The prevalence of agranulocytosis and related death in clozapine-treated patients: a comprehensive meta-analysis of observational studies
Clozapine treatment increases the risk of agranulocytosis, but findings on the epidemiology of agranulocytosis have been inconsistent. This meta-analysis examined the prevalence of agranulocytosis and related death in clozapine-treated patients. A literature search in the international (PubMed, Psyc...
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| Veröffentlicht in: | Psychological medicine 2020-03, Vol.50 (4), p.583-594 |
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| creator | Li, Xiao-Hong Zhong, Xiao-Mei Lu, Li Zheng, Wei Wang, Shi-Bin Rao, Wen-Wang Wang, Shuai Ng, Chee H Ungvari, Gabor S Wang, Gang Xiang, Yu-Tao |
| description | Clozapine treatment increases the risk of agranulocytosis, but findings on the epidemiology of agranulocytosis have been inconsistent. This meta-analysis examined the prevalence of agranulocytosis and related death in clozapine-treated patients.
A literature search in the international (PubMed, PsycINFO, and EMBASE) and Chinese (WanFang, Chinese National Knowledge Infrastructure, and Sinomed) databases was conducted. Prevalence estimates of agranulocytosis and related death in clozapine-treated patients were synthesized with the Comprehensive Meta-Analysis program using the random-effects model.
Thirty-six studies with 260 948 clozapine-treated patients published between 1984 and 2018 were included in the meta-analysis. The overall prevalence of agranulocytosis and death caused by agranulocytosis were 0.4% (95% CI 0.3-0.6%) and 0.05% (95% CI 0.03-0.09%), respectively. The prevalence of agranulocytosis was moderated by sample size, study quality, year of publication, and that of data collection.
The prevalence of clozapine-associated agranulocytosis is low. Agranulocytosis-related death appears rare. |
| doi_str_mv | 10.1017/S0033291719000369 |
| format | Article |
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A literature search in the international (PubMed, PsycINFO, and EMBASE) and Chinese (WanFang, Chinese National Knowledge Infrastructure, and Sinomed) databases was conducted. Prevalence estimates of agranulocytosis and related death in clozapine-treated patients were synthesized with the Comprehensive Meta-Analysis program using the random-effects model.
Thirty-six studies with 260 948 clozapine-treated patients published between 1984 and 2018 were included in the meta-analysis. The overall prevalence of agranulocytosis and death caused by agranulocytosis were 0.4% (95% CI 0.3-0.6%) and 0.05% (95% CI 0.03-0.09%), respectively. The prevalence of agranulocytosis was moderated by sample size, study quality, year of publication, and that of data collection.
The prevalence of clozapine-associated agranulocytosis is low. Agranulocytosis-related death appears rare.</description><identifier>ISSN: 0033-2917</identifier><identifier>EISSN: 1469-8978</identifier><identifier>DOI: 10.1017/S0033291719000369</identifier><identifier>PMID: 30857568</identifier><language>eng</language><publisher>England: Cambridge University Press</publisher><subject>Agranulocytosis - chemically induced ; Agranulocytosis - epidemiology ; Agranulocytosis - mortality ; Antipsychotic Agents - adverse effects ; Blood ; Cause of Death ; Clozapine ; Clozapine - adverse effects ; Death ; Death & dying ; Drug-Related Side Effects and Adverse Reactions - epidemiology ; Drug-Related Side Effects and Adverse Reactions - mortality ; Epidemiology ; Fatalities ; Humans ; Infrastructure ; Meta-analysis ; Monitoring systems ; Mortality ; Neutropenia ; Neutrophils ; Observational studies ; Observational Studies as Topic ; Prevalence ; Quality ; Schizophrenia ; Systematic review</subject><ispartof>Psychological medicine, 2020-03, Vol.50 (4), p.583-594</ispartof><rights>Copyright Cambridge University Press Mar 2020</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c395t-3b428f355c1692ec243fbcae8bdc7e5c8f330fcb925654d53268c29369ea25c33</citedby><cites>FETCH-LOGICAL-c395t-3b428f355c1692ec243fbcae8bdc7e5c8f330fcb925654d53268c29369ea25c33</cites><orcidid>0000-0002-2906-0029</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,777,781,12827,27905,27906,30980</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/30857568$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Li, Xiao-Hong</creatorcontrib><creatorcontrib>Zhong, Xiao-Mei</creatorcontrib><creatorcontrib>Lu, Li</creatorcontrib><creatorcontrib>Zheng, Wei</creatorcontrib><creatorcontrib>Wang, Shi-Bin</creatorcontrib><creatorcontrib>Rao, Wen-Wang</creatorcontrib><creatorcontrib>Wang, Shuai</creatorcontrib><creatorcontrib>Ng, Chee H</creatorcontrib><creatorcontrib>Ungvari, Gabor S</creatorcontrib><creatorcontrib>Wang, Gang</creatorcontrib><creatorcontrib>Xiang, Yu-Tao</creatorcontrib><title>The prevalence of agranulocytosis and related death in clozapine-treated patients: a comprehensive meta-analysis of observational studies</title><title>Psychological medicine</title><addtitle>Psychol Med</addtitle><description>Clozapine treatment increases the risk of agranulocytosis, but findings on the epidemiology of agranulocytosis have been inconsistent. This meta-analysis examined the prevalence of agranulocytosis and related death in clozapine-treated patients.
A literature search in the international (PubMed, PsycINFO, and EMBASE) and Chinese (WanFang, Chinese National Knowledge Infrastructure, and Sinomed) databases was conducted. Prevalence estimates of agranulocytosis and related death in clozapine-treated patients were synthesized with the Comprehensive Meta-Analysis program using the random-effects model.
