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Demographic and clinical characteristics of patients who recommence clozapine following therapy interruptions.

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Title: Demographic and clinical characteristics of patients who recommence clozapine following therapy interruptions.
Authors: John, Alexander Panickacheril (AUTHOR), Burrows, Sally (AUTHOR), Stanley, Susanne (AUTHOR), Acabo, Cherry (AUTHOR), Shymko, Gordon (AUTHOR), Jaworska, Aleksandra (AUTHOR), Velayudhan, Ajay (AUTHOR)
Source: Acta Psychiatrica Scandinavica. Mar2022, Vol. 145 Issue 3, p293-300. 8p. 2 Charts, 1 Graph.
Subjects: Clozapine, Demographic characteristics, People with schizophrenia, Regression analysis, Medical care, Agranulocytosis
Abstract: Objective: The proportion of patients who recommence clozapine after cessation, the time taken to resume clozapine post‐cessation, and distinguishing demographic and clinical characteristics of this group have been poorly researched. We evaluated these in the current study. Method: We retrospectively extracted selected demographic and clinical variables and clozapine treatment interruption and recommencement data up to December 2018 of a cohort of 458 patients who first commenced clozapine between 2006 and 2016. The study was conducted at three Australian health services. Results: Of the 310 (69%) patients who had at least one interruption of clozapine treatment, 170 (54.8%) did not resume clozapine, and 140 (45.2%) recommenced it after the first interruption. More than half of those who recommenced did so within a month and 80% by 12 months. Cox regression analysis revealed that age was significantly associated with recommencement, with a 2% decrease in the likelihood of restarting after an interruption for each year later that clozapine was initially commenced (HR = 0.98 95%CI: 0.97, 0.997, p = 0.02). Those who ceased clozapine due to adverse effects were less likely to restart than those who ceased due to noncompliance (HR = 0.63 95%CI: 0.41, 0.97, p = 0.03). More time on clozapine prior to interruption increased the likelihood of restarting it, with each additional month on clozapine increasing this likelihood by 1% (HR = 1.01 95%CI: 1.01, 1.02, p < 0.001). Conclusion: If the distinguishing demographic and clinical characteristics of the group identified in this study are corroborated through further research, this could further validate the need to identify treatment resistance and commence clozapine early in people with schizophrenia and provide appropriate interventions to those more at risk of permanent discontinuation of clozapine. [ABSTRACT FROM AUTHOR]
Copyright of Acta Psychiatrica Scandinavica is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
Database: Psychology and Behavioral Sciences Collection
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  Data: Demographic and clinical characteristics of patients who recommence clozapine following therapy interruptions.
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  Data: &lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22John%2C+Alexander+Panickacheril%22&quot;&gt;John, Alexander Panickacheril&lt;/searchLink&gt; (AUTHOR)&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Burrows%2C+Sally%22&quot;&gt;Burrows, Sally&lt;/searchLink&gt; (AUTHOR)&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Stanley%2C+Susanne%22&quot;&gt;Stanley, Susanne&lt;/searchLink&gt; (AUTHOR)&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Acabo%2C+Cherry%22&quot;&gt;Acabo, Cherry&lt;/searchLink&gt; (AUTHOR)&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Shymko%2C+Gordon%22&quot;&gt;Shymko, Gordon&lt;/searchLink&gt; (AUTHOR)&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Jaworska%2C+Aleksandra%22&quot;&gt;Jaworska, Aleksandra&lt;/searchLink&gt; (AUTHOR)&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Velayudhan%2C+Ajay%22&quot;&gt;Velayudhan, Ajay&lt;/searchLink&gt; (AUTHOR)
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  Data: &lt;searchLink fieldCode=&quot;JN&quot; term=&quot;%22Acta+Psychiatrica+Scandinavica%22&quot;&gt;Acta Psychiatrica Scandinavica&lt;/searchLink&gt;. Mar2022, Vol. 145 Issue 3, p293-300. 8p. 2 Charts, 1 Graph.
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  Data: Objective: The proportion of patients who recommence clozapine after cessation, the time taken to resume clozapine post‐cessation, and distinguishing demographic and clinical characteristics of this group have been poorly researched. We evaluated these in the current study. Method: We retrospectively extracted selected demographic and clinical variables and clozapine treatment interruption and recommencement data up to December 2018 of a cohort of 458 patients who first commenced clozapine between 2006 and 2016. The study was conducted at three Australian health services. Results: Of the 310 (69%) patients who had at least one interruption of clozapine treatment, 170 (54.8%) did not resume clozapine, and 140 (45.2%) recommenced it after the first interruption. More than half of those who recommenced did so within a month and 80% by 12 months. Cox regression analysis revealed that age was significantly associated with recommencement, with a 2% decrease in the likelihood of restarting after an interruption for each year later that clozapine was initially commenced (HR = 0.98 95%CI: 0.97, 0.997, p = 0.02). Those who ceased clozapine due to adverse effects were less likely to restart than those who ceased due to noncompliance (HR = 0.63 95%CI: 0.41, 0.97, p = 0.03). More time on clozapine prior to interruption increased the likelihood of restarting it, with each additional month on clozapine increasing this likelihood by 1% (HR = 1.01 95%CI: 1.01, 1.02, p &lt; 0.001). Conclusion: If the distinguishing demographic and clinical characteristics of the group identified in this study are corroborated through further research, this could further validate the need to identify treatment resistance and commence clozapine early in people with schizophrenia and provide appropriate interventions to those more at risk of permanent discontinuation of clozapine. [ABSTRACT FROM AUTHOR]
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  Data: &lt;i&gt;Copyright of Acta Psychiatrica Scandinavica is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites without the copyright holder&#39;s express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract.&lt;/i&gt; (Copyright applies to all Abstracts.)
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      – Type: doi
        Value: 10.1111/acps.13394
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      – Code: eng
        Text: English
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        PageCount: 8
        StartPage: 293
    Subjects:
      – SubjectFull: Clozapine
        Type: general
      – SubjectFull: Demographic characteristics
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      – SubjectFull: People with schizophrenia
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      – SubjectFull: Regression analysis
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      – SubjectFull: Medical care
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      – SubjectFull: Agranulocytosis
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              Text: Mar2022
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