RT info:eu-repo/semantics/article
T1 An international guideline with six personalised titration schedules for preventing myocarditis and pneumonia associated with clozapine
A1 Cuevas Castresana, Carlos de las
A1 De León, José
A1 Ruan, Can-Jun
A1 Schoretsanitis, Georgios
A1 Rohde, Christopher
A1 Yagcioglu, Ayse Elif Anil
A1 Baptista, Trino
A1 Kirilochev, Oleg
A1 Correll, Christoph U.
A2 Medicina InternaDermatología y Psiquiatría
A2 Adherencia Terapéutica
K1 Myocarditis
K1 Pneumonia
K1 Clozapine
AB White blood cell (WBC) monitoring has reduced clozapinetreated patient deaths associated with agranulocytosis to a rarity. However, clozapine protocols and package inserts worldwide provide no instructions for preventing myocarditis or pneumonia during clozapine titrations. Prescribers worldwide are largely unaware of that. Meanwhile, as they worry about agranulocytosis, their clozapine-treated patients are at risk of dying from pneumonia or myocarditis. Consequently, an international  guideline with 104 authors from 50 countries/ regions was recently published to provide personalised clozapine titration schedules for adult inpatients. This forum article reviews pneumonia and myocarditis occurring during clozapine titration, as well as the three most innovative aspects of this new guideline: (1) personalised titration, (2) C eactive protein (CRP) measures, and (3) dose predictions based on blood levels. Clozapine metabolism is influenced by 3 levels of complexity: (1) ancestry groups, (2) sex-smoking subgroups, and (3) presence/absence of poor metabolizer status.  hese 3 groups of variables should determine the maintenance dose and speed of clozapine titration; they are summarised in a table in the full-text. The international clozapine titration guideline recommends measuring CRP levels simultaneouslywith WBC, at baseline and weekly at least for the first 4 weeks of titration, the highest risk period for clozapine-induced myocarditis.
SN 2517-729X
YR 2022
FD 2022
LK http://riull.ull.es/xmlui/handle/915/39636
UL http://riull.ull.es/xmlui/handle/915/39636
LA en
DS Repositorio institucional de la Universidad de La Laguna
RD 03-ene-2025