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KarXT

Phase 3

Schizophrenia | Small molecule | Psychiatry |Bristol-Myers Squibb Company|Last Updated: Aug 3, 2026

Success Probability

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Market & Valuation

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Trial Design

RandomizedDouble-BlindPLACEBO_CONTROLLEDDMC
Total Trials5
Total Enrollment1,105

FDA Designations

No designations recorded

Clinical trial landscape

KarXT · 21 trials · 13 indications

Phase 3 17Phase 1 4
NCT07285798A Study of KarXT + KarX-EC for Treatment of Irritability in Children and Adolescents With Autism Spectrum DisorderIrritability Associated With Autism Spectrum Disorder
NOT YET_RECRUITING176 Analytics
NCT07284745A Study of KarXT + KarX-EC for Treatment of Irritability in Children and Adolescents With AutismIrritability Associated With Autism Spectrum Disorder
NOT YET_RECRUITING176 Analytics
NCT07424404A Study to Evaluate the Long-term Safety and Tolerability of KarXT and KarX-EC for the Treatment of Schizophrenia and Autism-Related Irritability in Adolescents, RespectivelySchizophrenia
RECRUITING400 Analytics
NCT06947941A Study to Evaluate Safety and Efficacy of KarXT + KarX-EC as a Treatment for Psychosis Associated With Alzheimer's Disease (ADEPT-5)Alzheimer Disease
RECRUITING325 Analytics
NCT07288567A Study to Evaluate the Efficacy and Safety of KarXT for the Treatment of Schizophrenia in Adolescents (EMERGENT TEEN)Schizophrenia
RECRUITING166 Analytics
NCT06937229A Study to Evaluate the Long-term Efficacy and Safety of KarXT + KarX-EC for Agitation in Alzheimer's Disease (ADAGIO-3)Alzheimer Disease
RECRUITING650 Analytics
NCT06976203A Study to Evaluate the Efficacy and Safety of KarXT + KarX-EC for Cognitive Impairment in Alzheimer's Disease (MINDSET 2)Alzheimer's Disease
RECRUITING586 Analytics
NCT06929273A Study to Assess the Long-term Safety of KarXT for the Treatment of Manic Episodes in Bipolar-I Disorder (BALSAM-3)Bipolar Disorder Type I With Mania
RECRUITING450 Analytics
NCT06976216A Study to Evaluate the Efficacy and Safety of KarXT + KarX-EC for Cognitive Impairment in Alzheimer's DiseaseAlzheimer's Disease
RECRUITING586 Analytics
NCT06951711A Study to Evaluate the Efficacy and Safety of KarXT for the Treatment of Manic Episodes in Bipolar-I Disorder (BALSAM-2)Bipolar Disorder Type I With Mania or Mania With Mixed Features
RECRUITING274 Analytics
PHASE3NOT YET_RECRUITING
A Study of KarXT + KarX-EC for Treatment of Irritability in Children and Adolescents With Autism Spectrum Disorder
Irritability Associated With Autism Spectrum DisorderUnlock trial analytics
PHASE3NOT YET_RECRUITING
A Study of KarXT + KarX-EC for Treatment of Irritability in Children and Adolescents With Autism
Irritability Associated With Autism Spectrum DisorderUnlock trial analytics
PHASE3RECRUITING
A Study to Evaluate the Long-term Safety and Tolerability of KarXT and KarX-EC for the Treatment of Schizophrenia and Autism-Related Irritability in Adolescents, Respectively
SchizophreniaUnlock trial analytics
PHASE3RECRUITING
A Study to Evaluate Safety and Efficacy of KarXT + KarX-EC as a Treatment for Psychosis Associated With Alzheimer's Disease (ADEPT-5)
Alzheimer DiseaseUnlock trial analytics
PHASE3RECRUITING
A Study to Evaluate the Efficacy and Safety of KarXT for the Treatment of Schizophrenia in Adolescents (EMERGENT TEEN)
SchizophreniaUnlock trial analytics
PHASE3RECRUITING
A Study to Evaluate the Long-term Efficacy and Safety of KarXT + KarX-EC for Agitation in Alzheimer's Disease (ADAGIO-3)
Alzheimer DiseaseUnlock trial analytics
PHASE3RECRUITING
A Study to Evaluate the Efficacy and Safety of KarXT + KarX-EC for Cognitive Impairment in Alzheimer's Disease (MINDSET 2)
Alzheimer's DiseaseUnlock trial analytics
PHASE3RECRUITING
A Study to Assess the Long-term Safety of KarXT for the Treatment of Manic Episodes in Bipolar-I Disorder (BALSAM-3)
Bipolar Disorder Type I With ManiaUnlock trial analytics
PHASE3RECRUITING
A Study to Evaluate the Efficacy and Safety of KarXT + KarX-EC for Cognitive Impairment in Alzheimer's Disease
Alzheimer's DiseaseUnlock trial analytics
PHASE3RECRUITING
A Study to Evaluate the Efficacy and Safety of KarXT for the Treatment of Manic Episodes in Bipolar-I Disorder (BALSAM-2)
Bipolar Disorder Type I With Mania or Mania With Mixed FeaturesUnlock trial analytics

