Observational studyActa psychiatrica Scandinavica2025
The Safety of 12-Weekly Monitoring of Neutrophil Count in Long-Term Clozapine Patients.
Observational study in Acta psychiatrica Scandinavica, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers, 1 of them a synthesis that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
4 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Involuntary Clozapine Treatment: A Systematic Review.Acta psychiatrica Scandinavica · 2026Pooled it
- Clozapine-related neutropenia and agranulocytosis in Korea: 2025 update for rethinking the role of monitoring system.Therapeutic advances in psychopharmacology · 2026Article
- Low awareness of clozapine-induced agranulocytosis in a mixed-method survey of 354 patients and carers.Schizophrenia (Heidelberg, Germany) · 2025Article
- The Safety of 12-Weekly Monitoring of Neutrophil Count in Long-Term Clozapine Patients.Acta psychiatrica Scandinavica · 2025Observational
Corrections and comments
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Authors and funding
4 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionClozapine is the only truly effective treatment for refractory schizophrenia, but its use is constrained by the requirements for frequent monitoring of neutrophil counts. In the UK during the COVID-19 pandemic, the frequency of clozapine blood monitoring was reduced in some units from 4-weekly to 12-weekly. We aimed to investigate the outcomes of reduced monitoring in long-term clozapine patients.
methodsThis was an anonymous, retrospective, observational cohort study. No restrictions were applied regarding care setting (i.e., outpatients or inpatients). All patients who registered for reduced frequency haematological monitoring from 1 March 2020 to 1 November 2022 were included and followed up till 1 August 2024. The primary outcome was death resulting from clozapine-induced agranulocytosis (CIA). Secondary outcomes were the proportion of patients with mild to moderate neutropenia during the follow-up period and the proportion of patients who reverted to standard monitoring during the study period.
resultsAmongst 1025 patients, there were no cases of agranulocytosis over 3365.9 patient-years of 12-weekly blood monitoring (incident rate 0.0 per 100 person-years). There were 43 episodes of mild neutropenia (so-called amber results-1.5-2.0 × 10
conclusionReducing the frequency of clozapine haematological monitoring to 12-weekly was safe in a group of long-term patients. No cases of agranulocytosis occurred and no deaths due to agranulocytosis were recorded. Most patients remained on extended-interval monitoring.
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