Effect of Adenine on Clozapine-induced Neutropenia in Patients with Schizophrenia: A Preliminary Study
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Objective: This study examined the utility of adenine for preventing clozapine-induced neutropenia. Methods: This retrospective study examined the effect of adenine on clozapine-induced neutropenia in patients with treatment- resistant schizophrenia and was conducted at Okehazama Hospital in Japan from July 2010 to June 2013. Adenine was available for use from June 2011 onwards. Twenty-one patients started receiving clozapine treatment from July 2010 to April 2011 (the pre-adenine adoption group), and 47 patients started receiving it from May 2011 to June 2013 (the post-adenine adoption group). The effects of adenine were assessed based on changes in the patients’ leukocyte counts and the frequency of treatment discontinuation due to clozapine-induced neutropenia. Results: Sixty-eight patients were treated with clozapine from July 2010 to June 2013. Of the 21 patients in the pre-adenine adoption group, 4 discontinued treatment due to clozapine-induced neutropenia, whereas only 2 of the 47 patients in the post-adenine adoption group discontinued treatment. The frequency of treatment discontinuation due to clozapine-induced neutropenia was significantly lower in post-adenine adoption group than in the pre-adenine adoption group (p=0.047). Conclusion: Adenine decreased the frequency of treatment discontinuation due to clozapine-induced neutropenia. Our data suggest that combined treatment with clozapine and adenine is a safe and effective strategy against treatment-resistant schizophrenia.
Abstract
Objective: This study examined the utility of adenine for preventing clozapine-induced neutropenia. Methods: This retrospective study examined the effect of adenine on clozapine-induced neutropenia in patients with treatment- resistant schizophrenia and was conducted at Okehazama Hospital in Japan from July 2010 to June 2013. Adenine was available for use from June 2011 onwards. Twenty-one patients started receiving clozapine treatment from July 2010 to April 2011 (the pre-adenine adoption group), and 47 patients started receiving it from May 2011 to June 2013 (the post-adenine adoption group). The effects of adenine were assessed based on changes in the patients’ leukocyte counts and the frequency of treatment discontinuation due to clozapine-induced neutropenia. Results: Sixty-eight patients were treated with clozapine from July 2010 to June 2013. Of the 21 patients in the pre-adenine adoption group, 4 discontinued treatment due to clozapine-induced neutropenia, whereas only 2 of the 47 patients in the post-adenine adoption group discontinued treatment. The frequency of treatment discontinuation due to clozapine-induced neutropenia was significantly lower in post-adenine adoption group than in the pre-adenine adoption group (p=0.047). Conclusion: Adenine decreased the frequency of treatment discontinuation due to clozapine-induced neutropenia. Our data suggest that combined treatment with clozapine and adenine is a safe and effective strategy against treatment-resistant schizophrenia.
참고문헌 (21)
- Kane J., "Clozapine for the treatment-resistant schizophrenic. A double-blind comparison with chlorpromazine", Arch Gen Psychiatry, 45, pp.789~796 (1988)
- Alvir JM., "Clozapine-induced agranulocytosis. Incidence and risk factors in the United States", N Engl J Med, 329, pp.162~167 (1993)
- Alvir JM., "Agranulocytosis: incidence and risk factors", J Clin Psychiatry, 55(Suppl B), pp.137~138 (1994)
- Klimke A., "The atypical neuroleptic clozapine(Leponex)--current knowledge and recent clinical aspects", Fortschr Neurol Psychiatr, 63, pp.173~193 (1995)
- Hummer M., "Clozapine-induced transient white blood count disorders", J Clin Psychiatry, 55, pp.429~432 (1994)
- Jann MW., "Pharmacokinetics and pharmacodynamics of clozapine", Clin Pharmacokinet, 24, pp.161~176 (1993)
- Latif Z., "Clozapine-induced late leukopenia", Ir J Med Sci, 181, pp.139~141 (2012)
- Lieberman JA., "HLA-B38, DR4, DQw3 and clozapine-induced agranulocytosis in Jewish patients with schizophrenia", Arch Gen Psychiatry, 47, pp.945~948 (1990)
- Kang BJ., "Long-term patient monitoring for clozapine-induced agranulocytosis and neutropenia in Korea : when is it safe to discontinue CPMS?", Hum Psychopharmacol, 21, pp.387~391 (2006)
- Lahdelma L., "Clozapine-induced agranulocytosis in Finland, 1982-2007 : long-term monitoring of patients is still warranted", J Clin Psychiatry, 73, pp.837~842 (2012)
- Kanaan RA., "Lithium and clozapine rechallenge : a retrospective case analysis", J Clin Psychiatry, 67, pp.756~760 (2006)
- Palominao A., "Leukocytosis after lithium and clozapine combination therapy", Ann Clin Psychiatry, 22, pp.205~206 (2010)
- Bender S., "Safety and efficacy of combined clozapinelithium pharmacotherapy", Int J Neuropsychopharmacol, 7, pp.59~63 (2004)
- Dennison U., "The incidence and clinical correlates of lithium toxicity : a retrospective review", Ir J Med Sci, 180, pp.661~665 (2011)
- Rajagopal G., "Prevention of clozapineinduced granulocytopenia", agranulocytosis with granulocytecolony stimulating factor(G-CSF)in an intellectually disabled patient with schizophrenia, 2007, pp.51, 82~85
- Khan AA., "Continuing clozapine with granulocyte colony-stimulating factor in patients with neutropenia", Ther Adv Psychopharmacol, 3, pp.266~271 (2013)
- Timmer-Bonte JN., "Modeling the cost effectiveness of secondary febrile neutropenia prophylaxis during standarddose chemotherapy", J Clin Oncol, 26, pp.290~296 (2008)
- Reznikoff P., "The treatment of agranulocytosis with adenine sulphate", J Clin Invest, 12, pp.45~53 (1933)
- Owan T., "The effects of adenine on the leukopenia after x-irradiation. I", Nihon Igaku Hoshasen Gakkai Zasshi, 21, pp.1170~1178 (1962)
- Lajtha LG., "Incorporation of 32P and adenine 14C into DNA by human bone marrow cells in vitro", Br J Cancer, 8, pp.367~379 (1954)
- Okada Y., "Identification of nine novel loci associated with white blood cell subtypes in a Japanese population. PLoS Genet, 7", e1002067 (2011)