Pharmacy Department, South London and Maudsley NHS Foundation Trust, London, UK.
Institute of Pharmaceutical Science, King's College, London, UK.
J Psychopharmacol. 2022 Feb;36(2):232-237. doi: 10.1177/02698811211058973. Epub 2022 Jan 7.
To examine the risk of infection in patients prescribed clozapine compared with patients prescribed paliperidone palmitate long-acting injection (PPLAI).
A retrospective, 1-year, cohort study conducted on events occurring in eligible patients beginning treatment for the first time with clozapine or PPLAI between June 2017 and June 2019 in a UK mental health trust providing in-patient and out-patient services.
The study included 64 patients starting clozapine and 120 patients starting PPLAI. Incidence of infection was greater in clozapine starters than in PPLAI starters (28% vs 6%; = 0.001; adjusted odds ratio 5.82 (95% confidence interval (CI) = 2.15-15.76, = 0.001). Infectious episodes in clozapine patients were not related to changes in neutrophil counts. Incident infection in the clozapine group was highest in the first 3 months of treatment. The most commonly reported infection in the clozapine group was chest infection; however, the majority of infections were non-chest-related.
Patients starting clozapine showed a substantially increased likelihood of infection compared with patients starting PPLAI.
本研究旨在评估与使用棕榈酸帕利哌酮长效注射剂（PPLAI）相比，使用氯氮平治疗的患者发生感染的风险。
本研究为回顾性、1 年队列研究，纳入了 2017 年 6 月至 2019 年 6 月间首次开始使用氯氮平或 PPLAI 进行治疗的合格患者，该研究在英国一家提供住院和门诊服务的精神卫生信托机构开展。
本研究共纳入了 64 例起始使用氯氮平的患者和 120 例起始使用 PPLAI 的患者。氯氮平起始治疗组的感染发生率高于 PPLAI 起始治疗组（28% vs. 6%，= 0.001；校正比值比 5.82（95%置信区间 2.15-15.76，= 0.001）。氯氮平治疗患者的感染与中性粒细胞计数变化无关。氯氮平组的感染主要发生在治疗的前 3 个月。氯氮平组最常报告的感染是胸部感染，但大多数感染与胸部无关。
与起始使用 PPLAI 的患者相比，起始使用氯氮平的患者发生感染的可能性显著增加。
