{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T13:36:41Z","timestamp":1791466601575,"version":"4.3.4"},"reference-count":34,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2025,3,16]],"date-time":"2025-03-16T00:00:00Z","timestamp":1742083200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100006095","name":"Helse S\u00f8r-\u00d8st RHF","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100006095","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Acta Psychiatr Scand"],"published-print":{"date-parts":[[2025,7]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>Both inflammation and smoking are known to affect clozapine metabolism. However, the impact of inflammation on clozapine metabolism in relation to smoking status is unclear. Therefore, we investigated correlations between C\u2010reactive protein (CRP) and clozapine levels in smokers and non\u2010smokers separately.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Patients were included retrospectively from a therapeutic drug monitoring (TDM) service in Oslo, Norway, during January 2005\u2013April 2022. Inclusion criteria were known smoking status and CRP measurements no longer than 7\u2009days before or after clozapine TDM. Exclusion criteria were confirmed blood sampling for TDM outside 10\u201330\u2009h after the last clozapine intake. Information about clozapine dosing was retrieved from the requisition forms.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      In 126 patients fulfilling the criteria (47% smokers), dose\u2010adjusted serum concentration (CD) of clozapine correlated significantly with CRP in non\u2010smokers (\n                      <jats:italic>R<\/jats:italic>\n                      \u2009=\u20090.492;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u2009001) but not in smokers (\n                      <jats:italic>R<\/jats:italic>\n                      \u2009=\u20090.191;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.166). When subgrouping non\u2010smoking patients into low CRP (&lt;\u20095\u2009mg\/L; reference [51% of the population]), mid CRP (5\u201350 [37%]) and high CRP (&gt;\u200950 [12%]), clozapine CD gradually increased in mid\u2010 (+48%,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.004) and high\u2010CRP groups (+204%,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001) compared with the low\u2010CRP group. No significant differences in clozapine CD were found between CRP groups among smokers (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&gt;\u20090.15).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>We report a significant correlation between CD of clozapine and CRP levels in non\u2010smoking patients only. In these patients, clozapine CD is more than 3\u2010fold higher at CRP\u2009&gt;\u200950 versus CRP &lt;\u20095. This suggests that non\u2010smokers are most susceptible to clozapine side effects during inflammation or infection and represent patients where TDM analyses are especially important for guiding clozapine dosing.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/acps.13801","type":"journal-article","created":{"date-parts":[[2025,3,16]],"date-time":"2025-03-16T21:18:56Z","timestamp":1742159936000},"page":"69-76","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["Correlation Between Clozapine and\n                    <scp>CRP<\/scp>\n                    Levels in Relation to Smoking Status"],"prefix":"10.1111","volume":"152","author":[{"given":"Robert L\u00f8vsletten","family":"Smith","sequence":"first","affiliation":[{"name":"Center for Psychopharmacology Diakonhjemmet Hospital  Oslo Norway"},{"name":"NORMENT Institute of Clinical Medicine, University of Oslo  Oslo 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