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Also known as xanomeline tartrate, xanomeline, KarXT, BMS-986510
Xanomeline/Trospium Chloride · 15 trials · 9 indications
The within-participant change in the Brief Assessment of Cognition in Schizophrenia composite cognitive score from baseline to follow-up after 24 weeks. Higher score means better cognition. There is no max score, as the tests have different scoring methods (number correct, reaction time).
PANSS Total Score is a clinical tool used to measure the severity of symptoms in individuals with schizophrenia. It includes 30 items divided into three subscales: Positive Symptoms (e.g., hallucinations, delusions) Negative Symptoms (e.g., social withdrawal, lack of motivation) General Psychopathology (e.g., anxiety, depression) Each item is rated from 1 (absent) to 7 (extreme), resulting in a total score range from 30 to 210. Higher PANSS Total Scores indicate more severe symptoms and worse clinical outcomes. Baseline is defined as last non-missing assessment prior to the first dose of study drug.
PANSS Total Score is a clinician administered measure of schizophrenia symptom severity used widely in antipsychotic research. It includes 30 items across 3 subscales: * Positive Symptoms (7 items) assessing excesses or distortions such as hallucinations, delusions, or grandiosity * Negative Symptoms (7 items) assessing diminished function such as social withdrawal or reduced motivation and * General Psychopathology (16 items) capturing broader symptoms like anxiety, depression, guilt, or cognitive impairment Each item is scored from 1 (absent) to 7 (extreme), producing a PANSS Total Score ranging from 30 to 210, with higher scores indicating more severe symptoms. Baseline is defined as the last non missing PANSS Total Score before first dose. This endpoint evaluates change from Baseline to Week 6, with negative values indicating improvement.
TEAEs are defined as events with an onset date on or after the first dose of KarXT. An Adverse Event is any symptom, physical sign, syndrome, or disease that either emerges during the study or, if present at baseline, worsens during the study, regardless of the suspected cause of the event using the National Cancer Institute Common Terminology Criteria for Adverse Events (NCI CTCAE), version 5.0.
The Positive and Negative Syndrome Scale (PANSS) is a medical scale used for measuring symptom severity of participants with schizophrenia and is widely used in the study of antipsychotic therapy. The PANSS rating form contains 7 positive symptom scales, 7 negative system scales, and 16 general psychopathology symptom scales. Participants are rated from 1 to 7 on each symptom scale. The positive symptoms in schizophrenia are the excess or distortion of normal function such as hallucinations, delusions, grandiosity, and hostility, and the negative symptoms in schizophrenia are the diminution or loss of normal functions. PANSS total score is the sum of all 30 items with a minimum score of 30 and a maximum score of 210. Higher scores indicate more severe symptoms. The PANSS Total Score is then the sum of the positive, negative, and general psychopathology symptom scores. Baseline is defined as the PANSS score at screening.
TEAEs are defined as events with an onset date on or after the first dose of KarXT. An Adverse Event is any symptom, physical sign, syndrome, or disease that either emerges during the study or, if present at baseline, worsens during the study, regardless of the suspected cause of the event using the National Cancer Institute Common Terminology Criteria for Adverse Events (NCI CTCAE), version 5.0.
