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Association with hospitalization and all-cause discontinuation among patients with schizophrenia on clozapine vs other oral second-generation antipsychotics: A systematic review and meta-analysis of cohort studies

JAMA Aug 05, 2019

Masuda T, et al. - Through a systematic review and meta-analysis of 63 cohort studies comprising 109,341 individuals, researchers contrasted various outcomes of clozapine vs oral non-clozapine second-generation antipsychotics (NC-SGAs). Clozapine was significantly correlated with lower hospitalization risk and all-cause discontinuation, irrespective of greater illness severity in comparison with NC-SGAs. Relationships were statistically significant for comparisons with quetiapine, fumarate, and aripiprazole with respect to hospitalization, and all NC-SGAs, except aripiprazole, for all-cause discontinuation. Regarding overall symptoms and Clinical Global Impressions scale severity, clozapine was also significantly related to better results. Clozapine was significantly correlated with progress in body weight, BMI, and type 2 diabetes. Therefore, the use of clozapine was related to better key efficiency outcomes and higher cardiometabolic-related risk outcomes vs NC-SGAs, regardless of more severely ill individuals being treated with clozapine.

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