{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,2]],"date-time":"2026-09-02T11:38:31Z","timestamp":1788349111627,"version":"build-2803163510"},"reference-count":37,"publisher":"Georg Thieme Verlag KG","issue":"04","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Pharmacopsychiatry"],"published-print":{"date-parts":[[2024,7]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>\n          Background Clozapine is the recommended treatment for managing\n                    treatment-resistant schizophrenia (TRS), and immunological mechanisms may be\n                    involved in its unique antipsychotic efficacy. This study investigated whether\n                    baseline immune abnormalities measured with blood cell count ratios can predict\n                    the clinical response after initiating treatment with clozapine in patients with\n                    clozapine na\u00efve TRS.<\/jats:p><jats:p>\n          Methods A longitudinal design was developed, involving 32 patients\n                    diagnosed with treatment-resistant, clozapine-na\u00efve schizophrenia-spectrum\n                    disorder. Patients were evaluated at baseline before clozapine starting and 8\n                    weeks of follow-up. Psychopathological status and immune abnormalities (blood\n                    cell count ratios: neutrophil-lymphocyte ratio [NLR], monocyte-lymphocyte ratio\n                    [MLR], platelet-lymphocyte ratio [PLR] and basophil-lymphocyte ratio [BLR]) were\n                    evaluated in each visit.<\/jats:p><jats:p>\n          Results Baseline NLR (b=\u2212\u20090.364; p=0.041) and MLR (b\u2009=\u2212\u20090.400; p=0.023)\n                    predicted the change in positive symptoms over the 8-week period. Patients who\n                    exhibited a clinical response showed higher baseline NLR (2.38\u00b10.96 vs.\n                    1.75\u00b10.83; p=0.040) and MLR (0.21\u00b10.06 vs. 0.17\u00b10.02; p=0.044) compared to\n                    non-responders. In the ROC analysis, the threshold points to distinguish between\n                    responders and non-responders were approximately 1.62 for NLR and 0.144 for MLR,\n                    yielding AUC values of 0.714 and 0.712, respectively. No statistically\n                    significant differences were observed in the blood cell count ratios from\n                    baseline to the 8-week follow-up.<\/jats:p><jats:p>\n          Conclusion Our study emphasizes the potential clinical significance of\n                    baseline NLR and MLR levels as predictors of initial clozapine treatment\n                    response in patients with TRS. Future studies with larger sample sizes and\n                    longer follow-up periods should replicate our findings.<\/jats:p>","DOI":"10.1055\/a-2290-6386","type":"journal-article","created":{"date-parts":[[2024,4,16]],"date-time":"2024-04-16T00:09:37Z","timestamp":1713226177000},"page":"173-179","source":"Crossref","is-referenced-by-count":5,"title":["Blood Cell Count Ratios at Baseline are Associated with Initial\n                    Clinical Response to Clozapine in Treatment-Resistant, Clozapine-Na\u00efve,\n                    Schizophrenia-Spectrum Disorder"],"prefix":"10.1055","volume":"57","author":[{"given":"Vicent","family":"Llorca-Bof\u00ed","sequence":"additional","affiliation":[{"name":"Department of Medicine, University of Barcelona, Barcelona,\n                    Spain"},{"name":"Barcelona Cl\u00ednic Schizophrenia Unit (BCSU), Neuroscience Institute,\n                    Hospital Cl\u00ednic de Barcelona, Barcelona, Spain"},{"name":"Institut d'Investigacions Biom\u00e8diques August Pi i Sunyer\n                    (IDIBAPS), Barcelona, Spain"},{"name":"Centro de Investigaci\u00f3n Biom\u00e9dica en Red en Salud Mental (CIBERSAM),\n                    Instituto de Salud Carlos III (ISCIII), Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Miquel","family":"Bioque","sequence":"additional","affiliation":[{"name":"Department of Medicine, University of Barcelona, Barcelona,\n                    Spain"},{"name":"Barcelona Cl\u00ednic Schizophrenia Unit (BCSU), Neuroscience Institute,\n                    Hospital Cl\u00ednic de Barcelona, Barcelona, Spain"},{"name":"Institut d'Investigacions Biom\u00e8diques August Pi i Sunyer\n                    (IDIBAPS), Barcelona, Spain"},{"name":"Centro de Investigaci\u00f3n Biom\u00e9dica en Red en Salud Mental (CIBERSAM),\n                    Instituto de Salud Carlos III (ISCIII), Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Santiago","family":"Madero","sequence":"additional","affiliation":[{"name":"Department of Medicine, University of Barcelona, Barcelona,\n                    Spain"},{"name":"Barcelona Cl\u00ednic Schizophrenia Unit (BCSU), Neuroscience Institute,\n                    Hospital Cl\u00ednic de Barcelona, Barcelona, Spain"},{"name":"Institut d'Investigacions Biom\u00e8diques August Pi i Sunyer\n                    (IDIBAPS), Barcelona, Spain"},{"name":"Centro de Investigaci\u00f3n Biom\u00e9dica en Red en Salud Mental (CIBERSAM),\n                    Instituto de Salud Carlos III (ISCIII), Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrea","family":"Mallorqu\u00ed","sequence":"additional","affiliation":[{"name":"Barcelona Cl\u00ednic Schizophrenia Unit (BCSU), Neuroscience Institute,\n                    Hospital Cl\u00ednic de Barcelona, Barcelona, Spain"},{"name":"Institut d'Investigacions Biom\u00e8diques August Pi i Sunyer\n                    (IDIBAPS), Barcelona, Spain"},{"name":"Centro de Investigaci\u00f3n Biom\u00e9dica en Red en Salud Mental (CIBERSAM),\n                    Instituto de Salud Carlos III (ISCIII), Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cristina","family":"Oliveira","sequence":"additional","affiliation":[{"name":"University of Coimbra, Coimbra, Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marina","family":"Garriga","sequence":"additional","affiliation":[{"name":"Institut d'Investigacions Biom\u00e8diques August Pi i Sunyer\n                    (IDIBAPS), Barcelona, Spain"},{"name":"Centro de Investigaci\u00f3n Biom\u00e9dica en Red en Salud Mental (CIBERSAM),\n                    Instituto de Salud Carlos III (ISCIII), Madrid, Spain"},{"name":"Bipolar and Depressive Disorders Unit, Neurosciences Institute,\n                    Hospital Cl\u00ednic Barcelona, Barcelona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eduard","family":"Parellada","sequence":"additional","affiliation":[{"name":"Department of Medicine, University of Barcelona, Barcelona,\n                    Spain"},{"name":"Barcelona Cl\u00ednic Schizophrenia Unit (BCSU), Neuroscience Institute,\n                    Hospital Cl\u00ednic de Barcelona, Barcelona, Spain"},{"name":"Institut d'Investigacions Biom\u00e8diques August Pi i Sunyer\n                    (IDIBAPS), Barcelona, Spain"},{"name":"Centro de Investigaci\u00f3n Biom\u00e9dica en Red en Salud Mental (CIBERSAM),\n                    Instituto de Salud Carlos III (ISCIII), Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Clemente","family":"Garc\u00eda-Rizo","sequence":"additional","affiliation":[{"name":"Department of Medicine, University of Barcelona, Barcelona,\n                    Spain"},{"name":"Barcelona Cl\u00ednic Schizophrenia Unit (BCSU), Neuroscience Institute,\n                    Hospital Cl\u00ednic de Barcelona, Barcelona, Spain"},{"name":"Institut d'Investigacions Biom\u00e8diques August Pi i Sunyer\n                    (IDIBAPS), Barcelona, Spain"},{"name":"University of Coimbra, Coimbra, Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"194","published-online":{"date-parts":[[2024,4,15]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"2783","DOI":"10.4088\/JCP.18COM12123","article-title":"Clinical guidance on the identification and management of treatment-resistant\n                    schizophrenia","volume":"80","author":"J M Kane","year":"2019","journal-title":"J Clin Psychiatry"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"327","DOI":"10.3389\/FPSYT.2018.00327","article-title":"Biological predictors of clozapine response: A systematic review","volume":"9","author":"R Samanaite","year":"2018","journal-title":"Front 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