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학술연구/단체지원/교육 등 연구자 활동을 지속하도록 DBpia가 지원하고 있어요.
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연구자들이 자신의 연구와 전문성을 널리 알리고, 새로운 협력의 기회를 만들 수 있는 네트워킹 공간이에요.
논문 기본 정보
- 자료유형
- 학술저널
- 저자정보
- 발행연도
- 2021.1
- 수록면
- 101 - 109 (9page)
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초록· 키워드
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Objective The effectiveness of clozapine is clearly superior to other antipsychotics in the treatment of refractory schizophrenia. Clozapine leads to various side effects, and therefore many patients are forced to discontinue. In this study, we analyzed the registry database of all cases in Japan to identify risk factors for discontinuation of clozapine. Methods The Clozaril patient monitoring service® (CPMS) database from July 31, 2009 to January 26, 2020 was acquired. We defined the following exclusion criteria: patients who had ever taken clozapine by a non-CPMS method, such as an individual import or clinical trial, patients who did not receive clozapine after being enrolled in CPMS, and patients with initial doses other than 12.5 mg (outside the current protocol). Therefore, all patients in this study are new users. Multivariate Cox regression analysis was used to investigate independent risk factors associated with time to discontinuation of clozapine. Results We identified 8,263 patients as the study population. Clozapine discontinuation was significantly associated with age 40 and older [hazard ratio (HR)=1.66, p<0.001], intolerance to olanzapine (HR=1.31, p=0.018), previous treatment with clozapine (HR=1.30, p=0.001), and leukocyte counts <6,000/mm3 (HR=1.24, p<0.001). The Kaplan-Meier curves for clozapine discontinuation by age group revealed that older age at the time of clozapine introduction tended to have lower continuation rates. Conclusion Careful administration is important because patients with these factors have a high risk of discontinuation. In addition, the initiation of clozapine during the younger period was more effective and more tolerated.
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참고문헌 (33)
참고문헌 신청
Chisholm D / 2008 / Schizophrenia treatment in the developing world : an interregional and multinational cost-effectiveness analysis / Bull World Health Organ 86:542~551
Provencher HL / 1997 / Positive and negative symptom behaviors and caregiver burden in the relatives of persons with schizophrenia / Schizophr Res 26:71~80
Hawton K / 2005 / Schizophrenia and suicide : systematic review of risk factors / Br J Psychiatry 187:9~20
Palmer CS / 1998 / A costeffectiveness clinical decision analysis model for schizophrenia / Am J Manag Care 4:345~355
Howes OD / 2017 / Treatment-resistant schizophrenia : Treatment Response and Resistance in Psychosis(TRRIP)working group consensus guidelines on diagnosis and terminology / Am J Psychiatry 174:216~229
Provencher HL / 1997 / Positive and negative symptom behaviors and caregiver burden in the relatives of persons with schizophrenia / Schizophr Res 26:71~80
Hawton K / 2005 / Schizophrenia and suicide : systematic review of risk factors / Br J Psychiatry 187:9~20
Palmer CS / 1998 / A costeffectiveness clinical decision analysis model for schizophrenia / Am J Manag Care 4:345~355
Howes OD / 2017 / Treatment-resistant schizophrenia : Treatment Response and Resistance in Psychosis(TRRIP)working group consensus guidelines on diagnosis and terminology / Am J Psychiatry 174:216~229
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