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Status:

RECRUITING

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-2)

Lead Sponsor:

Bristol-Myers Squibb

Conditions:

Alzheimer Disease

Eligibility:

All Genders

55-90 years

Phase:

PHASE3

Brief Summary

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 Criteria

Inclusion

  • \- 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 5 to 22, inclusive, at Screening (Visit 1).
  • Have one identified caregiver who should have sufficient contact (approximately 10 hours a week or more) 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).
  • CGI-S ≥ 4, as related to agitation, at Screening (Visit 1) and Baseline (Visit 2).
  • At least 1 of the following 3 criteria must be established from the CMAI-IPA at Screening (Visit 1) and Baseline (Visit 2; CMAI-IPA Physical/Verbal Aggression Positivity):
  • i) 1 or more aggressive behaviors occurring at least several times per week.
  • ii) 2 or more aggressive behaviors occurring at least once or twice per week.
  • iii) 3 or more aggressive behaviors occurring less than once per week.

Exclusion

  • \- 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. Mirtazapine or trazodone may be used as a hypnotic if started at least 8 weeks prior to Screening (Visit 1).
  • \- Other protocol-defined Inclusion/Exclusion criteria apply.

Key Trial Info

Start Date :

July 16 2025

Trial Type :

INTERVENTIONAL

Allocation :

ESTIMATED

End Date :

November 13 2028

Estimated Enrollment :

352 Patients enrolled

Trial Details

Trial ID

NCT07011745

Start Date

July 16 2025

End Date

November 13 2028

Last Update

March 4 2026

Active Locations (140)

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Page 1 of 35 (140 locations)

1

Chandler Clinical Trials, LLC

Chandler, Arizona, United States, 85224

2

Local Institution - 2631

Chandler, Arizona, United States, 85226-3732

3

Local Institution - 2625

Long Beach, California, United States, 90040

4

Local Institution - 2607

Long Beach, California, United States, 90805