Huiquan Zhou
Slide 1
Hi, everyone. Thank you for being here today. I am excited to present our study on the association between clozapine use and the risk of hospitalization among people with schizophrenia, using a self-controlled case series study design.
Slide 2
Schizophrenia is a chronic and severe mental disorder that often leads to recurrent hospitalizations, placing a significant burden on patients, families, and healthcare systems. Clozapine, the gold-standard treatment for TRS, has been shown to reduce symptoms and improve outcomes. However, critical gaps remain in our understanding of its real-world impact on hospitalization risk.
First, there is limited evidence of clozapine’s impact on specific types of hospitalizations, such as psychiatric versus non-psychiatric admissions. Second, the comparative effectiveness of clozapine versus depot in preventing hospitalizations remains controversial, with conflicting findings in the literature. Third, real-world evidence is limited, and previous cohort studies often fail to address confounding due to between-person comparisons.
To address these gaps, we conducted a self-controlled case series study, a robust method where each individual serves as their own control. This design divides the observation period for each individual into different exposure types, eliminating the influence of fixed confounders such as genetics or chronic comorbidities. Our study leverages a regional representative cohort of new clozapine users in Hong Kong, providing a unique opportunity to examine clozapine’s real-world effectiveness under the Chinese context.
Slide 3
We first compare the effectiveness of clozapine with other antipsychotics in general. We divided the observation periods into the pre-exposure period, the first clozapine exposure period, the washout period, the subsequent clozapine exposure period, and the period using other antipsychotics. We found that, compared to the use of other antipsychotics, both the first clozapine use and subsequent clozapine use showed significant lower risk associated with all-cause, psychiatric and non-psychiatric hospitalization.
Slide 4
We then compare the effectiveness of depot and combination use of depot and clozapine against the use of clozapine only. Similarly, we divided the whole observation period by different exposure types. The results showed that compare to clozapine use only, both combination use and depot use were associated with higher risk of all-cause, psychiatric and non-psychiatric hospitalization. We welcome and invite constructive comments and ideas from you.
