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SchizophreniaPhase 3NCT04659174

An Extension Study to Assess Long-term Safety, Tolerability, and Efficacy of KarXT in Adult Patients With Schizophrenia (EMERGENT-4)

A Phase 3 study testing Xanomeline and Trospium Chloride Capsules in people with Schizophrenia, run by Karuna Therapeutics, Inc., a Bristol Myers Squibb company at 44 sites in 2 countries.

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
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Trial summary

This is a Phase 3, multicenter, 53-week, outpatient, open-label extension (OLE) study to evaluate the long-term safety, tolerability, and efficacy of KarXT in subjects with Diagnostic and Statistical Manual-Fifth Edition (DSM-5) schizophrenia who previously completed the treatment period of one of the two Phase 3… Read more about this study

Who is it for?
Ages 18 to 65 years
Conditions the study is for
Schizophrenia
What is being tested?
Xanomeline and Trospium Chloride Capsules
Type of treatment
Pill or oral medicine
Could I receive a placebo?
No, everyone receives an active treatment
How many people
152 participants
Where
44 sitesin 2 countries
Study dates
1 Feb 2021to 3 Oct 2023
Phase
Phase 3
Are there results?
Yes, posted in the registrySummary in the doctors' view

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 to 65 years
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • Subject is aged 18 to 65 years, at time of enrollment into the preceding acute study (KAR-007/009).
  • Subject is capable of providing informed consent.
  • A signed informed consent form must be provided before any study assessments are performed.
  • Subject must be fluent in (oral and written) English (United States only) or local language (Ukraine only) to consent.
  • Subject has completed the treatment period on study drug (through Day 35 -2 days) of Studies KAR-007 or KAR-009.
  • Subject resides in a stable living situation, in the opinion of the investigator.
  • Subject has an identified, reliable informant/caregiver willing to be able to address some questions related to certain study visits, if needed. An informant/caregiver may not be necessary if the subject has been the patient of the investigator for ≥1 year.
  • Women of childbearing potential or men with sexual partners of childbearing potential must be sexually abstinent (in line with their preferred and usual lifestyle) or willing and able to use at least 1 highly effective method of contraception during the study and for at least 7 days after the last dose of KarXT. Sperm donation is not allowed for 7 days after the final dose of KarXT.

Who cannot join

  • Risk for suicidal behavior during the study as determined by the investigator's clinical assessment and Columbia-Suicide Severity Rating Scale (C-SSRS).
  • Any clinically significant abnormality, including any finding(s) from the physical examination, vital signs, ECG, or laboratory test at the end-of-treatment visit of Studies KAR-007 or KAR-009 that the investigator, in consultation with the medical monitor, would consider to jeopardize the safety of the subject.
  • Female subject is pregnant.
  • If, in the opinion of the investigator (and/or Sponsor), subject is unsuitable for enrollment in the study or subject has any finding that, in the view of the investigator (and/or Sponsor), may compromise the safety of the subject or affect his/her ability to adhere to the protocol visit schedule or fulfill visit requirements.
  • Subjects with extreme concerns relating to global pandemics such as coronavirus disease 2019 (COVID-19) that preclude study participation.
  • Risk of violent or destructive behavior.
  • Subjects participating in another investigational drug or device trial or planning on participating in another clinical trial during the course of the study.

Trial locations and contacts

44 sites in 2 countries.

44 sites in 2 countries

United States34 sites
  • Advanced Research Center, Inc.

    Anaheim, California, 92805

  • Atlanta Center for Medical Research

    Atlanta, Georgia, 30331

  • Community Clinical Research

    Austin, Texas, 78754

  • Advanced Research Center Inc

    Bellflower, California, 90706

  • CITrials

    Bellflower, California, 90706

  • Pillar Clinical Research

    Bentonville, Arkansas, 72712

  • Hassman Research Institute

    Berlin, New Jersey, 08009

  • Mitchell L. Glaser

    Chicago, Illinois, 60622

  • Uptown Research Institute

    Chicago, Illinois, 60640

  • Proscience Research Group

    Culver City, California, 90230

  • iResearch Atlanta, LLC

    Decatur, Georgia, 30030

  • InSite Clinical Research

    DeSoto, Texas, 75115

  • Collaborative NeuroScience Research, LLC

    Garden Grove, California, 92845

  • California Clinical Trial Medical Group

    Glendale, California, 91206

  • AMITA Health Center for Psychiatric Research

    Hoffman Estates, Illinois, 60169

  • Behavioral Clinical Research, Inc.

