MCKINNEY, Texas (AP) — A 17-year-old boy was fatally stabbed by a competitor in a “sneak, surprise attack” at a Texas high school track meet, a prosecutor told jurors Thursday, as a trial opened in a case that stunned an affluent Dallas suburb where the pair attended school.
Dozens of people lined up to get a seat in the Collin County courtroom. The death last year quickly drew wide attention, in part because of social media posts that amplified the case in racial terms. The accused, Karmelo Anthony, now 19, is Black, while the victim, Austin Metcalf, was white.
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A courtroom sketch, provided by Pat Lopez shows Karmelo Anthony, center, at the defense table, the jury on the left and the presiding judge on the right, on Thursday, June 4, 2026, in McKinney, Texas, during the trial of a teen accused of fatally stabbing another during a track meet in suburban Dallas last year. (Pat Lopez via AP)
A courtroom sketch, provided by Pat Lopez shows Karmelo Anthony, center, at the defense table, the jury on the left and the presiding judge on the right, on Thursday, June 4, 2026, in McKinney, Texas, during the trial of a teen accused of fatally stabbing another during a track meet in suburban Dallas last year. (Pat Lopez via AP)
A courtroom sketch, provided by Pat Lopez shows Karmelo Anthony, center, at the defense table, the jury on the left and the presiding judge on the right, on Thursday, June 4, 2026, in McKinney, Texas, during the trial of a teen accused of fatally stabbing another during a track meet in suburban Dallas last year. (Pat Lopez via AP)
The Collin County courthouse is shown Thursday, June 4, 2026, in McKinney, Texas. (AP Photo/Tony Gutierrez)
Supporters for Karmelo Anthony demonstrate in front of the Collin County courthouse Thursday, June 4, 2026, in McKinney, Texas. (AP Photo/Tony Gutierrez)
A courtroom sketch, provided by Pat Lopez shows Karmelo Anthony, center, at the defense table, the jury on the left and the presiding judge on the right, on Thursday, June 4, 2026, in McKinney, Texas, during the trial of a teen accused of fatally stabbing another during a track meet in suburban Dallas last year. (Pat Lopez via AP)
Anthony told police he was protecting himself when the two got into a confrontation during a track meet in Frisco, a booming city in Dallas' sprawling north suburbs, according to an arrest report.
But prosecutor Bill Wirskye told jurors it was a “senseless murder" and not a case of self-defense.
“He didn't want a fight,” Wirskye said of Metcalf.
The jury was seated this week under increased security at the courthouse, and a judge has set strict rules over the proceedings, including prohibiting attorneys from discussing the case publicly.
The stabbing happened on a rainy morning in April 2025. Witnesses told police the confrontation began when Anthony sat under a tent belonging to Metcalf's team, according to an arrest report. The teens went to different high schools in Frisco.
When Metcalf told Anthony that he needed to move, Anthony reached inside his bag and allegedly replied: “Touch me and see what happens,” the report said.
In his opening remarks, defense attorney Mike Howard said Metcalf made the first contact.
"In that split second, Melo has a decision to make: how and when to act. Self-defense is useless if you wait too late to defend yourself. ... He reacts in a split second of fear, chaos,” Howard said.
Metcalf was stabbed in the chest. Anthony faces up to life in prison if convicted of murder.
Mark Porter, a forensic video analyst, guided jurors through video recorded at the track meet, including some images that were magnified. He said about 15 minutes elapsed between Metcalf entering the stadium and Anthony's arrest.
The parents of both teens have said they were good students who planned to go to college. Metcalf's father has condemned those who seized on the race of the teenagers after the killing.
“This was not a race thing. This is not a political thing. Please do not comment if you do not know what happened,” Jeff Metcalf said on Fox News' “America Reports.”
“This is a human being thing,” he said. “This person made a bad choice and it affected both his family and my family forever.”
Authorities have also issued warnings about online discussions surrounding the killing. Frisco Police Chief David Shilson has urged people to beware of posts spreading “misinformation, hate, fear, and division."
