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Introduction: Clozapine is the gold-standard therapy for resistant schizophrenia. However, its use is limited by risks such as clozapine-induced agranulocytosis (CIA) and neutropenia (CIN), requiring strict monitoring. This study aimed to estimate the prevalence and mortality of CIA and CIN at GHU Paris Psychiatrie 95% CI: 1.327–5.163), while a higher ANC before treatment introduction decreased the risk (OR: 0.352; 95% CI: 0.229–0.542). Regarding the progression from mild to moderate neutropenia, receiving an anxiolytic treatment and being older than 49 years old significantly decreased the risk (OR: 0.189, 95% CI: 0.042–0.86; OR: 0.139, 95% CI: 025–0.772, respectively). Treatment was discontinued in 44% of the patients with neutropenia, and 53% were rechallenged with clozapine. Conclusion: Our study provides further evidence that CIA is a rare side effect. Given the benefits of clozapine and the rarity of agranulocytosis, our results suggest a looser approach to hematological monitoring and support the new French and US guidelines.
Sandroni et al. (Fri,) studied this question.