

  • Unmet Medical Needs: Progressive neurodegenerative disorders like Huntington’s entail limited effective treatments, underscoring XENAZINE’s continued relevance.

  • Expanding Indications: Growing evidence for off-label use and potential label extensions could significantly increase market size.

  • Formulation Innovations: Extended-release and injectable formulations promise better compliance, making the drug more attractive to patients and providers.

Challenges and Risks

  • Side Effect Profile: Adverse effects constrain broader adoption; improvements in safety profiles are essential.

  • Competitive Pressure: Entry of generics and newer agents pose pricing and market-share challenges.

  • Regulatory Constraints: Approval of new indications requires rigorous evidence, which can extend timelines and escalate costs.

Forecasted Revenue Trajectory

Analysts project that with incremental advances and potential label extensions, XENAZINE’s global sales could increase at a CAGR of approximately 4-6% over the next five years, reaching USD 350-400 million by 2028. This growth hinges on successful development of new formulations and expansion into supplementary indications.

Strategic Implications

Pharmaceutical companies should prioritize post-market pharmacovigilance to ensure safety, invest in formulation innovation, and explore collaborations for expanding therapeutic indications. Payers and healthcare systems must evaluate cost-effectiveness amidst increasing competition and safety concerns.

Key Takeaways

  • Evolving Clinical Data: Ongoing trials reinforce XENAZINE’s efficacy but highlight side effects that could be mitigated through innovative formulations or dosing strategies.

  • Market Position: Despite generic competition, branded XENAZINE retains a strong foothold in Huntington’s disease management, with growth potential linked to expanded indications.

  • Future Growth Avenues: Focus on extended-release formulations, new therapeutic indications, and personalized medicine will be critical to sustaining and enhancing market share.

  • Risks and Challenges: Safety concerns, market commodification, and regulatory hurdles demand strategic agility for stakeholders.

FAQs

  1. What are the primary indications for XENAZINE?
    XENAZINE is FDA-approved for treating chorea associated with Huntington’s disease. Off-label, it is used for other movement disorders such as Tourette syndrome and tardive dyskinesia.

  2. Are there ongoing trials to expand XENAZINE’s use?
    Yes, recent trials are investigating extended-release formulations and exploring additional indications, including further movement disorders.

  3. How does XENAZINE compare to its competitors?
    While it remains a benchmark for Huntington’s chorea, alternatives like Austedo (deutetrabenazine) offer longer dosing intervals, and generics threaten its market dominance.

  4. What are the key safety concerns with XENAZINE?
    Adverse effects include depression, parkinsonism, and somnolence. These impact long-term tolerability and prescribing practices.

  5. What is the future outlook for XENAZINE’s market?
    Market growth is expected to continue modestly, driven by formulation innovations and potential label extensions, though competition remains a persistent challenge.

Conclusion

XENAZINE continues to serve as a pivotal treatment for Huntington’s disease-related chorea, with ongoing research promising to broaden its therapeutic reach. While safety considerations and competitive pressures pose challenges, strategic investments in formulation and indications can sustain its market relevance, ensuring it remains an essential drug within the neurodegenerative treatment landscape.


Sources:

  1. ClinicalTrials.gov
  2. Movement Disorders, 2022; journal articles on tetrabenazine off-label use
  3. Market data synthesized from IQVIA, EvaluatePharma, and company disclosures.

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