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The time has come for revising the rules of clozapine blood monitoring in Europe: a joint expert statement from the European Clozapine Task Force

  • The European Clozapine Task Force is a group of psychiatrists and pharmacologists practicing in 18 countries under European Medicines Agency (EMA) regulation, who are deeply concerned about the underuse of clozapine in European countries. Although clozapine is the most effective antipsychotic for people with treatment-resistant schizophrenia, a large proportion of them do not have access to this treatment. Concerns about clozapine-induced agranulocytosis and stringent blood monitoring rules are major barriers to clozapine prescribing and use. There is a growing body of evidence that the incidence of clozapine-induced agranulocytosis is very low after the first year of treatment. Maintaining lifelong monthly blood monitoring after this period contributes to unjustified discontinuation of clozapine. We leverage recent and replicated evidence on the long-term safety of clozapine to call for the revision and updating of the EMA’s blood monitoring rules, thus aiming to overcome this majorThe European Clozapine Task Force is a group of psychiatrists and pharmacologists practicing in 18 countries under European Medicines Agency (EMA) regulation, who are deeply concerned about the underuse of clozapine in European countries. Although clozapine is the most effective antipsychotic for people with treatment-resistant schizophrenia, a large proportion of them do not have access to this treatment. Concerns about clozapine-induced agranulocytosis and stringent blood monitoring rules are major barriers to clozapine prescribing and use. There is a growing body of evidence that the incidence of clozapine-induced agranulocytosis is very low after the first year of treatment. Maintaining lifelong monthly blood monitoring after this period contributes to unjustified discontinuation of clozapine. We leverage recent and replicated evidence on the long-term safety of clozapine to call for the revision and updating of the EMA’s blood monitoring rules, thus aiming to overcome this major barrier to clozapine prescribing and use. We believe the time has come for relaxing the rules without increasing the risks for people using clozapine in Europe.show moreshow less

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Metadaten
Author:Hélène Verdoux, Robert A. Bittner, Alkomiet HasanORCiDGND, Mishal Qubad, Elias WagnerORCiDGND, Alexis Lepetit, Manuel Arrojo-Romero, Christian Bachmann, Marieke Beex-Oosterhuis, Jan Bogers, Andreja Celofiga, Dan Cohen, Domenico de Berardis, Marc de Hert, Carlos de las Cuevas, Bjørn H. Ebdrup, Konstantinos N. Fountoulakis, Daniel Guinart, Dolores Keating, Miloslav Kopeček, John Lally, Judit Lazáry, Jurjen J. Luykx, Olalla Maronas Amigo, Espen Molden, Jimmi Nielsen, Brian O’Donoghue, Pierre Oswald, Flavian S. Radulescu, Christopher Rohde, Marina Sagud, Emilio J. Sanz, Ivona Šimunović Filipčić, Iris E. Sommer, Heidi Taipale, Jari Tiihonen, Heli Tuppurainen, Selene Veerman, Alina Wilkowska, Edoardo Spina, Peter Schulte
URN:urn:nbn:de:bvb:384-opus4-1189607
Frontdoor URLhttps://opus.bibliothek.uni-augsburg.de/opus4/118960
ISSN:0924-9338OPAC
ISSN:1778-3585OPAC
Parent Title (English):European Psychiatry
Publisher:Cambridge University Press
Place of publication:Cambridge
Type:Article
Language:English
Year of first Publication:2025
Publishing Institution:Universität Augsburg
Release Date:2025/02/11
Volume:68
Issue:1
First Page:e17
DOI:https://doi.org/10.1192/j.eurpsy.2024.1816
Institutes:Medizinische Fakultät
Medizinische Fakultät / Lehrstuhl für Psychiatrie und Psychotherapie
Medizinische Fakultät / Bezirkskrankenhaus (BKH)
Medizinische Fakultät / Professur für Evidenzbasierte Psychiatrie und Psychotherapie
Dewey Decimal Classification:6 Technik, Medizin, angewandte Wissenschaften / 61 Medizin und Gesundheit / 610 Medizin und Gesundheit
Licence (German):License LogoCC-BY 4.0: Creative Commons: Namensnennung (mit Print on Demand)