    Hollywood, Florida, 33021

  • Research Centers of America

    Hollywood, Florida, 33024

  • Altea Research Institute

    Las Vegas, Nevada, 89102

  • Synergy San Diego

    Lemon Grove, California, 91945

  • Pillar Clinical Research

    Lincolnwood, Illinois, 60712

  • Woodland International Research Group

    Little Rock, Arkansas, 72211

  • CNS Network

    Long Beach, California, 90806

  • Hassman Research Institute

    Marlton, New Jersey, 08053

  • Innovative Clinical Research, Inc.

    Miami Lakes, Florida, 33016

  • Catalina Research Institute, LLC

    Montclair, California, 91763

  • Neuro-Behavioral Clinical Research, Inc.

    North Canton, Ohio, 44720

  • NRC Research Institute

    Orange, California, 92868

  • California Neuropsychopharmacology Clinical Research Institute

    Pico Rivera, California, 90660

  • Pillar Clinical Research, LLC

    Richardson, Texas, 75080

  • California Neuropsychopharmacology Clinical Research Institute

    San Diego, California, 92102

  • Artemis Institute for Clinical Research

    San Diego, California, 92103

  • Schuster Medical Research Institute

    Sherman Oaks, California, 91403

  • Arch Clinical Trials

    St Louis, Missouri, 63125

  • Collaborative Neuroscience Research, LLC.

    Torrance, California, 90502

Other trials in United States

Ukraine10 sites
  • Dnipropetrovsk Regional Clinical Hospital named after I.I. Mechnikov

    Dnipro, 49005

  • Institute of Neurology, Psychiatry and Narcology of the National Academy of Medical Sciences of Ukraine

    Kharkiv, 61068

  • Regional Clinical Psychiatric Hospital No. 3, Adult Psychiatric Department No. 3

    Kharkiv

  • Kherson Regional Insititution of Mental Care of Kherson Regional Council Male Psychiatric Department #3, Femail Psychiatric Department #10

    Kherson, 73488

  • Kyiv Regional Medical Incorporation "Psychiatry", Center for Novel Treatment and Rehabilitation of Psychotic Disorders

    Kyiv, 04080

  • Lviv Regional Clinical Psychiatric Hospital, Department #20

    Lviv, 79021

  • Lviv Regional Clinical Psychiatric Hospital, Department #25

    Lviv, 79021

  • Regional Facility for Psychiatric Care of Poltava Regional Council, 2-A acute general psychiatric male ward, 5-B acute, quiet, general psychiatric female ward, Poltava State Medical University, Academic Department of Psychiatry, Addictology and Medical

    Poltava, 36013

  • Cherkasy Regional Psychiatric Hospital of Cherkasy Regional Council, Female Department #11, Male Department #12

    Smila, Cherkasy Oblast, 20708

  • M.I. Pyrogov Vinnytsya National Medical University

    Vinnytsia, 21037

Other trials in Ukraine

About this study

Official title: An Open-label Extension Study to Assess the Long-term Safety, Tolerability, and Efficacy of KarXT in Subjects With DSM-5 Schizophrenia

This is a Phase 3, multicenter, 53-week, outpatient, open-label extension (OLE) study to evaluate the long-term safety, tolerability, and efficacy of KarXT in subjects with Diagnostic and Statistical Manual-Fifth Edition (DSM-5) schizophrenia who previously completed the treatment period of one of the two Phase 3 double-blind studies, KAR-007 or KAR-009. In this OLE study, all subjects will receive KarXT (a fixed combination of xanomeline 125 mg and trospium chloride 30 mg twice daily [BID]) for up to 52 weeks regardless of treatment assignment in the preceding Phase 3 acute study. The primary objective of the study is to assess the long-term safety and tolerability of KarXT in subjects with a DSM-5 diagnosis of schizophrenia. The secondary objective of this study is to assess the long-term efficacy and monitor trough concentrations of xanomeline and trospium after administration of KarXT.