Study Endpoints

Primary Endpoints

Change From Baseline in the Aberrant Behavior Checklist Irritability (ABC-I) Score at Week 8
Week 8
Number of participants with treatment emergent adverse events (TEAEs)
Up to 54 weeks
Number of participants with adverse events of special interest (AESIs)
Up to 54 weeks
Number of participants with serious adverse events (SAEs)
Up to 54 weeks
Change From Baseline in Neuropsychiatric Inventory-Clinician: Hallucinations and Delusions (NPI-C: H+D) Score
Up to approximately Week 14
Change From Baseline in Positive and Negative Syndrome Scale (PANSS) Total Score
Week 5
Change from baseline in Alzheimer's Disease Assessment Scale-Cognitive Subscale 11 (ADAS-Cog11)
At week 24
Clinician's Interview-Based Impression Plus Caregiver Input (CIBIC+)
At week 24
Change from baseline in Young Mania Rating Scale (YMRS) score
At week 3

The YMRS comprised of 11 items that assess the severity of manic symptoms. All items are given a severity rating, with 4 items graded from 0 to 8 (irritability, speech, thought content, and disruptive/aggressive behavior), and the remaining 7 items are graded from 0 to 4 points. The highest score obtainable on the YMRS is 60 and the higher the number the greater the number of symptoms and/or the greater their severity.

Number of participants with treatment-emergent adverse events (TEAEs)
At Week 52 from OLE baseline

Open-label extension (OLE) Part

Number of Participants With TEAEs From First Dose to End of Study Follow up.
From first dose to end of study follow up (63 days)

Number of participants with Treatment Emergent Adverse Events (TEAEs) from first dose to end of study follow up. An adverse event (AE) is defined as any new untoward medical occurrence or worsening of a pre-existing medical condition occurring in a clinical investigation participant after signing of informed consent, whether or not considered related to the study intervention. An AE can therefore be any unfavorable and unintended sign (such as an abnormal laboratory test result), symptom, or disease temporally associated with the study intervention.

Number of Participants With TEAEs at the End of Period 1 and Period 2.
Period 1 (From first dose to day 28) Period 2 (day 29 to day 56)

Number of participants with TEAEs at the end of period 1 and period 2. An adverse event (AE) is defined as any new untoward medical occurrence or worsening of a pre-existing medical condition occurring in a clinical investigation participant after signing of informed consent, whether or not considered related to the study intervention. An AE can therefore be any unfavorable and unintended sign (such as an abnormal laboratory test result), symptom, or disease temporally associated with the study intervention.

Number of Participants With Serious TEAEs at the End of Period 1 and Period 2.
Period 1 (From first dose to day 28); Period 2 (day 29 to day 56); Overall (63 days)

Number of participants with TEAEs at the end of period 1 and period 2. Serious Adverse Event (SAE) is defined as any untoward medical occurrence that, at any dose results in death, is life-threatening, and requires inpatient hospitalization or causes prolongation of existing hospitalization.

Number of Participants With TEAEs Leading to Treatment Discontinuation.
Period 1 (From first dose to day 28); Period 2 (day 29 to day 56); Overall (63 days)

Number of participants with TEAEs leading to treatment discontinuation.

Number of Participants With Pro-cholinergic and Anticholinergic TEAEs.
Period 1 (From first dose to day 28); Period 2 (day 29 to day 56); Overall (63 days)

The number of participants experiencing adverse events related to procholinergic symptoms (believed to be associated with xanomeline) and anticholinergic symptoms (believed to be associated with trospium) symptoms. Examples of procholinergic symptoms include vomiting, nausea, diarrhea, sweating and hyper-salivation. Examples of anticholinergic include dizziness, confusion, hallucinations, and somnolence.

Change from Baseline to End of Treatment in the Neuropsychiatric Inventory-Clinician: Hallucinations and Delusions (NPI-C: H+D) score
Baseline and end of Treatment (up to 14 Weeks)

Neuropsychiatric Inventory-Clinician: Hallucinations and Delusions scale includes 2 domains from the NPI-C scale, namely, hallucinations and delusions. These 2 domains include the following number of items to be rated by the clinician: Hallucinations, 7 items (maximum score = 21) and Delusions, 8 items (maximum score = 24). The maximum score for the NPI-C: H+D scale is 45. Higher scores on this scale indicate worse outcomes.

