Clozapine-induced agranulocytosis/granulocytopenia: mechanisms and monitoring

@article{Wiciski2018ClozapineinducedAM,
  title={Clozapine-induced agranulocytosis/granulocytopenia: mechanisms and monitoring},
  author={M. Wiciński and Mateusz M Węclewicz},
  journal={Current Opinion in Hematology},
  year={2018},
  volume={25},
  pages={22–28}
}
Purpose of review Clozapine-induced agranulocytosis/granulocytopenia (CIAG) is an uncommon condition, but potentially fatal in consequences. The pathogenesis, despite multiple experiments, is not fully elucidated. The current theory suggests reactive oxygen species – nitrenium ion as the most important factor of CIAG. In this review, mechanism and monitoring of CIAG will be discussed. Recent findings The mechanism of CIAG seems to have an autoimmune background, rather than toxic. Clozapine has… Expand
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TLDR
Two loci in the major histocompatibility complex are independently associated with clozapine-induced agranulocytosis/granulocytopenia (CIAG), and these associations dovetail with the roles of these genes in immunogenetic phenotypes and adverse drug responses for other medications, and provide insight into the pathophysiology of CIAG. Expand
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To investigate whether combinations of the identified genetic risk factors have a higher predictive value, should be confirmed in a larger case–control study. Expand
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A simple, personalized cell culture‐based strategy to identify CIAG‐susceptible patients, hypothesizing that an immunogenic and possibly haptene‐based mechanism underlies CIAG pathophysiology, results in robust effects of physiological clozapine levels. Expand
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State of Art of Idiosyncratic Drug-Induced Neutropenia or Agranulocytosis, with a Focus on Biotherapies
TLDR
Clinicians must continue their efforts to improve their knowledge of these adverse events with new drugs as biotherapies, as significant progress has been made in recent years in the field of idiosyncratic drug-induced neutropenia, leading to an improvement in their prognosis. Expand
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