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A Study to Evaluate the Efficacy and Safety of Adjunctive KarXT for the Treatment of Mania, With or Without Mixed Features, in Participants With Bipolar-I Disorder Taking Lithium, Valproate, or Lamotrigine

A Phase 3, Randomized, Double-blind, Placebo-controlled, Study to Evaluate the Efficacy and Safety of Adjunctive KarXT for the Treatment of Mania, With or Without Mixed Features, in Individuals With Bipolar-I Disorder Taking Lithium, Valproate, or Lamotrigine

Status
Recruiting
Phases
Phase 3
Study type
Interventional
Source
ClinicalTrials.gov
Registry ID
NCT07140913
Enrollment
424
Registered
2025-08-26
Start date
2025-10-08
Completion date
2027-06-28
Last updated
2026-06-23

For informational purposes only — not medical advice. Sourced from public registries and may not reflect the latest updates. Terms

Conditions

Bipolar Disorder, Mania

Keywords

Bipolar-I Disorder, Mania, KarXT, adjunctive treatment, mood stabilizer

Brief summary

The purpose of this study is to evaluate the efficacy and safety of adjunctive KarXT for the treatment of mania in participants with Bipolar-I Disorder.

Interventions

Specified dose on specified days

DRUGPlacebo

Specified dose on specified days

Sponsors

Bristol-Myers Squibb
Lead SponsorINDUSTRY

Study design

Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
DOUBLE (Subject, Investigator)

Eligibility

Sex/Gender
ALL
Age
18 Years to 65 Years
Healthy volunteers
No

Inclusion criteria

* Individuals have a primary diagnosis of Bipolar-I disorder established by a comprehensive psychiatric evaluation based on the DSM-5-TR criteria and confirmed by the Mini International Neuropsychiatric Interview (MINI) version 7.0.2. * Individual is experiencing an acute exacerbation or relapse of manic episode, with or without mixed features (≤ 3 weeks). * The individual requires hospitalization for the acute exacerbation or relapse of mania. * Body mass index ≥ 18 and ≤ 40 kg/m2. * Currently experiencing an acute episode of mania or mania with mixed features with a therapeutic dose of lithium, valproate, or lamotrigine. The dose of the mood stabilizer must have remained stable for at least two weeks prior to screening. Additionally, participants on valproate must have been receiving treatment with valproate for a minimum of seven months. * YMRS Total Score of ≥ 18 at Screening and at Baseline, and \< 20% reduction in YMRS from screening to baseline.

Exclusion criteria

* Any primary DSM-5-TR disorder other than BP-I within 12 months before screening (confirmed using MINI version 7.0.2 at screening) including BP-I depression (for previous 3 months only), BP-I with rapid cycling, first manic episode, BP-II, primary psychotic disorder, borderline personality disorder, and major depressive disorder, with the exception of mild anxiety disorders. * Individual has a DSM-5-TR diagnosis of moderate to severe substance use disorder (except tobacco use disorder) within the 12 months before screening (confirmed using MINI version 7.0.2 at screening), or current use as determined by urine toxicology screen or alcohol test. * Risk for suicidal behavior at screening as determined by the investigator's clinical assessment and the C-SSRS with an answer "Yes" to item 4 or 5 within 6 months before screening or between screening and baseline, or "Yes" to any of the 5 items (C-SSRS behavior) with an event occurring within the 12 months before screening, or between screening and baseline. * History of irritable bowel syndrome (with or without constipation) or any serious constipation requiring treatment within the last 6 months. * History or high risk of urinary retention, gastric retention, or narrow-angle glaucoma. * Participants with HIV, cirrhosis, biliary duct abnormalities, hepatobiliary carcinoma, and/or active hepatic viral infections based on either medical history or the LFT results. * Elevations in hepatic transaminases at screening ≥ 2 × ULN for ALT or AST and/or bilirubin \> 1.5× ULN, unless in the context of Gilbert's syndrome. * All grades of hepatic impairment (mild \[Child-Pugh Class A\], moderate \[Child-Pugh Class B\], and severe \[Child-Pugh Class C\]). * Other protocol-defined Inclusion/

Design outcomes

Primary

MeasureTime frame
Change from baseline in Young Mania Rating Scale (YMRS) at Week 5At Week 5

Secondary

MeasureTime frame
Change from baseline in Clinical Global Impressions Bipolar (CGI-BP) at Week 5At Week 5
Occurrence of response at Week 5 assessed as the number of participants with a ≥ 50% decrease from baseline in Young Mania Rating Scale (YMRS) scoreAt Week 5
Occurrence of response at Week 5 assessed as the number of participants with a ≥ 1 change from baseline in CGI-BPAt Week 5
Number of participants with Treatment-emergent Adverse Events (TEAEs)Up to Week 7
Number of participants with Serious Adverse Events (SAEs)Up to Week 7
Number of participants with TEAEs leading to treatment discontinuationUp to Week 5
Change from baseline in Columbia-Suicide Severity Rating Scale (C-SSRS)Up to Week 7
Change from baseline in Barnes Akathisia Rating Scale (BARS) at Week 5At Week 5
Change from baseline in Simpson Angus Scale (SAS) at Week 5At Week 5
Change from baseline in Abnormal Involuntary Movement Scale (AIMS) at Week 5At Week 5
Change from baseline in International Prostate Symptom Score (IPSS) at Week 5At Week 5

Countries

Argentina, Bulgaria, China, Denmark, France, India, Israel, Italy, Japan, Poland, Romania, Ukraine, United States

Contacts

CONTACTBMS Clinical Trials Contact Center www.BMSClinicalTrials.com
Clinical.Trials@bms.com855-907-3286
CONTACTFirst line of the email MUST contain NCT # and Site #.
STUDY_DIRECTORBristol-Myers Squibb

Bristol-Myers Squibb

Outcome results

None listed

Source: ClinicalTrials.gov · Data processed: Jun 24, 2026