Incidence of treatment-emergent adverse events (TEAEs)
From initial dose through 14 days after the final dose (up to 54 weeks)

The number and percentage of participants with TEAEs will be determined

Time from randomization to relapse during the 38-week study
Week 38
Part 1/1a: Geometric mean ratio (GMR) of Maximum observed plasma concentration (Cmax) of midazolam with and without KarXT
Up to approximately day 24
Part 1/1a: GMR of Area under the plasma concentration-time curve (AUC) of midazolam with and without KarXT
Up to approximately day 24
Part 2: GMR of Cmax of fexofenadine with and without KarXT
Up to approximately day 24
Part 2: GMR of AUC of fexofenadine with and without KarXT
Up to approximately day 24
Part 3: GMR of Cmax of digoxin with and without KarXT
Up to approximately day 24
Part 3: GMR of AUC of digoxin with and without KarXT
Up to approximately day 24
Number of participants with adverse events (AEs)
Up to 3 weeks
Number of participants with Serioues AEs (SAEs)
Up to Day 43
Number of participants with AEs of Special Interest (AESIs)
Up to Day 43
Number of participants with vital sign abnormalities
Up to 28 days post last dose

Part 1

Body weight
Up to 28 days post last dose

Part 1

Number of participants with 12-lead electrocardiogram abnormalities
Up to 28 days post last dose

Part 1

Number of participants with physical examination abnormalities
Up to 28 days post last dose

Part 1

Number of participants with clinical laboratory assessment abnormalities
Up to 28 days post last dose

Part 1

Columbia-Suicide Severity Rating Scale (C-SSRS)
On Day 30

Part 1

Maximum observed plasma concentration (Cmax)
Up to Day 29

Part 2

Time of maximum observed plasma concentration (Tmax)
Up to Day 29

Part 2

Area under the concentration-time curve in 1 dosing interval (AUC(TAU))
Up to Day 29

Part 2

Area under the plasma concentration-time curve from time zero to 24 hours (AUC(0-24))
Up to Day 29

Part 2

Apparent total body clearance (CLT/F)
Up to Day 29

Part 2

Apparent volume of distribution (Vz/F)
Up to Day 29

Part 2

Terminal elimination half-life (T-HALF)
Up to Day 29

Part 2

Secondary Endpoints

Change From Baseline in the Clinical Global Impression-Severity (CGI-S) Score at Week 8
Week 8
Number of Participants With ABC-I response at Week 8
Week 8
Change From Baseline on the ABC Subscale for Social Withdrawal at Week 8
Week 8
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Study Design & Arms

AllocationRANDOMIZED
MaskingQUADRUPLE
ModelPARALLEL
PurposeTREATMENT

Treatment Arms

ArmTypeDescription
KarXT + KarX-EC ArmEXPERIMENTAL -
PlaceboEXPERIMENTAL -
Administration of KarXT for SchizophreniaEXPERIMENTAL -
Administration of KarXT for Autism-related IrritabilityEXPERIMENTAL -
KarXTEXPERIMENTAL -
KarXT+KarX-ECEXPERIMENTAL -
KarXT + KarX-ECACTIVE_COMPARATOR -
KarXT or Adjuvant KarXTEXPERIMENTAL -
Administration of KarXTACTIVE_COMPARATOR -
KarXT on empty stomach and with foodEXPERIMENTAL -
Part 1EXPERIMENTAL -
Part 2EXPERIMENTAL -
Part 3EXPERIMENTAL -
Part 1aEXPERIMENTAL -
Cohort 1EXPERIMENTAL -
Cohort 2EXPERIMENTAL -
Cohort 3EXPERIMENTAL -
Group AEXPERIMENTAL -
Group BEXPERIMENTAL -
Group CEXPERIMENTAL -
Group DEXPERIMENTAL -

Interventions

NameTypeDescription
KarXTDRUGSpecified dose on specified days
KarX-ECDRUGSpecified dose on specified days
KarXT + KarX-EC Matching PlaceboDRUGSpecified dose on specified days
KarXT + KarX-EC Arm Matching PlaceboDRUGSpecified dose on specified days
KarXT Matching PlaceboOTHERSpecified dose on specified days
PlaceboOTHERSpecified dose on specified days
LithiumDRUGTherapeutic dose
ValproateDRUGTherapeutic dose
LamotrigineDRUGTherapeutic dose
MidazolamDRUGSpecified dose on specified days
FexofenadineDRUGSpecified dose on specified days
DigoxinDRUGSpecified dose on specified days
OmeprazoleDRUGSpecified dose on specified days
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Eligibility Criteria

Age Range5 Years to 17 Years
SexALL
Healthy VolunteersNo
Study Sites54

Inclusion Criteria * Participants must have a confirmed diagnosis of ASD, as defined by the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, Text Revision (DSM-5-TR) criteria, confirmed by the K-SADS-PL and must be experiencing symptoms of irritability. * Participants must have...

