Appendicitis Associated With Clozapine: Analyses Based on a Spontaneous Reporting System Database in Japan
Fuminari Misawa1, Nozomi Nakajima1, Yasuo Fujii1
1From the Yamanashi Prefectural Kita Hospital, Nirasaki.
Journal of Clinical Psychopharmacology
|March 31, 2023
Summary
Clozapine treatment is linked to a higher risk of appendicitis compared to other antipsychotics. This risk increases over time, requiring heightened clinical awareness during treatment.
Area of Science:
- Pharmacovigilance
- Gastrointestinal Health
- Psychiatric Drug Safety
Background:
- Recent reports suggest a link between clozapine and appendicitis.
- Limited research exists beyond case reports on this association.
- A comprehensive investigation using a large database was warranted.
Purpose of the Study:
- To investigate the association between clozapine and appendicitis.
- To compare appendicitis reporting frequency between clozapine and nonclozapine second-generation antipsychotics (NC-SGAs).
- To analyze the temporal relationship between clozapine use and appendicitis onset.
Main Methods:
- Utilized Japanese Adverse Drug Event Report data.
- Included patients treated with clozapine or NC-SGAs.
- Calculated adjusted reporting odds ratios and performed time-to-event analysis.
Main Results:
- Appendicitis was reported in 1.0% of 8921 patients; 83 of 85 appendicitis cases involved clozapine.
- Appendicitis was significantly more frequent with clozapine compared to NC-SGAs.
- The risk of developing appendicitis associated with clozapine increased over time.
Conclusions:
- Clozapine is associated with an elevated risk of appendicitis compared to NC-SGAs.
- The risk of clozapine-associated appendicitis escalates with treatment duration.
- Clinicians should exercise increased vigilance for appendicitis in patients undergoing clozapine therapy.
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