Very concerning study results,
is this drug a dud?
Efficacy and Safety of Xanomeline-Trospium Chloride in Schizophrenia: A Randomized Clinical Trial - PubMed
First, the sample in this trial is different from most antipsychotic studies because African Americans make up 60% of the participants. Typically, this group is under-represented in clinical trials, so this could make comparisons to other studies a bit trickier.
Also, all the patients were inpatient for the full 5 weeks of the trial and had to voluntarily agree to stay for that long. If they chose to leave, they were dropped from the study. This could introduce some bias, since people who agree to stay in a hospital setting for 5 weeks may not be representative of all patients with the condition.
When it comes to the results, patients on placebo had a 12-point reduction on the PANSS scale just from being in the hospital, while those on Cobenfy had a 20-point reduction. The 8-point difference between the two groups doesn’t seem huge, especially considering that other drugs like Olanzapine showed a 16-point reduction and Clozapine showed a 22-point reduction in similar studies.