Risk of neutropenia among clozapine users and non-users : results from 5,847 patients
dc.contributor.author | Goldani, Andre Akira Sueno | pt_BR |
dc.contributor.author | Ponte, Francisco Diego Rabelo da | pt_BR |
dc.contributor.author | Feiten, Jacson Gabriel | pt_BR |
dc.contributor.author | Lobato, Maria Inês Rodrigues | pt_BR |
dc.contributor.author | Belmonte-de-Abreu, Paulo Silva | pt_BR |
dc.contributor.author | Gama, Clarissa Severino | pt_BR |
dc.date.accessioned | 2024-03-05T04:37:00Z | pt_BR |
dc.date.issued | 2022 | pt_BR |
dc.identifier.issn | 1516-4446 | pt_BR |
dc.identifier.uri | http://hdl.handle.net/10183/272897 | pt_BR |
dc.description.abstract | Objective: Clozapine is underprescribed due to neutropenia risk. Blood tests every 3 months in those on continuous treatment for > 1 year who have never had an absolute neutrophil count (ANC) < 2,000/µL has been proposed as a monitoring strategy; however, there are no South American data to support this recommendation. This study sought to investigate whether clozapine use and other variables could explain the occurrence of ANC < 1,000/µL in patients with severe mental disorders. Methods: A total of 5,847 subjects were included, 1,038 on clozapine. We performed a Cox regression considering the outcome as ANC < 1,000/µL at any time point. Predictors were sex, age, ethnicity, clozapine use, ANC > 2,000/µL during the first year of blood monitoring, and presence of a severe medical condition. Results: In the Cox regression model, ethnicity (white) (hazard ratio [HR] 0.53; 95%CI 0.29-0.99, p < 0.05) and ANC > 2,000/µL (HR 0.04; 95%CI 0.01-0.10, p < 0.001) were protective factors, while presence of a severe medical condition (HR 69.35; 95%CI 37.45-128.44, p < 0.001) was a risk factor for ANC < 1,000/µL. Other variables were not significant, including clozapine use (HR 1.33; 95%CI 0.74-2.39, p > 0.05). Conclusions: These findings suggest that clozapine does not increase the risk of neutropenia in subjects with ANC > 2,000/µL during the first year of use and in the absence of a severe medical condition. These results could help guide clinical and public-health decisions regarding clozapine blood monitoring guidelines. | en |
dc.format.mimetype | application/pdf | pt_BR |
dc.language.iso | eng | pt_BR |
dc.relation.ispartof | Revista brasileira de psiquiatria (1999). São Paulo. Vol. 44, no. 1 (Jan./Feb. 2022), p. 21-25 | pt_BR |
dc.rights | Open Access | en |
dc.subject | Clozapine | en |
dc.subject | Clozapina | pt_BR |
dc.subject | Hematological monitoring | en |
dc.subject | Neutropenia | pt_BR |
dc.subject | Hemogram | en |
dc.subject | Testes hematológicos | pt_BR |
dc.subject | Contagem de células sanguíneas | pt_BR |
dc.subject | Absolute neutrophil count | en |
dc.subject | Neutrófilos | pt_BR |
dc.title | Risk of neutropenia among clozapine users and non-users : results from 5,847 patients | pt_BR |
dc.type | Artigo de periódico | pt_BR |
dc.identifier.nrb | 001194939 | pt_BR |
dc.type.origin | Nacional | pt_BR |
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