Conditions
Schizophrenia
Being tested
Xanomeline and Trospium Chloride Capsules
Medical subject headings
Schizophrenia

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Xanomeline and Trospium Chloride CapsulesDrug

    Also called KarXT

    Oral xanomeline 50 mg/trospium chloride 20 mg BID on days 1-2 followed by xanomeline 100 mg/trospium chloride 20 mg BID on days 3-7. The dosage is increased to xanomeline 125 mg/trospium chloride 30 mg BID on days 8-364 unless the subject is experiencing adverse events from the xanomeline 100 mg/ trospium chloride 20 mg dose. Subjects who were increased to xanomeline 125 mg/trospium chloride 30 mg will have the option to return to xanomeline 100 mg/ trospium chloride 20 mg depending on clinical response and tolerability. Re-escalation to 125/30 BID or re-titration in cases in which the subject has been off KarXT for a longer period of time (at least a week) is allowed and will require a discussion between the principal investigator and the medical monitor.

Study groups in NCT04659174
Study groupRoleWhat they receive
KarXTExperimentalNot described
Receives: Drug: Xanomeline and Trospium Chloride Capsules

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Number of Participants With Treatment-Emergent Adverse Events (TEAEs)

    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.

    Measured: From first dose to end of study (Up to approximately 53 weeks)

Secondary outcomes (8)
  1. Number of Participants With Serious Adverse Events (SAEs)

    An SAE is any untoward medical occurrence, in the view of either the investigator or sponsor, that results in death; is life-threatening; results in inpatient hospitalization or prolongation of existing hospitalization; results in persistent or significant disability/incapacity, and/or; is a congenital anomaly/birth defect using the National Cancer Institute Common Terminology Criteria for Adverse Events (NCI CTCAE), version 5.0.

    Measured: From first dose to end of study (Up to approximately 53 weeks)

  2. Number of Participants With Treatment-Emergent Adverse Events (TEAE) Leading to Study Drug Discontinuation

    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.

    Measured: From first dose to end of study (Up to approximately 53 weeks)

  3. Change From Baseline in Positive and Negative Syndrome Scale (PANSS) Total Score at Week 52

    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 and the negative symptoms 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. Open-label Extension Baseline (OLEB) is defined as the most recent measurement prior to the first administration of study drug in KAR-008. The assessments performed on Visit 10 (Day 35) of studies KAR-007 or KAR-009 will be considered for OLEB baseline along with any additional procedures that will be performed on Day 0 of KAR-008.

    Measured: Open-label extension baseline, week 52

  4. Change From Baseline in Positive and Negative Syndrome Scale (PANSS) Positive Score at Week 52

    PANSS positive score is the sum of all PANSS 7 positive symptom scales with a minimum score of 7 and a maximum score of 49. Higher scores indicate more severe symptoms. 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. Open-label Extension Baseline (OLEB) is defined as the most recent measurement prior to the first administration of study drug in KAR-008. The assessments performed on Visit 10 (Day 35) of studies KAR-007 or KAR-009 will be considered for OLEB baseline along with any additional procedures that will be performed on Day 0 of KAR-008.

    Measured: Open-labe extension baseline, week 52

  5. Change From Baseline in Positive and Negative Syndrome Scale (PANSS) Negative Score at Week 52

    PANSS negative score is the sum of all PANSS 7 negative symptom scales with a minimum score of 7 and a maximum score of 49. Higher scores indicate more severe symptoms. Participants are rated from 1 to 7 on each symptom scale. The negative symptoms in schizophrenia are the diminution or loss of normal functions. Open-label Extension Baseline (OLEB) is defined as the most recent measurement prior to the first administration of study drug in KAR-008. The assessments performed on Visit 10 (Day 35) of studies KAR-007 or KAR-009 will be considered for OLEB baseline along with any additional procedures that will be performed on Day 0 of KAR-008.

