Xanomeline and Trospium Improves Social Functioning and Life Engagement in Schizophrenia: EMERGENT Trials Analysis

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Key Takeaways

Xanomeline and trospium significantly improved social functioning in schizophrenia patients, with a notable reduction in prosocial factor scores compared to placebo.
The treatment also enhanced life engagement, showing significant improvements in motivation and social interaction over five weeks.
The EMERGENT trials involved 640 participants, with a double-blind, placebo-controlled design, highlighting the robustness of the findings.
These results suggest a promising new approach to schizophrenia management, addressing both clinical symptoms and social reintegration.

Learn more about the findings from the first 3 EMERGENT trials, and their use in the 4th and 5th trials, presented at the 30th Annual Nevada Psychiatric Association National Psychopharmacology Update.

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CONFERENCE REPORTER

A post hoc pooled analysis of the EMERGENT-1, EMERGENT-2, and EMERGENT-3 trials has demonstrated that xanomeline and trospium significantly improves social functioning and life engagement in individuals with schizophrenia. The findings were presented via poster session at the 30th Annual Nevada Psychiatric Association National Psychopharmacology Update.¹

Study Design and Participant Demographics

The first 3 EMERGENT trials were 5-week, double-blind, placebo-controlled studies enrolling 640 participants with acute schizophrenia exacerbations. Participants were randomized to receive xanomeline and trospium (314 participants) or placebo (326 participants), with dosing titrated up to 125 mg of xanomeline and 30 mg trospium 2 times daily.¹

Significant Improvements in Social Functioning

The EMERGENT trials assessed social functioning using PANSS-derived measures. After 5 weeks of treatment, xanomeline and trospium showed a significantly greater reduction in the prosocial factor, with a least squares mean change from baseline to week 5 at -5.9, compared with -3.1 in the placebo group.¹ This improvement was observed across 6 PANSS items: hallucinatory behavior, suspiciousness/persecution, emotional withdrawal, passive social withdrawal, stereotyped thinking, and active social avoidance.

Enhanced Life Engagement with Treatment

Beyond social functioning, the study evaluated life engagement, a factor encompassing motivation and social interaction. By week 5, xanomeline and trospium demonstrated significantly greater reductions in the PANSS-derived life engagement factor compared with placebo.¹ Dosed patients had a least square mean of -7 compared with -3.8 in the placebo group.¹ Improvements were seen in 10 of 11 PANSS life engagement items, with notable changes in emotional withdrawal, depression, and disturbance of volition.

Future Implications for Schizophrenia Treatment

The study findings highlight xanomeline and trospium’s potential in enhancing patient well-being through improved social and functional outcomes. The results suggest a new approach to schizophrenia management, addressing both clinical symptoms and social reintegration.

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Reference

1. Correll C, Zitnik G, Vuocolo S, et al. Effect of xanomeline and trospium chloride on social functioning and life engagement in schizophrenia: post hoc pooled analysis from the EMERGENT trials. Presented at: Nevada Psychiatric Association 30th Annual Psychopharmacology Update; February 13, 2025.