| Arm | Type | Description |
|---|---|---|
| Xanomeline/trospium | EXPERIMENTAL | Xanomeline/trospium that is provided to all participants |
| KarXT | EXPERIMENTAL | - |
| Placebo | PLACEBO_COMPARATOR | - |
| KarXT + Lithium, Valproate, or Lamotrigine | EXPERIMENTAL | - |
| Placebo + Lithium, Valproate, or Lamotrigine | PLACEBO_COMPARATOR | - |
| KarXT + KarX-EC | EXPERIMENTAL | - |
| Drug: KarXT | EXPERIMENTAL | - |
| Xanomeline 50 mg and trospium chloride 20mg (KarXT) | EXPERIMENTAL | 5 weeks of xanomeline 50mg/trospium 20mg bid (low dose arm). |
| Xanomeline 100 mg and trospium chloride 20mg (KarXT) | EXPERIMENTAL | 5 weeks of xanomeline 100mg/trospium 20mg bid (middle dose arm). |
| Xanomeline 125 mg and trospium chloride 30mg (KarXT) | EXPERIMENTAL | 5 weeks of xanomeline 125mg/trospium 30mg bid (high dose arm). |
| Xanomeline plus placebo | ACTIVE_COMPARATOR | Drug: Xanomeline tartrate 75 mg TID, for 225 mg total daily dose Placebo, TID |
| Xanomeline plus trospium | EXPERIMENTAL | Drug: Xanomeline tartrate 75 mg TID, for 225 mg total daily dose Drug: Trospium chloride 20 mg BID, for a 40 mg total daily dose |
| Name | Type | Description |
|---|---|---|
| Xanomeline/trospium | DRUG | Participants will receive oral xanomeline/trospium during the trial (target dose 125/30 BID). |
| Xanomeline/Trospium Chloride | DRUG | Specified dose on specified days |
| Placebo | DRUG | Specified dose on specified days |
| Xanomeline/Trospium Chloride Capsule | DRUG | Specified dose on specified days |
| Xanomeline Enteric Capsule | DRUG | Specified dose on specified days |
| Xanomeline and Trospium Chloride Capsules | DRUG | Oral xanomeline 50 mg/trospium 20 mg BID on days 1-2 followed by xanomeline 100 mg/trospium 20 mg BID on days 3-7. The dose is increased to xanomeline 125 mg/trospium 30 mg BID on days 8-35 unless the subject is experiencing adverse events from the xanomeline 100 mg/ trospium 20 mg dose. Subjects who were increased to xanomeline 125 mg/trospium 30 mg will have the option to return to xanomeline 100 mg/ trospium 20 mg depending on clinical response and tolerability. |
| Placebo Capsules | DRUG | Placebo Capsules |
| Xanomeline and trospium chloride (KarXT) | DRUG | Subjects will be randomized to 5 weeks of low, middle, or high dose of Xanomeline and trospium chloride, and will complete a PET scan with \[18\]F DOPA at the beginning and end of the treatment period. |
| xanomeline tartrate | DRUG | xanomeline tartrate, 75 mg capsule, TID |
| Trospium chloride | DRUG | trospium chloride, over encapsulated 20 mg tablet, BID |
Inclusion criteria: 1. Be between 18 and 55 years of age. 2. Be willing and able to provide informed consent, after the nature of the study has been fully explained. This includes being able to understand the locally approved informed consent (and information letter) in the local language. 3. Have ...
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Xanomeline/Trospium Chloride is an investigational small molecule drug candidate being developed by Bristol-Myers Squibb Company (ticker: BMY) for neurological and psychiatric conditions. It is a fixed combination of xanomeline tartrate and trospium chloride, and it is currently in Phase 3 clinical development. It is not yet approved for any indication.
Xanomeline/Trospium Chloride is being studied for the treatment of schizophrenia, psychosis, mania in bipolar I disorder, and Alzheimer disease. Clinical trials have enrolled participants with schizophrenia, schizoaffective disorder, and bipolar I disorder with mania, with or without mixed features. It remains investigational and has not been approved for any use.
Xanomeline/Trospium Chloride targets the muscarinic acetylcholine receptors CHRM1 and CHRM4 as an agonist. Xanomeline is the active muscarinic agonist component, while trospium chloride is included to limit peripheral muscarinic side effects. This dual-target agonist approach distinguishes it from dopamine-based antipsychotic mechanisms.
Xanomeline/Trospium Chloride is being developed by Bristol-Myers Squibb Company, which trades under the ticker BMY. Bristol-Myers Squibb is the sponsor of the clinical development program, which includes Phase 3 trials in schizophrenia and bipolar mania, as well as a Phase 1 PET/MRI study.
Xanomeline/Trospium Chloride is in Phase 3 clinical development. It is an investigational drug and has not been approved by the FDA or any regulatory agency. The program includes multiple Phase 3 trials, with 10 total trials reported, of which 9 are completed and 2 are currently active.
Xanomeline/Trospium Chloride is being evaluated in several clinical trials, including NCT07686263, a Phase 3 relapse prevention study in schizophrenia; NCT07140913, a Phase 3 adjunctive trial in bipolar I mania; NCT07084831, a Phase 3 cognitive impairment study in schizophrenia; and NCT07423546, a Phase 1 PET/MRI study of dopamine transmission.
Yes, Xanomeline/Trospium Chloride is also known as KarXT, as well as xanomeline tartrate, xanomeline, and Xanomeline and Trospium Chloride Capsules. These names refer to the same investigational fixed-dose combination developed by Bristol-Myers Squibb. The abbreviation XT is also used in some trial titles.