ArticleThe British journal of psychiatry : the journal of mental science2024
Identifying clinically relevant agranulocytosis in people registered on the UK clozapine Central Non-Rechallenge Database: retrospective cohort study.
Article in The British journal of psychiatry : the journal of mental science, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers, 1 of them a synthesis that pooled it.
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Who cites it
6 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Risk factors associated with blood dyscrasia during clozapine treatment: a systematic review and meta-analysis.Psychological medicine · 2026Pooled it
- Association between initial 30-day cumulative clozapine dose and risk of agranulocytosis: A nationwide register-based cohort study.Psychiatry and clinical neurosciences · 2026Article
- Late-Onset Neutropenia in Clozapine Users: Unrelated or Drug-Induced? A Case-Registry Analysis of Incidence, Characteristics, and Rechallenge Attempts.Schizophrenia bulletin · 2026Article
- Abnormality prediction and forecasting of laboratory values from electrocardiogram signals using multimodal deep learning.Scientific reports · 2025Article
- Depression diagnosis from patient interviews using multimodal machine learning.Frontiers in psychiatry · 2025Article
- Letter to the FDA Proposing Major Changes in the US Clozapine Package Insert Supported by Clozapine Experts Worldwide. Part II: A Review of Fatal Outcomes in US Pharmacovigilance Data and Proposed Changes.Journal of clinical psychopharmacologyArticle
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9 authors.
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No grant is acknowledged in the PubMed record.
Abstract
backgroundClozapine is the most effective antipsychotic for treatment-resistant psychosis. However, clozapine is underutilised in part because of potential agranulocytosis. Accumulating evidence indicates that below-threshold haematological readings in isolation are not diagnostic of life-threatening clozapine-induced agranulocytosis (CIA).
aimsTo examine the prevalence and timing of CIA using different diagnostic criteria and to explore demographic differences of CIA in patients registered on the UK Central Non-Rechallenge Database (CNRD).
methodWe analysed data of all patients registered on the UK Clozaril
resultsOf the 3029 patients registered on the CNRD with 283 726 blood measurements, 593 (19.6%) were determined to have threshold-based agranulocytosis and 348 (11.4%) pattern-based agranulocytosis. In the total sample (75 533), the prevalence of threshold-based agranulocytosis and pattern-based agranulocytosis was 0.8% and 0.5%, respectively. The median time to threshold-based agranulocytosis was 32 weeks (IQR 184) and 15 (IQR 170) weeks for pattern-based agranulocytosis. Among age groups, the prevalence of pattern-based agranulocytosis and threshold-based agranulocytosis was highest in the >48 age group. Prevalence rates were greatest for White (18%) and male individuals (13%), and lowest for Black individuals (0.1%). The proportion of people who were determined to have pattern-based agranulocytosis without passing through neutropenia was 70%.
conclusionsThreshold-based definition of agranulocytosis may over-diagnose CIA. Monitoring schemes should take into consideration neutrophil patterns to correctly identify clinically relevant CIA. In marked contrast to previous studies, CIA occurred least in Black individuals and most in White individuals.
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