Abstract：
UNASSIGNED: The literature associates clozapine with pneumonia/aspiration pneumonia.
UNASSIGNED: The international pharmacovigilance database (VigiBase™) uses the information component (IC) as statistical signal. VigiBase clozapine reports were analyzed for pneumonia/aspiration pneumonia from introduction to 10 May 2023.
UNASSIGNED: There were 6392 cases of all types of pneumonia (5572 cases of pneumonia, 775 of aspiration pneumonia, and 45 combined). The IC was 3.52 for aspiration pneumonia, introduced as a VigiBase label in 2003, and 1.91 for pneumonia. Patients were reclassified as 3628 with no signs of aspiration and 1533 with signs. Signs of aspiration were strongly associated with some co-medications: olanzapine, odds ratio (OR) = 23.8, 95% confidence interval (CI), 14.9-38.0; risperidone OR = 18.6, CI, 11.4-30.4; valproic acid, OR = 5.5, CI, 4.5-6.6; and benzodiazepines OR = 5.5, CI, 4.5-6.6. In 2415 cases with completed data, fatal outcomes made up 45% (signs of aspiration made no difference), but there was wide variability from 0% (females <45 years of age; duration ≤30 days) to 76% (males >64 years of age; duration >1 year). During the first week, pneumonia was associated with 1) very high titration doses, 2) very small doses in Parkinson\'s disease, and 3) Japan vs other countries.
UNASSIGNED: In clozapine-treated patients: 1) at least 30% of pneumonia cases may be aspiration pneumonia, 2) stopping some co-medications may decrease the risk of aspiration pneumonia, 3) average lethality in pneumonia was 45% but may be around 75% in geriatric patients with long-term treatment, and 4) safer titrations may sometimes require 5-mg tablets.
UNASSIGNED: The international pharmacovigilance database (VigiBase™) uses the information component (IC) as statistical signal. VigiBase clozapine reports were analyzed for pneumonia/aspiration pneumonia from introduction to 10 May 2023.
UNASSIGNED: There were 6392 cases of all types of pneumonia (5572 cases of pneumonia, 775 of aspiration pneumonia, and 45 combined). The IC was 3.52 for aspiration pneumonia, introduced as a VigiBase label in 2003, and 1.91 for pneumonia. Patients were reclassified as 3628 with no signs of aspiration and 1533 with signs. Signs of aspiration were strongly associated with some co-medications: olanzapine, odds ratio (OR) = 23.8, 95% confidence interval (CI), 14.9-38.0; risperidone OR = 18.6, CI, 11.4-30.4; valproic acid, OR = 5.5, CI, 4.5-6.6; and benzodiazepines OR = 5.5, CI, 4.5-6.6. In 2415 cases with completed data, fatal outcomes made up 45% (signs of aspiration made no difference), but there was wide variability from 0% (females <45 years of age; duration ≤30 days) to 76% (males >64 years of age; duration >1 year). During the first week, pneumonia was associated with 1) very high titration doses, 2) very small doses in Parkinson\'s disease, and 3) Japan vs other countries.
UNASSIGNED: In clozapine-treated patients: 1) at least 30% of pneumonia cases may be aspiration pneumonia, 2) stopping some co-medications may decrease the risk of aspiration pneumonia, 3) average lethality in pneumonia was 45% but may be around 75% in geriatric patients with long-term treatment, and 4) safer titrations may sometimes require 5-mg tablets.
摘要：
■文献将氯氮平与肺炎/吸入性肺炎相关联。
■国际药物警戒数据库（VigiBase™）使用信息成分（IC）作为统计信号。分析了从介绍到2023年5月10日的肺炎/吸入性肺炎的VigiBase氯氮平报告。
■有6392例所有类型的肺炎（5572例肺炎，775例吸入性肺炎，和45合并）。吸入性肺炎的IC为3.52,2003年作为VigiBase标签推出，肺炎为1.91。患者被重新分类为3628，无误吸迹象，1533有迹象。误吸的迹象与一些共同用药密切相关：奥氮平，优势比(OR)=23.8，95%置信区间(CI)，14.9-38.0；利培酮OR=18.6，CI，11.4-30.4；丙戊酸，OR=5.5，CI，4.5-6.6；苯二氮卓类药物OR=5.5，CI，4.5-6.6。在2415个数据完整的案例中，致命性结局占45%（误吸迹象没有区别），但是差异很大，从0％（女性<45岁；持续时间≤30天）到76％（男性>64岁；持续时间>1年）。在第一周,肺炎与：1）非常高的滴定剂量有关，2）帕金森氏病的小剂量和3）日本与其他国家。
■在氯氮平治疗的患者中：1）至少30％的肺炎病例可能是吸入性肺炎，2）停止一些联合用药可能会降低吸入性肺炎的风险，3）肺炎的平均致死率为45％，但在长期治疗的老年患者中可能约为75％，和4）更安全的滴定有时可能需要5-mg片剂。
■国际药物警戒数据库（VigiBase™）使用信息成分（IC）作为统计信号。分析了从介绍到2023年5月10日的肺炎/吸入性肺炎的VigiBase氯氮平报告。
■有6392例所有类型的肺炎（5572例肺炎，775例吸入性肺炎，和45合并）。吸入性肺炎的IC为3.52,2003年作为VigiBase标签推出，肺炎为1.91。患者被重新分类为3628，无误吸迹象，1533有迹象。误吸的迹象与一些共同用药密切相关：奥氮平，优势比(OR)=23.8，95%置信区间(CI)，14.9-38.0；利培酮OR=18.6，CI，11.4-30.4；丙戊酸，OR=5.5，CI，4.5-6.6；苯二氮卓类药物OR=5.5，CI，4.5-6.6。在2415个数据完整的案例中，致命性结局占45%（误吸迹象没有区别），但是差异很大，从0％（女性<45岁；持续时间≤30天）到76％（男性>64岁；持续时间>1年）。在第一周,肺炎与：1）非常高的滴定剂量有关，2）帕金森氏病的小剂量和3）日本与其他国家。
■在氯氮平治疗的患者中：1）至少30％的肺炎病例可能是吸入性肺炎，2）停止一些联合用药可能会降低吸入性肺炎的风险，3）肺炎的平均致死率为45％，但在长期治疗的老年患者中可能约为75％，和4）更安全的滴定有时可能需要5-mg片剂。
