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Exploring low clozapine C/D ratios, inverted clozapine-norclozapine ratios and undetectable concentrations as measures of non-adherence in clozapine patients: A literature review and a case series of 17 patients from 3 studies
dc.rights.license | open | en_US |
dc.contributor.author | RUAN, Can-Jun | |
dc.contributor.author | OLMOS, Ismael | |
dc.contributor.author | RICCIARDI, Carina | |
dc.contributor.author | SCHORETSANITIS, Georgios | |
dc.contributor.author | VINCENT, Philippe D | |
dc.contributor.author | ANIL YAĞCIOĞLU, A Elif | |
dc.contributor.author | EAP, Chin B | |
dc.contributor.author | BAPTISTA, Trino | |
dc.contributor.author | CLARK, Scott R | |
dc.contributor.author | FERNANDEZ-EGEA, Emilio | |
dc.contributor.author | KIM, Se Hyun | |
dc.contributor.author | LANE, Hsien-Yuan | |
dc.contributor.author | LEUNG, Jonathan | |
dc.contributor.author | MAROÑAS AMIGO, Olalla | |
dc.contributor.author | MOTUCA, Mariano | |
dc.contributor.author | EVERY-PALMER, Susanna | |
dc.contributor.author | PROCYSHYN, Ric M | |
dc.contributor.author | ROHDE, Christopher | |
dc.contributor.author | SUHAS, Satish | |
dc.contributor.author | SCHULTE, Peter F J | |
dc.contributor.author | SPINA, Edoardo | |
dc.contributor.author | TAKEUCHI, Hiroyoshi | |
hal.structure.identifier | Bordeaux population health [BPH] | |
dc.contributor.author | VERDOUX, Helene | |
dc.contributor.author | CORRELL, Christoph U | |
dc.contributor.author | MOLDEN, Espen | |
dc.contributor.author | DE LAS CUEVAS, Carlos | |
dc.contributor.author | DE LEON, Jose | |
dc.date.accessioned | 2023-10-17T09:48:35Z | |
dc.date.available | 2023-10-17T09:48:35Z | |
dc.date.issued | 2023-07-22 | |
dc.identifier.issn | 1573-2509 | en_US |
dc.identifier.uri | https://oskar-bordeaux.fr/handle/20.500.12278/184456 | |
dc.description.abstractEn | Up to 1/2 of outpatients prescribed clozapine may be partially/fully non-adherent, based on therapeutic drug monitoring (TDM). Three indices for measuring partial/full non-adherence are proposed a: 1) clozapine concentration/dose (C/D) ratio which drops to half or more of what is expected in the patient; 2) clozapine/norclozapine ratio that becomes inverted; and 3) clozapine concentration that becomes non-detectable. These 3 proposed indices are based on a literature review and 17 cases of possible non-adherence from 3 samples: 1) an inpatient study in a Chinese hospital, 2) an inpatient randomized clinical trial in a United States hospital, and 3) and a Uruguayan outpatient study. The first index of non-adherence is a clozapine C/D ratio which is less than half the ratio corresponding to the patient's specific ancestry group and sex-smoking subgroup. Knowing the minimum therapeutic dose of the patient based on repeated TDM makes it much easier to establish non-adherence. The second index is inverted clozapine/norclozapine ratios in the absence of alternative explanations. The third index is undetectable concentrations. By using half-lives, the chronology of the 3 indices of non-adherence was modeled in two patients: 1) the clozapine C/D ratio dropped to ≥1/2 of what is expected from the patient (around day 2); 2) the clozapine/norclozapine ratio became inverted (around day 3); and 3) the clozapine concentration became undetectable by the laboratory (around days 9-11). Prospective studies should further explore these proposed clozapine indices in average patients, poor metabolizers (3 presented) and ultrarapid metabolizers (2 presented). | |
dc.language.iso | EN | en_US |
dc.subject.en | Clozapine/blood | |
dc.subject.en | Clozapine/metabolism | |
dc.subject.en | Clozapine/therapeutic use | |
dc.subject.en | Drug interaction | |
dc.subject.en | Medication adherence | |
dc.subject.en | Schizophrenia | |
dc.title.en | Exploring low clozapine C/D ratios, inverted clozapine-norclozapine ratios and undetectable concentrations as measures of non-adherence in clozapine patients: A literature review and a case series of 17 patients from 3 studies | |
dc.title.alternative | Schizophr Res | en_US |
dc.type | Article de revue | en_US |
dc.identifier.doi | 10.1016/j.schres.2023.07.002 | en_US |
dc.subject.hal | Sciences du Vivant [q-bio]/Santé publique et épidémiologie | en_US |
dc.identifier.pubmed | 37487869 | en_US |
bordeaux.journal | Schizophrenia Research | en_US |
bordeaux.hal.laboratories | Bordeaux Population Health Research Center (BPH) - UMR 1219 | en_US |
bordeaux.institution | Université de Bordeaux | en_US |
bordeaux.institution | INSERM | en_US |
bordeaux.team | AHEAD | en_US |
bordeaux.peerReviewed | oui | en_US |
bordeaux.inpress | non | en_US |
bordeaux.import.source | pubmed | |
hal.identifier | hal-04245813 | |
hal.version | 1 | |
hal.date.transferred | 2023-10-17T09:48:38Z | |
hal.popular | non | en_US |
hal.audience | Internationale | en_US |
hal.export | true | |
workflow.import.source | pubmed | |
dc.rights.cc | Pas de Licence CC | en_US |
bordeaux.COinS | ctx_ver=Z39.88-2004&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.jtitle=Schizophrenia%20Research&rft.date=2023-07-22&rft.eissn=1573-2509&rft.issn=1573-2509&rft.au=RUAN,%20Can-Jun&OLMOS,%20Ismael&RICCIARDI,%20Carina&SCHORETSANITIS,%20Georgios&VINCENT,%20Philippe%20D&rft.genre=article |
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