Lamarque V
Laboratoires Sandoz, Rueil Malmaison.
Encephale. 1996 Dec;22 Spec No 6:35-6.
Before clozapine was marketed, 4 cases of agranulocytosis occurred amongst the 2,900 patients exposed to the drug in the clinical studies from 1962 to 1972. At that time, the frequency of 0.14% was considered comparable to that published with some phenothiazines. After clozapine was launched in different countries, several notifications of agranulocytosis/granulocytopenia were reported, with a high mortality ratio in some countries. This outbreak of agranulocytosis has led to the implementation of recommendations, particularly a strict worldwide hematologic surveillance with a discontinuation of clozapine when the white blood cells drop below a critical level. This article emphasizes the positive impact of these precautionary measures on the present incidence of the agranulocytosis and on the mortality ratio.
在氯氮平上市之前，1962年至1972年的临床研究中，2900名使用该药物的患者中有4例发生了粒细胞缺乏症。当时，0.14%的发生率被认为与一些吩噻嗪类药物公布的发生率相当。氯氮平在不同国家上市后，有几例粒细胞缺乏症/粒细胞减少症的报告，在一些国家死亡率很高。这次粒细胞缺乏症的爆发导致了一些建议的实施，特别是在全球范围内进行严格的血液学监测，当白细胞降至临界水平以下时停用氯氮平。本文强调了这些预防措施对目前粒细胞缺乏症发病率和死亡率的积极影响。
