Key PointsQuestionMeta-analyzing nonrandomized cohort studies, how does clozapine compare with other second-generation antipsychotics (SGAs)? FindingsIn this systematic review and meta-analysis of 63 cohort studies comprising 109 341 participants, although more severely ill patients received clozapine, use of clozapine was associated with better effectiveness outcomes regarding hospitalization, all-cause discontinuation, and overall symptoms but with a higher risk of cardiometabolic-related outcomes vs other SGAs. MeaningIn a more generalizable sample of patients with schizophrenia than in randomized trials, clozapine was statistically and clinically associated with better effectiveness outcomes compared with other SGAs, but some concerns about safety require careful monitoring and clinical attention.
JAMA Psychiatry – American Medical Association
Published: Oct 31, 2019
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