Countries:United StatesFranceGermanyHungaryIndiaJapanPolandRomaniaSpainAustraliaCanadaArgentinaUnited KingdomColombiaBrazilBulgariaChileChinaCroatiaCzechiaGreeceIsraelItalyMexicoPortugalSouth KoreaTaiwanUkraineFinlandNetherlandsPuerto RicoDenmarkNew ZealandSlovakiaSwedenBelgiumSerbiaTurkey (Türkiye)PeruSwitzerland
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Recent Changes (Last 90 Days)

LOWAug 3, 2026NCT07284745primaryCompletionDate: changed
LOWAug 3, 2026NCT07284745primaryCompletionDate: changed
LOWJul 30, 2026NCT06126224lastUpdatePostDate: changed
LOWJul 30, 2026NCT06585787lastUpdatePostDate: changed
LOWJul 30, 2026NCT06126224lastUpdatePostDate: changed
LOWJul 30, 2026NCT06585787lastUpdatePostDate: changed
LOWJul 28, 2026NCT06937229lastUpdatePostDate: changed
LOWJul 28, 2026NCT06937229lastUpdatePostDate: changed
LOWJul 27, 2026NCT06882785lastUpdatePostDate: changed
LOWJul 27, 2026NCT06951698lastUpdatePostDate: changed
LOWJul 27, 2026NCT06882785lastUpdatePostDate: changed
LOWJul 27, 2026NCT06951698lastUpdatePostDate: changed
LOWJul 27, 2026NCT06882785lastUpdatePostDate: changed
LOWJul 27, 2026NCT06951698lastUpdatePostDate: changed
LOWJul 24, 2026NCT06929273lastUpdatePostDate: changed
LOWJul 24, 2026NCT06929273lastUpdatePostDate: changed
MEDIUMJul 23, 2026NCT06572449TRIAL_REMOVED: changed
MEDIUMJul 23, 2026NCT06572449TRIAL_REMOVED: changed
MEDIUMJul 23, 2026NCT06572449TRIAL_REMOVED: changed
HIGHJul 22, 2026NCT07118215Status: RECRUITING → COMPLETED

Frequently asked questions about KarXT

What is KarXT used for?

KarXT is an investigational small molecule being studied for the treatment of psychosis associated with Alzheimer's disease and for manic episodes in bipolar-I disorder. It is in Phase 3 clinical development for these indications, which include bipolar disorder type I with mania or mania with mixed features.

Who makes KarXT?

KarXT is being developed by Bristol-Myers Squibb Company, traded on the New York Stock Exchange under the ticker BMY. The company is conducting Phase 3 clinical trials to evaluate the drug's efficacy and safety in Alzheimer's disease psychosis and bipolar-I disorder mania.

What phase is KarXT in?

KarXT is in Phase 3 clinical development. It is an investigational drug, not yet approved by regulatory authorities. Multiple Phase 3 trials are currently recruiting participants to assess its safety and efficacy for psychosis associated with Alzheimer's disease and for manic episodes in bipolar-I disorder.

What clinical trials is KarXT in?

KarXT is being evaluated in several Phase 3 trials, including NCT05511363 (ADEPT-1) and NCT05980949 (ADEPT-3) for psychosis associated with Alzheimer's disease, and NCT06929273 (BALSAM-3) and NCT06951711 (BALSAM-2) for manic episodes in bipolar-I disorder. All trials are currently recruiting.

Is KarXT the same as xanomeline?

KarXT is a combination of xanomeline and trospium chloride. Xanomeline is a muscarinic acetylcholine receptor agonist, while trospium is a peripheral antimuscarinic agent. The combination is designed to target central muscarinic receptors while minimizing peripheral side effects.

How does KarXT work?

KarXT combines xanomeline, a muscarinic acetylcholine receptor agonist, with trospium chloride, a peripheral antimuscarinic agent. This mechanism aims to modulate central cholinergic signaling to treat psychiatric symptoms while reducing peripheral side effects. It is being studied for Alzheimer's disease psychosis and bipolar mania.