RT info:eu-repo/semantics/article
T1 Investigating in VigiBase over 6000 cases of pneumonia in clozapine-treated patients in the context of the literature: focus on high lethality and the association with aspiration pneumonia
A1 Cuevas Castresana, Carlos de las
A1 León, José de
A1 Ruan, Can-Jun
A1 Schoretsanitis, Georgios
A1 Villasante Tezanos, Alejandro G.
A1 Spina,
AD  Edoardo
A1 Sanz Álvarez, Emilio José
A1 Betancort Montesinos, Moisés
A2 Medicina InternaDermatología y Psiquiatría
A2 Adherencia Terapéutica
K1 clozapine/adverse effects
K1 clozapine/toxicity
K1 fever
K1 infection
K1 mortality/drug effects
K1 pneumonia
K1 pneumonia, aspiration
K1 respiratory aspiration
AB The literature associates clozapine with pneumonia/aspiration pneumonia. Areas covered:  Clozapine reports to the international pharmacovigilance database (VigiBase™) were analyzed for pneumonia/aspiration pneumonia from introduction to May 10, 2023. VigiBase uses the information component (IC) as a statistical signal. Expert Opinion: There were 5572 cases of pneumonia, 775 of aspiration pneumonia, and 45 combined leading to 6392 cases of all types of pneumonia. The IC was 3.52 for aspiration pneumonia, introduced as a VigiBase label in 2003, and 1.91 for pneumonia. Patients were reclassified as 3628 with no signs of aspiration and 1533 with signs. Signs of aspiration were strongly associated with some co-medications: olanzapine, odds ratio (OR)= 23.8, 95% confidence interval (CI), 14.9-380; risperidone OR= 18.6, CI, 11.4-30.4; valproic acid, OR= 5.5, CI, 4.5-6.6; and benzodiazepines OR= 5.5, CI, 4.5-6.6.  In 2415 cases with completed data, fatal outcomes made up 45% (signs of aspiration made no difference), but there was wide variability from 0% (females <45 years of age; duration ≤30 days) to 76% (males >64 years of age; duration >1 year). During the first week, pneumonia was associated with: 1) very high titration doses, 2) very small doses in Parkinson’s disease and 3) overrepresentation in Japan.
YR 2024
FD 2024
LK http://riull.ull.es/xmlui/handle/915/39606
UL http://riull.ull.es/xmlui/handle/915/39606
LA en
DS Repositorio institucional de la Universidad de La Laguna
RD 27-dic-2024