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A Phase 3 Study to Evaluate the Safety and Efficacy of KarXT + KarX-EC for the Treatment of Agitation Associated With Alzheimer's Disease (ADAGIO-1)

NCT07011732

RecruitingPhase 3

Sponsor: Bristol-Myers Squibb

Conditions: Alzheimer Disease

Interventions: Xanomeline/Trospium Chloride Capsule, Xanomeline Enteric Capsule, Placebo

Countries: United States, Argentina, Brazil, Bulgaria, Canada, China, Croatia, Greece

The purpose of this study is to evaluate the efficacy and safety of KarXT + KarX-EC in adult participants with agitation related to Alzheimer's Disease.

Eligibility overview

Sex: ALL

Age: 55 Years to 90 Years

Healthy volunteers: No

Study type: INTERVENTIONAL

Eligibility criteria

Inclusion Criteria

\- A diagnosis of Alzheimer's disease (AD) in accordance with the 2024 Alzheimer's Association criteria with one of the following confirmations of AD pathology: i) Historical evidence of AD diagnosis with amyloid positron emission tomography (PET), Aβ42/40 ratio in CSF, pTau181/Aβ42 ratio in CSF or pTau217/Aβ42 ratio in plasma using an Health Authority (HA)-authorized diagnostic assay.

ii) If no historical evidence available: A. A plasma biomarker will be assessed for eligibility if allowed per regulatory requirements. The test cutoff(s) will be based on diagnostic use approval.

B. If a plasma biomarker assay cannot be used or if the assay result is inconclusive, conduct one the following:

* Amyloid PET.
* Aβ42/40 ratio or pTau181/Aβ42 ratio in CSF using an HA-authorized diagnostic assay.

  * Mini-Mental State Examination (MMSE) score of ≤ 24 at Screening (Visit 1).
  * Have an identified caregiver who has sufficient contact (approximately 8 hours over a week) and is willing to:

    i) Attend all visits and report on participant's status. ii) Oversee participant compliance with medication and study procedures. iii) Participate in the study assessments and provide informed consent to participate in the study.
  * History of agitation that meets the International Psychogeriatric Association (IPA) consensus definition for agitation in cognitive disorders with onset at least two weeks prior to Screening (Visit 1).
  * AD participants are required to have NPI/NPI-NH Agitation/Aggression score ≥ 4 at Screening (Visit 1) and Baseline (Visit 2).
  * CMAI-IPA Total Score ≥ 30 at Screening (Visit 1) and Baseline (Visit 2).

Exclusion Criteria

\- Medical Conditions: i) Agitation symptoms that are primarily attributable to a condition other than the AD causing the dementia.

ii) History of bipolar disorder, schizophrenia, or schizoaffective disorder. iii) History of (or at high risk for) urinary retention, gastric retention, or narrow-angle glaucoma as evaluated by the Investigator.

iv) Risk of suicidal behavior during the study as determined by the Investigator's clinical assessment and/or C-SSR.

\- Prior/Concomitant Therapy: i) Recent history of receiving monoamine oxidase inhibitors, anticonvulsants (eg, lamotrigine, divalproex), mood stabilizers (eg, lithium), tricyclic antidepressants (eg, imipramine, desipramine), or any other psychoactive medications except for as needed anxiolytics (eg, lorazepam).

A. Selective serotonin reuptake inhibitors and serotonin norepinephrine reuptake inhibitors taken at a stable dose for at least 8 weeks prior to Screening (Visit 1) may be permitted.

B. Trazodone may be used as a hypnotic or for agitation if started at least 8 weeks prior to Screening (Visit 1).

C. Mirtazapine may be used as a hypnotic if started at least 8 weeks prior to Screening (Visit 1).

\- Other protocol-defined Inclusion/Exclusion criteria apply.

Locations (158)

Scottsdale, Arizona, United States
Anaheim, California, United States
La Jolla, California, United States
Pomona, California, United States
Torrance, California, United States
Walnut Creek, California, United States
Colorado Springs, Colorado, United States
Maitland, Florida, United States
Maitland, Florida, United States
Merritt Island, Florida, United States
Miami, Florida, United States
Miami, Florida, United States
Miami, Florida, United States
Miami, Florida, United States
Ocala, Florida, United States
Orlando, Florida, United States
Port Orange, Florida, United States
Marrero, Louisiana, United States
Gaithersburg, Maryland, United States
Foxborough, Massachusetts, United States
Newton, Massachusetts, United States
South Dartmouth, Massachusetts, United States
Springfield, Massachusetts, United States
Bloomfield Hills, Michigan, United States
Troy, Michigan, United States
Las Vegas, Nevada, United States
Middletown, New Jersey, United States
Princeton, New Jersey, United States
Inwood, New York, United States
New Windsor, New York, United States
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