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المؤلفDe Leon, Jose
المؤلفSchoretsanitis, Georgios
المؤلفSmith, Robert L.
المؤلفMolden, Espen
المؤلفSolismaa, Anssi
المؤلفSeppälä, Niko
المؤلفKopeček, Miloslav
المؤلفŠvancer, Patrik
المؤلفOlmos, Ismael
المؤلفRicciardi, Carina
المؤلفIglesias-Garcia, Celso
المؤلفIglesias-Alonso, Ana
المؤلفSpina, Edoardo
المؤلفRuan, Can Jun
المؤلفWang, Chuan Yue
المؤلفWang, Gang
المؤلفTang, Yi Lang
المؤلفLin, Shih Ku
المؤلفLane, Hsien Yuan
المؤلفKim, Yong Sik
المؤلفKim, Se Hyun
المؤلفRajkumar, Anto P.
المؤلفGonzález-Esquivel, Dinora F.
المؤلفJung-Cook, Helgi
المؤلفBaptista, Trino
المؤلفRohde, Christopher
المؤلفNielsen, Jimmi
المؤلفVerdoux, Hélène
المؤلفQuiles, Clelia
المؤلفSanz, Emilio J.
المؤلفDe Las Cuevas, Carlos
المؤلفCohen, Dan
المؤلفSchulte, Peter F.J.
المؤلفErtuǧrul, Aygün
المؤلفAnll Yaǧcloǧlu, A. Elif
المؤلفChopra, Nitin
المؤلفMcCollum, Betsy
المؤلفShelton, Charles
المؤلفCotes, Robert O.
المؤلفKaithi, Arun R.
المؤلفKane, John M.
المؤلفFarooq, Saeed
المؤلفNg, Chee H.
المؤلفBilbily, John
المؤلفHiemke, Christoph
المؤلفLópez-Jaramillo, Carlos
المؤلفMcGrane, Ian
المؤلفLana, Fernando
المؤلفEap, Chin B.
المؤلفArrojo-Romero, Manuel
المؤلفRǎdulescu, Flavian
المؤلفSeifritz, Erich
المؤلفEvery-Palmer, Susanna
المؤلفBousman, Chad A.
المؤلفBebawi, Emmanuel
المؤلفBhattacharya, Rahul
المؤلفKelly, Deanna L.
المؤلفOtsuka, Yuji
المؤلفLazary, Judit
المؤلفTorres, Rafael
المؤلفYecora, Agustin
المؤلفMotuca, Mariano
المؤلفChan, Sherry K.W.
المؤلفZolezzi, Monica
المؤلفOuanes, Sami
المؤلفDe Berardis, Domenico
المؤلفGrover, Sandeep
المؤلفProcyshyn, Ric M.
المؤلفAdebayo, Richard A.
المؤلفKirilochev, Oleg O.
المؤلفSoloviev, Andrey
المؤلفFountoulakis, Konstantinos N.
المؤلفWilkowska, Alina
المؤلفCubała, Wiesław J.
المؤلفAyub, Muhammad
المؤلفSilva, Alzira
المؤلفBonelli, Raphael M.
المؤلفVillagrán-Moreno, José M.
المؤلفCrespo-Facorro, Benedicto
المؤلفTemmingh, Henk
المؤلفDecloedt, Eric
المؤلفPedro, Maria R.
المؤلفTakeuchi, Hiroyoshi
المؤلفTsukahara, Masaru
المؤلفGründer, Gerhard
المؤلفSagud, Marina
المؤلفCelofiga, Andreja
المؤلفIgnjatovic Ristic, Dragana
المؤلفOrtiz, Bruno B.
المؤلفElkis, Helio
المؤلفPacheco Palha, António J.
المؤلفLlerena, Adrián
المؤلفFernandez-Egea, Emilio
المؤلفSiskind, Dan
المؤلفWeizman, Abraham
المؤلفMasmoudi, Rim
المؤلفMohd Saffian, Shamin
المؤلفLeung, Jonathan G.
المؤلفBuckley, Peter F.
المؤلفMarder, Stephen R.
تاريخ الإتاحة2023-07-24T10:42:46Z
تاريخ النشر2022-03-01
اسم المنشورPharmacopsychiatry
المعرّفhttp://dx.doi.org/10.1055/a-1625-6388
الاقتباسDe Leon, J., Schoretsanitis, G., Smith, R. L., Molden, E., Solismaa, A., Seppälä, N., ... & Müller, D. J. (2022). An international adult guideline for making clozapine titration safer by using six ancestry-based personalized dosing titrations, CRP, and clozapine levels. Pharmacopsychiatry, 55(02), 73-86.
الرقم المعياري الدولي للكتاب0176-3679
معرّف المصادر الموحدhttps://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=85122150966&origin=inward
معرّف المصادر الموحدhttp://hdl.handle.net/10576/46238
الملخصThis international guideline proposes improving clozapine package inserts worldwide by using ancestry-based dosing and titration. Adverse drug reaction (ADR) databases suggest that clozapine is the third most toxic drug in the United States (US), and it produces four times higher worldwide pneumonia mortality than that by agranulocytosis or myocarditis. For trough steady-state clozapine serum concentrations, the therapeutic reference range is narrow, from 350 to 600 ng/mL with the potential for toxicity and ADRs as concentrations increase. Clozapine is mainly metabolized by CYP1A2 (female non-smokers, the lowest dose; male smokers, the highest dose). Poor metabolizer status through phenotypic conversion is associated with co-prescription of inhibitors (including oral contraceptives and valproate), obesity, or inflammation with C-reactive protein (CRP) elevations. The Asian population (Pakistan to Japan) or the Americas' original inhabitants have lower CYP1A2 activity and require lower clozapine doses to reach concentrations of 350 ng/mL. In the US, daily doses of 300-600 mg/day are recommended. Slow personalized titration may prevent early ADRs (including syncope, myocarditis, and pneumonia). This guideline defines six personalized titration schedules for inpatients: 1) ancestry from Asia or the original people from the Americas with lower metabolism (obesity or valproate) needing minimum therapeutic dosages of 75-150 mg/day, 2) ancestry from Asia or the original people from the Americas with average metabolism needing 175-300 mg/day, 3) European/Western Asian ancestry with lower metabolism (obesity or valproate) needing 100-200 mg/day, 4) European/Western Asian ancestry with average metabolism needing 250-400 mg/day, 5) in the US with ancestries other than from Asia or the original people from the Americas with lower clozapine metabolism (obesity or valproate) needing 150-300 mg/day, and 6) in the US with ancestries other than from Asia or the original people from the Americas with average clozapine metabolism needing 300-600 mg/day. Baseline and weekly CRP monitoring for at least four weeks is required to identify any inflammation, including inflammation secondary to clozapine rapid titration.
اللغةen
الناشرThieme
الموضوعAmerican continental ancestry group
Asian continental ancestry group
clozapine/adverse effects
clozapine/blood
clozapine/metabolism
clozapine/therapeutic use
clozapine/toxicity
CYP1A2
drug labeling
European continental ancestry group
infection
inflammation
mortality/drug effects
Native
sex
smoking.
العنوانAn International Adult Guideline for Making Clozapine Titration Safer by Using Six Ancestry-Based Personalized Dosing Titrations, CRP, and Clozapine Levels
النوعArticle
الصفحات73-86
رقم العدد2
رقم المجلد55
ESSN1439-0795


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