The medication KarXT represents a significant departure from the conventional antipsychotic drugs by targeting muscarinic receptors instead of blocking the D2 dopamine receptors. This novel treatment for schizophrenia has shown remarkable efficacy and tolerability in a recent clinical trial. The outcomes of this study were published in The Lancet journal.
The EMERGENT-2 trial, a phase 3 study was conducted across 22 inpatient sites in the USA that assessed the effectiveness and safety of KarXT in individuals experiencing acute psychosis due to schizophrenia. The participants were randomly assigned to receive either KarXT or a placebo over a 5-week period.
The results from the trial revealed that KarXT led to a substantial reduction in both positive and negative symptoms of schizophrenia when compared to placebo. Also, the drug was well tolerated with the participants experiencing fewer adverse events than anticipated.
The mechanism of action of KarXT differs from that of traditional antipsychotics which offers a promising alternative for individuals with schizophrenia. The most common adverse events associated with KarXT included constipation, dyspepsia and headache that were generally manageable. The rates of extrapyramidal motor symptoms, weight gain and somnolence were comparable between the KarXT and placebo groups.
These findings have sparked optimism suggesting that KarXT could revolutionize the treatment landscape for schizophrenia. Further trials, including EMERGENT-3, EMERGENT-4 and EMERGENT-5 are underway to provide additional insights into the long-term efficacy and safety of KarXT. Overall, KarXT offers new possibilities to improve the quality of life of the individuals affected by schizophrenia.
Source:
Kaul, I., Sawchak, S., Correll, C. U., Kakar, R., Breier, A., Zhu, H., Miller, A. C., Paul, S. M., & Brannan, S. K. (2024). Efficacy and safety of the muscarinic receptor agonist KarXT (xanomeline–trospium) in schizophrenia (EMERGENT-2) in the USA: results from a randomised, double-blind, placebo-controlled, flexible-dose phase 3 trial. In The Lancet (Vol. 403, Issue 10422, pp. 160–170). Elsevier BV. https://doi.org/10.1016/s0140-6736(23)02190-6