Karuna Therapeutics, Inc. announced that results from the EMERGENT-1 Phase 2 clinical trial evaluating KarXT for the treatment of schizophrenia were published in theNew England Journal of Medicine (NEJM). The double-blind, placebo-controlled, five-week inpatient EMERGENT-1 Phase 2 trial enrolled 182 adults with an acute exacerbation of schizophrenia. In this trial, a twice-daily, flexible-dose treatment with KarXT demonstrated a statistically significant and clinically meaningful 11.6-point reduction in the Positive and Negative Syndrome Scale (PANSS) total score compared to placebo at Week 5, the primary outcome measure of the study, with an effect size of 0.75 (p<0.0001). Results published in NEJM also include data for pre-specified secondary outcome measures. Four of the five pre-specified secondary outcome measures, including PANSS positive symptom subscore, PANSS negative symptom subscore, PANSS Marder negative symptom subscore, and Clinical Global Impression – Severity frequency counts, showed statistically significant reductions following treatment with KarXT compared to placebo at Week 5 (p<0.001). KarXT was generally well-tolerated, with similar discontinuation rates between KarXT and placebo arms, both overall (20% vs. 21%) and due to treatment-emergent adverse events (2% in both arms). The most common adverse events associated with KarXT, including constipation, nausea, dry mouth, dyspepsia and vomiting, were mild-to-moderate in severity and were not associated with treatment discontinuation. Rates of nausea, vomiting, and dry mouth decreased over the course of the trial, while rates of constipation remained essentially constant. Incidences of somnolence, weight gain and extrapyramidal symptoms, which are common problematic side effects of current antipsychotic therapies, were similar in the placebo and KarXT treatment groups. The published manuscript titled “Muscarinic Cholinergic Receptor Agonist and Peripheral Antagonist for Schizophrenia,” is available online, and will appear in the February 25, 2021 issue of NEJM.