Associated Press writer Ed White in Detroit contributed.
A courtroom sketch, provided by Pat Lopez shows Karmelo Anthony, center, at the defense table, the jury on the left and the presiding judge on the right, on Thursday, June 4, 2026, in McKinney, Texas, during the trial of a teen accused of fatally stabbing another during a track meet in suburban Dallas last year. (Pat Lopez via AP)
The Collin County courthouse is shown Thursday, June 4, 2026, in McKinney, Texas. (AP Photo/Tony Gutierrez)
Supporters for Karmelo Anthony demonstrate in front of the Collin County courthouse Thursday, June 4, 2026, in McKinney, Texas. (AP Photo/Tony Gutierrez)
A courtroom sketch, provided by Pat Lopez shows Karmelo Anthony, center, at the defense table, the jury on the left and the presiding judge on the right, on Thursday, June 4, 2026, in McKinney, Texas, during the trial of a teen accused of fatally stabbing another during a track meet in suburban Dallas last year. (Pat Lopez via AP)
PRINCETON, N.J. & TOKYO--(BUSINESS WIRE)--Jun 4, 2026--
Otsuka Pharmaceutical Development & Commercialization, Inc. and Otsuka Pharmaceutical Co., Ltd. (Otsuka) today announced that VOYXACT ® (sibeprenlimab-szsi) preserved kidney function compared to placebo over 12 months in adults with primary IgA nephropathy (IgAN) at risk for disease progression. VOYXACT demonstrated an increase in mean change for the estimated glomerular filtration rate (eGFR) from baseline of +0.7 mL/min/1.73 m 2 compared to a decline of -4.8 mL/min/1.73 m 2 in the placebo-treated group, providing early evidence that sibeprenlimab may stabilize eGFR decline in patients with IgA nephropathy, which will be further validated in the ongoing Phase 3 VISIONARY trial. These results were presented at the European Renal Association (ERA) Congress 2026 in Glasgow as part of a pre-specified interim analysis of the VISIONARY Phase 3 trial. In the VISIONARY study, VOYXACT was well tolerated with a favorable safety profile in line with previously reported data 1. Full data from the VISIONARY study final analysis will be presented at a future medical conference. These findings provide clinical evidence linking upstream selective A-PRoliferation-Inducing Ligand (APRIL) inhibition to downstream preservation of kidney function, reinforcing VOYXACT’s ability to improve long-term outcomes.
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“For patients with IgA nephropathy, slowing the loss of kidney function is essential to improve long-term outcomes, including the likelihood of kidney failure and the need for dialysis or transplant,” said Vlado Perkovic, MBBS, Ph.D., Provost at the University of New South Wales, Australia. “These data are very encouraging and suggest that selective inhibition of APRIL may slow eGFR decline, helping patients preserve kidney function and improve long-term outcomes.”
In this pre-specified interim analysis of the global VISIONARY Phase 3 trial (n=320; sibeprenlimab, n=152; placebo, n=168), patients treated with sibeprenlimab showed an increase in the mean eGFR change from baseline of +0.7 (95% CI, -0.9 to 2.3) mL/min/1.73 m² compared to a decline of -4.8 (95% CI, -6.3 to -3.3) mL/min/1.73 m² in the placebo-treated arm, representing a treatment effect of 5.5 (95% CI, 3.4 to 7.6) mL/min/1.73 m². At 12 months, sibeprenlimab showed a mean eGFR change from baseline that meets the KDIGO treatment goal to reduce the annual kidney function decline to the normal physiological rate of (<1 mL/min/1.73 m 2 /year).
