dc.contributor.author | Myles, N | |
dc.contributor.author | Myles, H | |
dc.contributor.author | Xia, S | |
dc.contributor.author | Large, M | |
dc.contributor.author | Kisely, S | |
dc.contributor.author | Galletly, C | |
dc.contributor.author | Bird, R | |
dc.contributor.author | Siskind, D | |
dc.date.accessioned | 2019-06-07T01:42:30Z | |
dc.date.available | 2019-06-07T01:42:30Z | |
dc.date.issued | 2018 | |
dc.identifier.issn | 0001-690X | |
dc.identifier.doi | 10.1111/acps.12898 | |
dc.identifier.uri | http://hdl.handle.net/10072/381437 | |
dc.description.abstract | Background: Clozapine is associated with life-threatening neutropenia.
There are no previous meta-analyses of the epidemiology of clozapineassociated
neutropenia.
Objectives: To determine the cumulative incidence of mild, moderate
and severe neutropenia, incidence of death related to severe
neutropenia, case fatality rate of neutropenia and the longitudinal
incidence of neutropenia following exposure to clozapine.
Data sources: A systematic search of Medline, EMBASE and
PsycINFO using search terms [clozapine OR clopine OR zaponex OR
clozaril] AND [neutropenia OR agranulocytosis].
Methods: Random effects meta-analysis to determine event rates and
longitudinal incidence of events per 100 person-years of exposure.
Results: A total of 108 studies were included. The incidence of
clozapine-associated neutropenia was 3.8% (95% CI: 2.7–5.2%) and
severe neutropenia 0.9% (95% CI: 0.7–1.1%). The incidence of death
related to neutropenia following prescription of clozapine was 0.013%
(95% CI: 0.01–0.017%). The case fatality rate of severe neutropenia
was 2.1% (95% CI: 1.6–2.8%). The peak incidence of severe
neutropenia occurred at one month of exposure and declined to
negligible levels after one year of treatment.
Conclusion: Severe neutropenia associated with clozapine is a rare event
and occurs early with a substantial decline in risk after one year of
exposure. Death from clozapine-associated neutropenia is extremely
rare. Implications for haematological monitoring are discussed. | |
dc.description.peerreviewed | Yes | |
dc.language | English | |
dc.language.iso | eng | |
dc.publisher | Wiley-Blackwell | |
dc.publisher.place | United States | |
dc.relation.ispartofpagefrom | 101 | |
dc.relation.ispartofpageto | 109 | |
dc.relation.ispartofissue | 2 | |
dc.relation.ispartofjournal | Acta Psychiatrica Scandinavica | |
dc.relation.ispartofvolume | 138 | |
dc.subject.fieldofresearch | Biomedical and clinical sciences | |
dc.subject.fieldofresearch | Psychology | |
dc.subject.fieldofresearchcode | 32 | |
dc.subject.fieldofresearchcode | 52 | |
dc.title | Meta-analysis examining the epidemiology of clozapine-associated neutropenia | |
dc.type | Journal article | |
dc.type.description | C1 - Articles | |
dc.type.code | C - Journal Articles | |
gro.hasfulltext | No Full Text | |
gro.griffith.author | Bird, Robert | |
gro.griffith.author | Kisely, Steve R. | |