In this issue of JAMA, Zafonte and colleagues1 present the findings of the Citicoline Brain Injury Treatment Trial (COBRIT), a phase 3, double-blind study comparing citicoline vs placebo. In this trial, 1213 study participants with complicated mild, moderate, or severe traumatic brain injury (TBI) were randomized to receive 2000 mg of citicoline or placebo daily for 90 days. The study, which did not demonstrate any benefits of citicholine treatment, is likely to have implications not only for the use of citicoline in patients with TBI but also for the design of future trials of TBI therapies.
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