Supporting the preservation of kidney function observed in the change from baseline analysis, the annualized slope of eGFR showed -3.0 (95% CI, -4.6 to -1.4) mL/min/1.73 m²/year with sibeprenlimab compared to -7.6 (95% CI, -9.1 to -6.1) mL/min/1.73 m²/year with placebo over 12 months, showing a treatment effect of 4.6 (95% CI, 2.5 to 6.8) mL/min/1.73 m²/year. The overall safety profile of VOYXACT was comparable to placebo, with infections and injection site reactions as the most common adverse events. Sibeprenlimab was generally well tolerated, and the types and frequencies of treatment-emergent adverse events (TEAEs) were comparable to placebo 1.
“Together with previously observed reductions in Gd-IgA1, proteinuria, and hematuria, these new eGFR data show preserved kidney function over 12 months, which expand the growing body of evidence for VOYXACT demonstrating the potential to meaningfully improve clinical outcomes for adults with primary IgAN at risk for disease progression,” said John Kraus, M.D., Ph.D., executive vice president and chief medical officer, Otsuka. “These findings strengthen the rationale for selective APRIL inhibition as a targeted approach that modulates B-cell activity to reduce pathogenic IgA production, without B-cell depletion, differentiating selective APRIL inhibition as a safe and effective option for improving outcomes for patients with IgA nephropathy.”
About the VISIONARY Study
The VISIONARY Phase 3 trial is ongoing and will evaluate the long-term safety and efficacy of sibeprenlimab in preserving kidney function based on annualized slope of estimated glomerular filtration rate (key second efficacy endpoint), estimated glomerular filtration rate change from baseline (secondary efficacy endpoint) over a 24-month treatment period. Additional longer-term assessments are planned in the Phase 2/3 open-label extension study (NCT05248659).
About IgAN
IgA nephropathy (IgAN) is a progressive, immune-mediated, chronic kidney disease that typically manifests in adults aged 20-40 years and can lead to end-stage kidney disease (ESKD) over the lifetime of most patients 2-4. IgAN is characterized by the accumulation of Gd-IgA1 complexes in the kidneys 3. IgAN can lead to progressive loss of kidney function and, eventually, ESKD, imposing a significant burden on patients 3. Despite supportive care, there is an unmet need for treatments that address the root causes of the condition 5. Continued research in IgAN remains crucial to uncovering opportunities for advancement in our understanding and treatment of patients 5.
About VOYXACT® (sibeprenlimab-szsi)
VOYXACT (sibeprenlimab-szsi) is a humanized monoclonal antibody that binds to and blocks APRIL, which plays a key role in the 4-hit process of IgAN pathogenesis and is an important initiating and sustaining factor in IgAN progression by promoting the production of pathogenic galactose-deficient IgA1 (Gd-IgA1) 5-8. Inhibition of APRIL results in reduced levels of serum galactose-deficient IgA1 (Gd-IgA1), which is implicated in the pathogenesis of IgAN. VOYXACT is a self-administered, subcutaneous injection dosed once every four weeks. VOYXACT is the first and only FDA-approved treatment for primary IgAN that selectively inhibits APRIL, a key immune driver of the disease 1. VOYXACT was granted accelerated approval by the U.S. FDA on November 25, 2025. Otsuka has initiated a rolling submission of a supplemental Biologics License Application (sBLA) to the U.S. FDA for VOYXACT traditional approval, including data from the 24-month eGFR endpoint.
INDICATION and IMPORTANT SAFETY INFORMATION forVOYXACT® (sibeprenlimab-szsi)
INDICATION
VOYXACT is indicated to reduce proteinuria in adults with primary immunoglobulin A nephropathy (IgAN) at risk for disease progression.
This indication is approved under accelerated approval based on reduction of proteinuria. It has not been established whether VOYXACT slows kidney function decline over the long-term in patients with IgAN. Continued approval for this indication may be contingent upon verification and description of clinical benefit in a confirmatory clinical trial.
IMPORTANT SAFETY INFORMATION
CONTRAINDICATION
VOYXACT is contraindicated in patients with serious hypersensitivity to sibeprenlimab-szsi or any of the excipients of VOYXACT.