    Measured: Open-label extension baseline, week 52

  6. Change From Baseline in PANSS Negative Marder Factor Score at Week 52

    PANSS Negative Marder Factor Score is the sum of 5 negative scales and 2 general scales (N1. Blunted affect; N2. Emotional withdrawal; N3. Poor rapport; N4. Passive/apathetic social withdrawal; N6. Lack of spontaneity; G7. Motor retardation; and G16. Active social avoidance). Participants are rated from 1 to 7 on each symptom scale. Higher score indicates more severe symptoms. The negative symptoms in schizophrenia are the diminution or loss of normal functions. Open-label Extension Baseline (OLEB) is defined as the most recent measurement prior to the first administration of study drug in KAR-008. The assessments performed on Visit 10 (Day 35) of studies KAR-007 or KAR-009 will be considered for OLEB baseline along with any additional procedures that will be performed on Day 0 of KAR-008.

    Measured: Open-label extension baseline, week 52

  7. Change From Baseline in Clinical Global Impression-Severity (CGI-S) Score at Week 52

    Completed independently by a clinician, the CGI-S categorizes the severity of the illness as: 1 = Normal, not at all ill; 2 = Borderline mentally ill; 3 = Mildly ill; 4 = Moderately ill; 5 = Markedly ill; 6 = Severely ill; and 7 = Among the most extremely ill patients, by asking the clinical 1 question and providing a rating based upon observed and reported symptoms, behavior, and function in the past 7 days to reflect the average severity level across the 7 days. Higher score indicates more severe illness. Open-label Extension Baseline (OLEB) is defined as the most recent measurement prior to the first administration of study drug in KAR-008. The assessments performed on Visit 10 (Day 35) of studies KAR-007 or KAR-009 will be considered for OLEB baseline along with any additional procedures that will be performed on Day 0 of KAR-008.

    Measured: Open-label extension baseline, week 52

  8. Percentage of PANSS Responders With >=30% Reduction in PANSS Total Score at Week 52

    A PANSS responder is defined as a participant with reduction from open-label extension baseline (OLEB) of at least a 30% improvement at Week 52 in the PANSS total score. 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. 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. OLEB is defined as the most recent measurement prior to the first administration of study drug in KAR-008. The assessments performed on Visit 10 (Day 35) of studies KAR-007 or KAR-009 will be considered for OLEB baseline along with any additional procedures that will be performed on Day 0 of KAR-008.

    Measured: At week 52

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted9 Dec 2020
  2. Study start1 Feb 2021
  3. Primary completion3 Oct 2023
  4. Study completion3 Oct 2023

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase 3
Primary purpose
Treatment
Allocation
Not applicable
Intervention model
Single group
Masking
None (open label)
Enrolment
152 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT04659174
Sponsor's protocol ID
KAR-008
Status last verified
Oct 2024
First submitted
2 Dec 2020
Last updated
28 Oct 2024
Data monitoring committee
Yes
FDA-regulated drug
Yes
FDA-regulated device
No
Individual data sharing
No

Questions about this trial

What is this clinical trial studying?

A Phase 3 study testing Xanomeline and Trospium Chloride Capsules in people with Schizophrenia, run by Karuna Therapeutics, Inc., a Bristol Myers Squibb company at 44 sites in 2 countries.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 8 inclusion and 7 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: finished, as of the sponsor's last update on 28 Oct 2024. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 44 sites in United States, Ukraine. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

What does this phase mean?

Phase 3 studies compare the treatment with the current standard treatment or a placebo in a large group, to confirm how well it works and watch for side effects.

Not every study follows the same path, and some studies (observational studies, device studies) have no phase.

Are results available for this study?

Yes. Results are posted in the registry (first posted 28 Oct 2024). A summary is in the For doctors view, and the full results are on ClinicalTrials.gov.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Number of Participants With Treatment-Emergent Adverse Events (TEAEs) (time frame: From first dose to end of study (Up to approximately 53 weeks)). It is what the study was designed to measure, not a finding.

Where can I read the original study information?
Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 28 Oct 2024; AzTrials last refreshed its copy on 3 Nov 2026.

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