Key Takeaways
Extended Takeaways
- At week 5, 59.0% (n = 49) of KarXT-treated patients achieved a ≥ 20% PANSS total score reduction, while 15.7% (n = 13) achieved a ≥ 50% reduction, showing that response rates fell as a more stringent threshold was applied.
- The number needed to treat was NNT = 3 (3–5) for ≥ 20% improvement, NNT = 4 (3–7) for ≥ 30%, NNT = 7 (4–20) for ≥ 40%, and NNT = 11 (6–145) for ≥ 50% improvement in PANSS total score between baseline and week 5, which can help set expectations for short-term inpatient treatment.
- For onset of benefit, the ≥ 20% and ≥ 30% PANSS response thresholds separated from placebo by week 2, whereas the ≥ 40% and ≥ 50% thresholds did not reach P < .05 until week 4.
- KarXT improved all 5 PANSS Marder factors by week 5, with effect sizes ranging from 0.48 to 0.66, suggesting benefit across disorganized thought, uncontrolled hostility, and anxiety/depression in addition to positive and negative symptoms.
- Between-group differences on all 5 PANSS Marder factors were significant starting at week 2, indicating that multidomain symptom improvement emerged at the first postbaseline assessment.
- This was a 5-week inpatient study in acutely psychotic adults with schizophrenia and baseline PANSS total scores of 97.3 ± 9.34 in the KarXT group and 96.6 ± 8.39 in the placebo group, so the findings are most applicable to short-term treatment of acute exacerbations rather than long-term management or treatment-resistant schizophrenia.
