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Meta-Analysis
. 2017 Nov;62(11):772-777.
doi: 10.1177/0706743717718167. Epub 2017 Jun 28.

Clozapine Response Rates among People with Treatment-Resistant Schizophrenia: Data from a Systematic Review and Meta-Analysis

Dan Siskind  1   2 , Victor Siskind  3 , Steve Kisely  1   2
Affiliations
Meta-Analysis

Clozapine Response Rates among People with Treatment-Resistant Schizophrenia: Data from a Systematic Review and Meta-Analysis

Dan Siskind et al. Can J Psychiatry. 2017 Nov.

Abstract
in English, French

Clozapine is the most effective antipsychotic for the 25% to 33% of people with schizophrenia who are treatment resistant, but not all people achieve response. Using data from a previously published clozapine systematic review and meta-analysis, we explored the proportion of people who achieved response and examined the absolute and percentage change in Positive and Negative Syndrome Scale (PANSS) scores. Overall, 40.1% (95% confidence interval [CI], 36.8%-43.4%) responded, with a mean reduction in PANSS of 22.0 points (95% CI, 20.9-23.1), a reduction of 25.8% (95% CI, 24.7%-26.9%) from baseline. These reductions are clinically meaningful. A 40% response rate to clozapine suggests that 12% to 20% of people with schizophrenia will be ultra-resistant.

La clozapine est l’antipsychotique le plus efficace pour les 25 à 33% des personnes souffrant de schizophrénie qui sont réfractaires au traitement; toutefois, les personnes n’obtiennent pas toutes une réponse. À l’aide des données d’une revue systématique et d’une méta-analyse publiées précédemment, nous avons exploré la proportion de gens qui obtenaient une réponse, et examiné le pourcentage absolu et les changements de pourcentage dans les scores à l’échelle des syndromes positifs et négatifs (PANSS). Globalement, 40,1% (IC à 95% 36,8% à 43,4%) ont répondu, avec une réduction moyenne à la PANSS de 22,0 points (IC à 95% 20,9 à 23,1), une réduction de 25,8% (IC à 95% 24,7% à 26,9%) par rapport au départ. Ces réductions sont cliniquement significatives. Un taux de réponse de 40% à la clozapine suggère que de 12% à 20% des personnes souffrant de schizophrénie seront ultra-réfractaires.

Keywords: PANSS; clozapine; response; schizophrenia; treatment-resistant.

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Conflict of interest statement

Declaration of Conflicting Interests: The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

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