Establishing the characteristics of an effective pharmacogenetic test for clozapine-induced agranulocytosis

M. Verbelen*, D. A. Collier, D. Cohen, J. H. MacCabe, C. M. Lewis

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

19 Citations (Scopus)
189 Downloads (Pure)


Clozapine is the only evidence-based therapy for treatment-resistant schizophrenia, but it induces agranulocytosis, a rare but potentially fatal haematological adverse reaction, in less than 1% of users. To improve safety, the drug is subject to mandatory haematological monitoring throughout the course of treatment, which is burdensome for the patient and one of the main reasons clozapine is underused. Therefore, a pharmacogenetic test is clinically useful if it identifies a group of patients for whom the agranulocytosis risk is low enough to alleviate monitoring requirements. Assuming a genotypic marker stratifies patients into a high-risk and a low-risk group, we explore the relationship between test sensitivity, group size and agranulocytosis risk. High sensitivity minimizes the agranulocytosis risk in the low-risk group and is essential for clinical utility, in particular in combination with a small high-risk group.

Original languageEnglish
Pages (from-to)461-466
Number of pages6
JournalThe pharmacogenomics journal
Issue number5
Early online date3 Mar 2015
Publication statusPublished - 24 Oct 2015


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