WARNINGS AND PRECAUTIONS
Immunosuppression and Increased Risk of Infections: VOYXACT suppresses the immune system by reducing antibody production, which may increase the risk of infections. Patients with chronic or recurring infections may have an increased risk of serious infection. In clinical trials, infections occurred in 49% of patients treated with VOYXACT compared with 45% of patients treated with placebo.
Before initiating VOYXACT, assess patients for active infections. During treatment, monitor patients for signs and symptoms of infection. If a serious infection develops, consider interrupting VOYXACT until the infection is controlled.
Immunosuppression and Immunization Risks: Because of its mechanism of action, VOYXACT may interfere with immune responses to vaccines and increase the risk of infection from live vaccines. Live vaccines are not recommended within 30 days prior to initiation of VOYXACT or during treatment with VOYXACT as safety has not been established. No data are available on the secondary transmission of infection from persons receiving live vaccines to patients receiving VOYXACT or on the efficacy of immunizations administered while receiving VOYXACT.
Common Adverse Reactions: The most common adverse reactions (reported in ≥10% of patients treated with VOYXACT and at a higher incidence than placebo) in patients treated with VOYXACT and placebo, respectively, were infections (49% versus 45%) and injection site reactions (24% versus 23%). The most common infection was upper respiratory infection (15% versus 14%), and the most common injection site reaction was injection site erythema (13% versus 12%). Most adverse reactions were reported as mild or moderate in severity and resolved without treatment interruption or discontinuation.
Pregnancy: There are no available data on VOYXACT use in pregnant women to evaluate for a drug-associated risk of major birth defects, miscarriage or other adverse maternal or fetal outcomes. Monoclonal antibodies, such as sibeprenlimab-szsi, can be actively transported across the placenta as pregnancy progresses; therefore, potential effects on a fetus are likely to be greater during the second and third trimester of pregnancy.
Lactation: There are no data on the presence of sibeprenlimab-szsi in human milk, the effects of sibeprenlimab-szsi on the breastfed infant, or the effects of sibeprenlimab-szsi on milk production.
Pediatric Use: Safety and effectiveness of VOYXACT in pediatric patients have not been established.
Geriatric Use: Clinical studies of VOYXACT did not include sufficient numbers of patients aged 65 and over to determine whether they respond differently from younger adult patients.
Pregnant women exposed to VOYXACT, or their healthcare providers, should report VOYXACT exposure by calling 1-833-869-9228 or visiting www.VOYXACT.com
To report SUSPECTED ADVERSE REACTIONS, contact Otsuka America Pharmaceutical, Inc. at 1-800-438-9927 or FDA at 1-800-FDA-1088 ( www.fda.gov/medwatch ).
Please seeFULL PRESCRIBING INFORMATIONandPATIENT INFORMATION
About Otsuka
Otsuka Pharmaceutical Co., Ltd. is a total healthcare company that focuses on each individual's potential to enhance their well-being. Our medical-related business provides treatments and diagnostics for both physical and mental health. Our nutraceutical business supports daily health maintenance and improvement. Otsuka's unique products and services are based on scientific evidence, under the guidance of our corporate philosophy: Otsuka-people creating new products for better health worldwide.
Otsuka America Pharmaceutical, Inc. and Otsuka Pharmaceutical Development & Commercialization, Inc. are the US-based indirect subsidiaries of the global healthcare company Otsuka Pharmaceutical Co. Ltd. Otsuka’s US companies share a deep commitment to the development and commercialization of innovative products in the spaces of neuroscience, nephrology, and immunology. At our core is perseverance–a fierce determination to overcome any obstacle, regardless of setbacks, on behalf of patients, caregivers, and their loved ones. We will not be bound by doing what’s been done before. Learn more at www.otsuka-us.com.
References
Otsuka Presents Positive Interim Phase 3 VISIONARY eGFR Data Showing VOYXACT® (sibeprenlimab-szsi) Preserved Kidney Function Over 12 Months in IgA Nephropathy (IgAN)
