Effect of influenza vaccination on serum clozapine and its main metabolite concentrations in patients with schizophrenia

Raaska, Kari; Raitasuo, Virpi; Neuvonen, Pertti J.

doi:10.1007/s002280100375

Cited by 31 publications

(31 citation statements)

References 18 publications

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“…Raaska et al found a non-significant increase of CRP in a group of 12 schizophrenic patients after influenza vaccination and highest levels of CRP at day 2 [18]. CRP was measured before and 2, 4, 7 and 14 days after vaccination.…”

Section: Discussionmentioning

confidence: 99%

“…Other studies suggested highest increases of CRP in the first week after vaccinations [12,18]. We therefore measured CRP at baseline and 2, 3, 4 and 5 days thereafter.…”

Section: Discussionmentioning

confidence: 99%

“…Several vaccines have been used in in vivo models to induce a mild inflammatory response [5,12,14,15]. It is not clear whether influenza and pneumococcal vaccines increase serum CRP concentrations [16][17][18][19].…”

Section: Introductionmentioning

confidence: 99%

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Influenza and pneumococcal vaccination as a model to assess C-reactive protein response to mild inflammation

Posthouwer

Voorbij

Grobbee

et al. 2004

Vaccine

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This study was set up to examine whether an influenza vaccine or an influenza vaccine in combination with pneumococcal vaccine can be used as a model to study responses to mild stimulation of the inflammatory system.In this study, 19 subjects received the influenza vaccine, 20 subjects the combination of influenza and pneumococcal vaccine. CRP and prothrombin fragment 1 and 2 (F1 + 2) were measured at baseline, and two times after vaccination. Influenza vaccination increased CRP by 0.20 mg/L, and influenza in combination with pneumococcal vaccine increased CRP by 0.60 mg/L. F1 + 2 increased 0.15 nmol/L after the combined vaccination; an increase in response to the influenza vaccination was not statistically significant.Our findings show that the influenza vaccine alone as well as the combination of the influenza and pneumococcal vaccine increases CRP-levels with a peak 2 days after vaccination.

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Section: Discussionmentioning

confidence: 99%

“…Other studies suggested highest increases of CRP in the first week after vaccinations [12,18]. We therefore measured CRP at baseline and 2, 3, 4 and 5 days thereafter.…”

Section: Discussionmentioning

confidence: 99%

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Influenza and pneumococcal vaccination as a model to assess C-reactive protein response to mild inflammation

Posthouwer

Voorbij

Grobbee

et al. 2004

Vaccine

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“…This was recently highlighted by Raaska et al, who reported an increase in clozapine serum concentration in two patients who developed minor infections [76]. In all these cases, cytokine plasma levels were linked to the reduction of P450-dependent drug clearance.…”

Section: Discussionmentioning

confidence: 84%

“…Such a concept was clearly defined in a recent article by Raaska et al, who pointed out that a minor infection could also modify drug metabolism, thus creating a clinical condition similar to those described for vaccine-drug interactions [76].…”

Section: Discussionmentioning

confidence: 97%

Vaccine–Drug Interactions: Cytokines, Cytochromes, and Molecular Mechanisms

et al. 2015

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Vaccinations are recommended throughout life to reduce the risk of vaccine-preventable diseases and their sequelae. Vaccines are often administered in patients with chronic diseases who are likely to be treated with several drugs. A growing number of clinical observations have indicated the possibility of interactions between vaccines and drugs, leading to changes in drug metabolism after vaccination. These interactions represent a significant concern because of the increasing use of vaccines in older patients who are likely to be treated with several drugs. Because of the possible implications of adverse reactions in terms of public health, several studies were performed to verify the risk posed by these interactions and to clarify the biologic mechanisms that drive these events. Of the several mechanisms proposed to be at the basis of vaccine-drug interactions, the most convincing evidence suggests a role of inflammatory cytokines on the regulation of specific cytochrome P450 enzymes in the liver. Differences in the cytochrome P450 enzymes involved in the metabolism of these drugs could explain these contrasting results and provide important insights to fully understand the clinical importance of these events. Further studies are required to verify whether vaccine-drug interactions may occur in other clinical settings, especially the ones for which patients are required to be vaccinated against specific diseases.

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Drug Interactions of Cytokines and Anticytokine Therapeutic Proteins

Slatter

Wienkers

Dickmann

2013

Pharmaceutical Sciences Encyclopedia

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The suppression of drug metabolism by proinflammatory cytokines and the relief of suppression by disease treatment are a current issue in the development of drug interaction labels for new biologic products. This topic has been the subject of a number of recent reviews that capture the history of related work as well as current regulatory and pharmaceutical industry thinking. This chapter provides an overview of some recent data developed in industrially relevant preclinical models and outlines the pros and cons of these models with respect to the generation of actionable data—that is, data that are robust enough to preclude the need for a clinical drug–disease interaction study and/or a class label for a new cytokine or anticytokine therapeutic agent.

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Effect of influenza vaccination on serum clozapine and its main metabolite concentrations in patients with schizophrenia

Abstract: Influenza vaccination using conventional trivalent influenza vaccine does not affect serum concentrations of clozapine or its main metabolites. However, an infection-related increase in CRP may be associated with increased serum concentration of clozapine.

Cited by 31 publications

References 18 publications

Influenza and pneumococcal vaccination as a model to assess C-reactive protein response to mild inflammation

Influenza and pneumococcal vaccination as a model to assess C-reactive protein response to mild inflammation

Vaccine–Drug Interactions: Cytokines, Cytochromes, and Molecular Mechanisms

Drug Interactions of Cytokines and Anticytokine Therapeutic Proteins

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