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  • Novel Combination...

Novel Combination Therapy Xanomeline-Trospium Promising for Treatment of Schizophrenia: JAMA

Written By : Dr Riya Dave |Medically Reviewed By : Dr. Kamal Kant Kohli Published On 2024-05-02T20:02:50+05:30  |  Updated On 3 May 2024 12:30 PM IST
Novel Combination Therapy Xanomeline-Trospium  Promising for Treatment of Schizophrenia: JAMA
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Researchers have found that the investigational combination of xanomeline-trospium (KarXT) is effective and well-tolerated in individuals with schizophrenia who are experiencing acute psychosis. The randomized controlled phase III EMERGENT-3 trial demonstrated that the combination therapy significantly reduced Positive and Negative Syndrome Scale (PANSS) total scores over five weeks compared to placebo, indicating its potential as an alternative treatment option. This study was published in the journal JAMA Psychiatry by Kaul and colleagues.

Schizophrenia is a chronic and severe mental disorder that affects how a person thinks, feels, and behaves. Traditional antipsychotic medications often target dopamine receptors, but the combination therapy of xanomeline-trospium represents a new approach that does not involve D2 dopamine receptor blocking activity.

The EMERGENT-3 trial was a randomized, double-blind, multicenter, placebo-controlled trial involving 256 participants aged 18 to 65 with a diagnosis of schizophrenia. Participants were assigned to either the xanomeline-trospium group (n=125) or the placebo group (n=131). The xanomeline-trospium group received varying doses of the combination therapy over the five-week treatment period, while the placebo group received a placebo.

The primary outcome was a change in PANSS total scores from baseline to week 5. Secondary endpoints included changes in PANSS positive and negative subscale scores.

The key findings of the study were:

• Participants receiving xanomeline-trospium experienced a greater reduction in PANSS total scores compared to those on placebo (−20.6 vs −12.2).

• The least squares mean difference was −8.4 (95% CI −12.4 to −4.3, P<0.001).

• The Cohen d effect size was 0.60, indicating a moderate effect of the combination therapy.

• The xanomeline-trospium group showed significant reduction in PANSS positive subscale score (−7.1 vs −3.6) at week 5 compared to placebo.

• The combination therapy was well tolerated, with few serious treatment-emergent adverse events.

• Discontinuation rates were similar between the therapy and placebo groups (6.4% vs 5.5%).

The findings suggest that the novel combination therapy xanomeline-trospium may offer a new treatment option for individuals with schizophrenia experiencing acute psychosis. The results are consistent with previous trials and support the potential for xanomeline-trospium to be the first non-dopamine medication with proven efficacy in treating acute episodes of schizophrenia.

Xanomeline-trospium demonstrates promise as a novel combination therapy for treating acute psychosis in individuals with schizophrenia. The therapy's efficacy and tolerability make it a potential alternative to traditional antipsychotics. Further research is needed to evaluate the long-term durability of the therapy's effect and safety.

Reference:

Kaul, I., Sawchak, S., Walling, D. P., Tamminga, C. A., Breier, A., Zhu, H., Miller, A. C., Paul, S. M., & Brannan, S. K. (2024). Efficacy and safety of xanomeline-trospium chloride in schizophrenia: A randomized clinical trial. JAMA Psychiatry (Chicago, Ill.). https://doi.org/10.1001/jamapsychiatry.2024.0785

JAMA PsychiatrySchizophreniaAcute psychosisXanomeline-trospiumPositive and Negative Syndrome Scale (PANSS)Antipsychotic medication
Source : JAMA Psychiatry
Dr Riya Dave
Dr Riya Dave

    Dr Riya Dave has completed dentistry from Gujarat University in 2022. She is a dentist and accomplished medical and scientific writer known for her commitment to bridging the gap between clinical expertise and accessible healthcare information. She has been actively involved in writing blogs related to health and wellness.

    Dr. Kamal Kant Kohli
    Dr. Kamal Kant Kohli

    Dr Kamal Kant Kohli-MBBS, DTCD- a chest specialist with more than 30 years of practice and a flair for writing clinical articles, Dr Kamal Kant Kohli joined Medical Dialogues as a Chief Editor of Medical News. Besides writing articles, as an editor, he proofreads and verifies all the medical content published on Medical Dialogues including those coming from journals, studies,medical conferences,guidelines etc. Email: drkohli@medicaldialogues.in. Contact no. 011-43720751

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