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dc.contributor.authorMyles, N
dc.contributor.authorMyles, H
dc.contributor.authorXia, S
dc.contributor.authorLarge, M
dc.contributor.authorKisely, S
dc.contributor.authorGalletly, C
dc.contributor.authorBird, R
dc.contributor.authorSiskind, D
dc.date.accessioned2019-06-07T01:42:30Z
dc.date.available2019-06-07T01:42:30Z
dc.date.issued2018
dc.identifier.issn0001-690X
dc.identifier.doi10.1111/acps.12898
dc.identifier.urihttp://hdl.handle.net/10072/381437
dc.description.abstractBackground: 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.peerreviewedYes
dc.languageEnglish
dc.language.isoeng
dc.publisherWiley-Blackwell
dc.publisher.placeUnited States
dc.relation.ispartofpagefrom101
dc.relation.ispartofpageto109
dc.relation.ispartofissue2
dc.relation.ispartofjournalActa Psychiatrica Scandinavica
dc.relation.ispartofvolume138
dc.subject.fieldofresearchBiomedical and clinical sciences
dc.subject.fieldofresearchPsychology
dc.subject.fieldofresearchcode32
dc.subject.fieldofresearchcode52
dc.titleMeta-analysis examining the epidemiology of clozapine-associated neutropenia
dc.typeJournal article
dc.type.descriptionC1 - Articles
dc.type.codeC - Journal Articles
gro.hasfulltextNo Full Text
gro.griffith.authorBird, Robert
gro.griffith.authorKisely, Steve R.


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