{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,25]],"date-time":"2026-08-25T09:07:28Z","timestamp":1787648848518,"version":"build-2736575974"},"reference-count":19,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2025,5,3]],"date-time":"2025-05-03T00:00:00Z","timestamp":1746230400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Acta Psychiatr Scand"],"published-print":{"date-parts":[[2025,9]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Clozapine is the only truly effective treatment for refractory schizophrenia, but its use is constrained by the requirements for frequent monitoring of neutrophil counts. In the UK during the COVID\u201019 pandemic, the frequency of clozapine blood monitoring was reduced in some units from 4\u2010weekly to 12\u2010weekly. We aimed to investigate the outcomes of reduced monitoring in long\u2010term clozapine patients.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This was an anonymous, retrospective, observational cohort study. No restrictions were applied regarding care setting (i.e., outpatients or inpatients). All patients who registered for reduced frequency haematological monitoring from 1 March 2020 to 1 November 2022 were included and followed up till 1 August 2024. The primary outcome was death resulting from clozapine\u2010induced agranulocytosis (CIA). Secondary outcomes were the proportion of patients with mild to moderate neutropenia during the follow\u2010up period and the proportion of patients who reverted to standard monitoring during the study period.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Amongst 1025 patients, there were no cases of agranulocytosis over 3365.9 patient\u2010years of 12\u2010weekly blood monitoring (incident rate 0.0 per 100 person\u2010years). There were 43 episodes of mild neutropenia (so\u2010called amber results\u20141.5\u20132.0\u2009\u00d7\u200910\n                      <jats:sup>9<\/jats:sup>\n                      \/L) or neutropenia (red results &lt;\u20091.5\u2009\u00d7\u200910\n                      <jats:sup>9<\/jats:sup>\n                      \/L), an overall incident rate of 1.28 per 100 person\u2010years. During follow\u2010up, 41 patients (4%) reverted permanently to standard 4\u2010weekly monitoring, and 157 patients (15%) temporarily interrupted reduced frequency monitoring but restarted 12\u2010weekly monitoring before the end of the follow\u2010up period. In total, 42 patients (4%) died during the observation period\u2014no death was related to agranulocytosis.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Reducing the frequency of clozapine haematological monitoring to 12\u2010weekly was safe in a group of long\u2010term patients. No cases of agranulocytosis occurred and no deaths due to agranulocytosis were recorded. Most patients remained on extended\u2010interval monitoring.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/acps.13818","type":"journal-article","created":{"date-parts":[[2025,5,3]],"date-time":"2025-05-03T03:55:56Z","timestamp":1746244556000},"page":"187-192","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["The Safety of 12\u2010Weekly Monitoring of Neutrophil Count in Long\u2010Term Clozapine Patients"],"prefix":"10.1111","volume":"152","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2557-1710","authenticated-orcid":false,"given":"David","family":"Taylor","sequence":"first","affiliation":[{"name":"Institute of Pharmaceutical Science King's College London  London UK"},{"name":"Pharmacy Department South London and Maudsley NHS Foundation Trust  London 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