Thirty-six studies with 260 948 clozapine-treated patients published between 1984 and 2018 were included in the meta-analysis. The overall prevalence of agranulocytosis and death caused by agranulocytosis were 0.4% (95% CI 0.3-0.6%) and 0.05% (95% CI 0.03-0.09%), respectively. The prevalence of agranulocytosis was moderated by sample size, study quality, year of publication, and that of data collection.
The prevalence of clozapine-associated agranulocytosis is low. Agranulocytosis-related death appears rare.</description><subject>Agranulocytosis - chemically induced</subject><subject>Agranulocytosis - epidemiology</subject><subject>Agranulocytosis - mortality</subject><subject>Antipsychotic Agents - adverse effects</subject><subject>Blood</subject><subject>Cause of Death</subject><subject>Clozapine</subject><subject>Clozapine - adverse effects</subject><subject>Death</subject><subject>Death & dying</subject><subject>Drug-Related Side Effects and Adverse Reactions - epidemiology</subject><subject>Drug-Related Side Effects and Adverse Reactions - mortality</subject><subject>Epidemiology</subject><subject>Fatalities</subject><subject>Humans</subject><subject>Infrastructure</subject><subject>Meta-analysis</subject><subject>Monitoring systems</subject><subject>Mortality</subject><subject>Neutropenia</subject><subject>Neutrophils</subject><subject>Observational studies</subject><subject>Observational Studies as 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prevalence of agranulocytosis and related death in clozapine-treated patients: a comprehensive meta-analysis of observational studies</title><author>Li, Xiao-Hong ; Zhong, Xiao-Mei ; Lu, Li ; Zheng, Wei ; Wang, Shi-Bin ; Rao, Wen-Wang ; Wang, Shuai ; Ng, Chee H ; Ungvari, Gabor S ; Wang, Gang ; Xiang, Yu-Tao</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c395t-3b428f355c1692ec243fbcae8bdc7e5c8f330fcb925654d53268c29369ea25c33</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2020</creationdate><topic>Agranulocytosis - chemically induced</topic><topic>Agranulocytosis - epidemiology</topic><topic>Agranulocytosis - mortality</topic><topic>Antipsychotic Agents - adverse effects</topic><topic>Blood</topic><topic>Cause of Death</topic><topic>Clozapine</topic><topic>Clozapine - adverse effects</topic><topic>Death</topic><topic>Death & dying</topic><topic>Drug-Related Side Effects and Adverse Reactions - 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Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Li, Xiao-Hong</au><au>Zhong, Xiao-Mei</au><au>Lu, Li</au><au>Zheng, Wei</au><au>Wang, Shi-Bin</au><au>Rao, Wen-Wang</au><au>Wang, Shuai</au><au>Ng, Chee H</au><au>Ungvari, Gabor S</au><au>Wang, Gang</au><au>Xiang, Yu-Tao</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>The prevalence of agranulocytosis and related death in clozapine-treated patients: a comprehensive meta-analysis of observational studies</atitle><jtitle>Psychological medicine</jtitle><addtitle>Psychol Med</addtitle><date>2020-03-01</date><risdate>2020</risdate><volume>50</volume><issue>4</issue><spage>583</spage><epage>594</epage><pages>583-594</pages><issn>0033-2917</issn><eissn>1469-8978</eissn><abstract>Clozapine treatment increases the risk of agranulocytosis, but findings on the epidemiology of agranulocytosis have been inconsistent. This meta-analysis examined the prevalence of agranulocytosis and related death in clozapine-treated patients.
A literature search in the international (PubMed, PsycINFO, and EMBASE) and Chinese (WanFang, Chinese National Knowledge Infrastructure, and Sinomed) databases was conducted. Prevalence estimates of agranulocytosis and related death in clozapine-treated patients were synthesized with the Comprehensive Meta-Analysis program using the random-effects model.
Thirty-six studies with 260 948 clozapine-treated patients published between 1984 and 2018 were included in the meta-analysis. The overall prevalence of agranulocytosis and death caused by agranulocytosis were 0.4% (95% CI 0.3-0.6%) and 0.05% (95% CI 0.03-0.09%), respectively. The prevalence of agranulocytosis was moderated by sample size, study quality, year of publication, and that of data collection.
The prevalence of clozapine-associated agranulocytosis is low. Agranulocytosis-related death appears rare.</abstract><cop>England</cop><pub>Cambridge University Press</pub><pmid>30857568</pmid><doi>10.1017/S0033291719000369</doi><tpages>12</tpages><orcidid>https://orcid.org/0000-0002-2906-0029</orcidid></addata></record> |
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| ispartof | Psychological medicine, 2020-03, Vol.50 (4), p.583-594 |
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| source | MEDLINE; Cambridge Journals; Applied Social Sciences Index & Abstracts (ASSIA) |
| subjects | Agranulocytosis - chemically induced Agranulocytosis - epidemiology Agranulocytosis - mortality Antipsychotic Agents - adverse effects Blood Cause of Death Clozapine Clozapine - adverse effects Death Death & dying Drug-Related Side Effects and Adverse Reactions - epidemiology Drug-Related Side Effects and Adverse Reactions - mortality Epidemiology Fatalities Humans Infrastructure Meta-analysis Monitoring systems Mortality Neutropenia Neutrophils Observational studies Observational Studies as Topic Prevalence Quality Schizophrenia Systematic review |
| title | The prevalence of agranulocytosis and related death in clozapine-treated patients: a comprehensive meta-analysis of observational studies |
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