To print: Select File and then Print from your browser's menu --------------------------------------------------------------------------------------- Title: Zanaflex Available In Canada For Patients With Muscle Spasticity URL: http://www.pslgroup.com/dg/144772.htm Doctor's Guide November 10, 1999
TORONTO, ON -- November 10, 1999 -- Canadian pharmaceutical company Draxis Health Inc. introduced Zanaflex(R) (tizanidine hydrochloride), an important advance in the management of spasticity, a troubling condition affecting tens of thousands of Canadians. Spasticity, a common complication of central nervous system disorders such as multiple sclerosis, spinal cord injury, stroke, cerebral palsy and brain injury, is characterized by abnormal increases in muscle tone (tension). The condition causes stiffness or rigidity, restricting normal movement and produces painful muscle spasms that are frequently debilitating. Zanaflex represents the first oral treatment advance for spasticity available to Canadians in more than two decades. It acts by reducing patients' abnormally increased muscle tone, thereby providing greater flexibility, freedom of movement and lessened risk of muscle spasms. Zanaflex is the first anti-spasticity medication that reduces muscle tone without causing a corresponding reduction in muscle strength. This provides affected individuals with greater freedom to pursue daily activities and preserves muscle strength more effectively than has been possible with current medications for central nervous system disorders. "Zanaflex is changing the way we treat patients with spasticity," says Dr. Yves Lapierre, Neurologist and Director of the Multiple Sclerosis Clinic at the Montreal Neurological Institute. "For the first time we may now alleviate the discomfort and pain of increased muscle tone and spasm without loss of motor capacity. In so doing, we are giving back the hope of a less restricted lifestyle for people living with spasticity," he added. "Zanaflex has made a terrific difference for me," says Mrs. Wreatha Maw of Brandon, Manitoba and Zanaflex patient for the past three years. "It lessens the severity of my spasms, allowing me greater quality of life. I am glad that it is now available to help other Canadians with spasticity," she added. It is estimated that 50,000 Canadians have multiple sclerosis, while some 30,000 suffer from a spinal cord injury. As many as half of these patients will require medical treatment for spasticity which refers to increased tone or tension in a muscle. Normally muscle tone is adjusted by the activity of nerve cells in the spinal cord that receives two different sources of information: -- Sensory nerve fibres, that have direct contact with muscles, signal the spinal cord nerve cells informing them of the level of tension/tone in the muscle; -- Descending fibres from the brain also contact spinal cord nerve cells and help to coordinate and adjust tension/tone as appropriate. These two systems together regulate the signals that muscles receive and determine muscle tone. In a person with central nervous system disorders such as multiple sclerosis, spinal cord injury and cerebral palsy, damage to the brain and its descending fibres has occurred. The brain of the individual with spasticity is unable to influence or coordinate the amount of flexibility a muscle should have. The signal from the muscle itself dominates the spinal cord and, as a result, the muscle is too tense, or spastic. "We welcome all treatment advances that will help people living with multiple sclerosis manage the disease and its complications such as spasticity," said Dr. William J. McIlroy, National Medical Advisor, Multiple Sclerosis Society of Canada. "Any new advance is good news for the 50,000 Canadians living with multiple sclerosis. We encourage individuals living with multiple sclerosis who are interested in new treatments to discuss them with their physician." The most common drug used in the treatment of spasticity is baclofen. Non-pharmacological treatments, of somewhat limited efficacy, include: -- Physical therapy such as passive stretching or applying splints and/or casts; -- TENS - transcutaneous electrical nerve stimulation; and -- A surgical procedure known as dorsal rhizotomy, in which some of the sensory nerve fibres that come from the muscles and enter the spinal cord are cut. Clinical trials(1) with Zanaflex demonstrate: -- Mean muscle tone scores were significantly decreased by 21 to 37 per cent. -- The frequency of spasms often associated with pain were significantly reduced in patients receiving Zanaflex versus those taking placebo. -- Improvements in muscle tone occurred in up to 82 per cent of Zanaflex patients, versus up to 65 per cent of baclofen recipients. Zanaflex works through a dual mode of action: it adjusts muscle tone by regulating both the descending fibres and the spinal cord nerve cells. It, therefore, reduces muscle tone without causing a corresponding reduction in muscle strength. This provides patients with more preserved muscle strength than has previously been possible with current medications. The most common side effects associated with Zanaflex include dry mouth, somnolence or drowsiness. These were uncommon, however, and occur less frequently than in patients receiving baclofen, the traditional therapy for spasticity. Zanaflex can be taken in combination with other anti-spasticity agents and NSAIDS without undesirable side effects. Reference: (1) Wagstaff, Antona J., Bryson, Harriet M. Tizanidine. A Review of its Pharmacology, Clinical Efficacy and Tolerability in the Management of Spasticity Associated with Cerebral and Spinal Disorders. Adis International, Auckland, New Zealand. Drugs 1997 Mar: 53 (3) 435-452. 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