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Clozapine-associated neutropenia in Latin America: incidence report of 5380 Chilean users

Research output: Contribution to journalArticlepeer-review

Cristián I. Mena, Rubén A. Nachar, Nicolás A. Crossley, Alfonso A. González-Valderrama

Original languageEnglish
Pages (from-to)257-263
Number of pages7
JournalInternational Clinical Psychopharmacology
Volume34
Issue number5
DOIs
Published1 Sep 2019

King's Authors

Abstract

Systematic information about Latino clozapine users is still scarce. Our aim was to evaluate the risk of clozapine-associated neutropenia in a Chilean cohort using the last Food and Drug Administration's recommendations for clozapine monitoring. Findings should improve clinical practice and promote changes in clozapine guidelines in Latin America. We conducted a retrospective observational study of 5380 Chilean clozapine users that started clozapine treatment between 2003 and 2015. The absolute risk of severe neutropenia was 0.61% (33/5380) with an incidence of 0.086 cases per 100 person-years of follow-up. 87.9% of cases with severe neutropenia appeared during first 18 weeks. Cases of mild neutropenia were 3.9% of total sample and occurred almost constantly without a specific risk time. 77.5% of cases of moderate or severe neutropenia didn't present an event of mild neutropenia before. 22.8% of clozapine users (1227/5380) discontinued treatment for any cause and 4.2% (225/5380) due to neutropenia in any severity level. Clozapine-associated neutropenia risk in Latino users is similar than in the rest of the world. The evidence of a very low risk for severe neutropenia and the behaviour of mild neutropenia cases confirm the feasibility of changes in Latin American clozapine guidelines using current Food and Drug Administration's recommendations as a model.

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