Clozapine research from India: A systematic review

Grover, Sandeep; Kathiravan, Sanjana

doi:10.1016/j.ajp.2022.103353

Cited by 1 publication

(1 citation statement)

References 143 publications

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“…The first case of clozapine-associated myocarditis in India was reported to the international pharmacovigilance database in 2021 5 . On the other hand, there are no published cases in international journals listed in PubMed and Grover and Kathiravan 64 found no published data on myocarditis in a systematic review of clozapine research in India that included 169 references.…”

Section: Discussionmentioning

confidence: 99%

Can slow personalized titration using C-Reactive Protein monitoring decrease the high rates and mortality of clozapine-associated myocarditis seen in some countries? A call for research

de Leon

2024

J Clin Psychopharmacol

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Purpose/Background The hypothesis that slower personalized titration may prevent clozapine-associated myocarditis and decrease the disproportion incidence of 3% found in Australia was not described in a recent Australian article in this journal. Methods Six countries in addition to Australia have published information suggesting a similar incidence of clozapine-associated myocarditis. On September 19, 2023, PubMed searches were updated for articles from the United States, Korea, Japan, Canada, New Zealand, and Turkey. Findings/Results An incidence of 3.5% (4/76) was found in a US hospital, but US experts were the first to propose that clozapine-associated myocarditis may be a hypersensitivity reaction associated with rapid titration and possibly preventable. Koreans and Japanese are of Asian ancestry and need lower minimum therapeutic doses for clozapine than patients of European ancestry. A 0.1% (2/1408) incidence of myocarditis during clozapine titration was found in a Korean hospital, but pneumonia incidence was 3.7% (52/1408). In 7 Japanese hospitals, 34% (37/110) of cases of clozapine-associated inflammation were found during faster titrations (based on the official Japanese titration) versus 13% (17/131) during slower titrations (based on the international titration guideline for average Asian patients). Recent limited studies from Canada, New Zealand, and Turkey suggest that slower personalized titration considering ancestry may help prevent clozapine-associated myocarditis. Implications/Conclusions Other countries have very limited published data on clozapine-associated myocarditis. Based on a recent Australian case series and these non-Australian studies, the author proposes that Australia (and other countries) should use slow personalized titration for clozapine based on ancestry and c-reactive protein monitoring.

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Section: Discussionmentioning

confidence: 99%

Can slow personalized titration using C-Reactive Protein monitoring decrease the high rates and mortality of clozapine-associated myocarditis seen in some countries? A call for research

de Leon

2024

J Clin Psychopharmacol

View full text Add to dashboard Cite

show abstract

Clozapine research from India: A systematic review

Cited by 1 publication

References 143 publications

Can slow personalized titration using C-Reactive Protein monitoring decrease the high rates and mortality of clozapine-associated myocarditis seen in some countries? A call for research

Can slow personalized titration using C-Reactive Protein monitoring decrease the high rates and mortality of clozapine-associated myocarditis seen in some countries? A call for research

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