A prospective survey of delayed adverse reactions to iohexol in urography and computed tomography

Munechika, Hirotsugu; Hiramatsu, Yoshihiro; Kudo, Sho; Sugimura, Kazuro; Hamada, Chikuma; Yamaguchi, Koichi; Katayama, Hitoshi

doi:10.1007/s00330-002-1339-9

Cited by 47 publications

(41 citation statements)

References 12 publications

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“…The incidence of ADRs following non-ionic ICM administration has been reported ranging from 0.6% to 2.3% in most published studies, 8,9 with one notable exception of 5.0% by Munechika et al 5 after using iohexol for urography and CT. In our study, the overall ADR rate of 1.52% (immediate ADRs, 0.58%, and delayed ADRs, 0.97%, respectively) is in line with those reported for other non-ionic ICMs using a comparable methodology (Table 9).…”

Section: Discussionmentioning

confidence: 99%

“…Any immediate ADR (occurred within 1 h after ICM administration) 4 or delayed ADR (occurred >1 h to 7 days after ICM administration) 5 was recorded in the separate questionnaire regarding the type of signs/symptoms, onset time, lasing duration, severity, causal relationship and outcome. In addition, each ADR was evaluated for seriousness and was designated as a serious ADR if it met one of the following criteria: fatal or life-threatening, leading to significant or permanent damage/impairment or requiring hospitalization in an intensive care unit, hospital stay prolongation or leading to congenital anomalies.…”

Section: Methodsmentioning

confidence: 99%

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Post-marketing surveillance study with iodixanol in 20 185 Chinese patients from routine clinical practices

Hou²,

B³

et al. 2014

BJR

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Objective:To determine the incidence of immediate and delayed adverse drug reactions (ADRs), and to assess patient discomfort following administration of iodixanol during imaging examinations in routine clinical practice.Methods:A total of 20 185 patients across 95 clinical centres were enrolled in a prospective post-marketing surveillance registry with iodixanol. Patients were monitored for occurrence of ADRs immediately following iodixanol administration and for up to 7 days after administration.Results:The overall rate of ADRs was 1.52%, of which 0.58% was immediate and 0.97% was delayed onset. Two patients had non-fatal serious ADRs (0.01%). The ADRs were significantly more common in patients who underwent contrast-enhanced CT/coronary CT angiography vs others (p < 0.001), in those receiving pre-heated iodixanol vs non-heating (p < 0.001), in those aged 70 years or younger (p < 0.001), in those in whom a power injector was used for contrast delivery (p < 0.001) and in those with a history of an allergic reaction to contrast (p = 0.024). Multivariate analysis showed that female gender, intravenous route of contrast injection, body weight ≥80 kg, age less than 65 years, contrast flow rate ≥4 ml s−1 and prior reaction to iodinated contrast medium were all significant and independent contributors to ADRs. Pre-treatment contrast volume and history of cardiac disease, gout, hypertension, diabetes mellitus or asthma did not affect the rate of ADRs. Discomfort was generally mild, with 94.8% of patients reporting a composite score of 0–3.Conclusion:The safety of iodixanol in routine clinical practice was shown to be similar to the published safety profiles of other non-ionic iodinated contrast agents. Patient discomfort during administration was mild or absent in most patients.Advances in knowledge:The major strength of this study is that it included 20 185 patients enrolled in various types of imaging examinations. The safety profile of iodixanol was comparable to previously published work.

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Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Post-marketing surveillance study with iodixanol in 20 185 Chinese patients from routine clinical practices

Hou²,

B³

et al. 2014

BJR

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“…1). Hypersensitivity reactions are either immediate reactions, which occur within 1 h after CM administration, or nonimmediate reactions, which become apparent more than 1 h after CM exposure (3). About 70% of the immediate symptoms are reported to start within the first 5 min of CM administration (4).…”

Section: Introductionmentioning

confidence: 99%

Management of hypersensitivity reactions to iodinated contrast media

Brockow

Christiansen²,

Kanny³

et al. 2005

Allergy

258

256

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All iodinated contrast media (CM) are known to cause both immediate (≤1 h) and nonimmediate (>1 h) hypersensitivity reactions. Although for most immediate reactions an allergic hypersensitivity cannot be demonstrated, recent studies indicate that the severe immediate reactions may be IgE‐mediated, while most of the nonimmediate exanthematous skin reactions, appear to be T‐cell mediated. Patients who experience such hypersensitivity reactions are therefore advised to undergo an allergologic evaluation. Several investigators have found skin testing to be useful in confirming a CM allergy, especially in patients with nonimmediate skin eruptions. If a patient with confirmed allergy to a CM needs a new CM exposure, a skin test negative CM should be chosen and premedication may be tried. However, none of these precautional measures is a guarantee against a repeat reaction. More research focusing on pathomechanisms, diagnostic testing and premedication is therefore clearly needed in order to prevent CM‐induced hypersensitivity reactions in the future.

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“…Although the prevalence of severe reactions varied depending on the studies, severe life-threatening reactions was 0.04-0.28% [1, 2, 4, 6, 7, 8, 9]. It has also been reported that RCM was the most responsible drug that accounted for 18.0% of in-hospital anaphylaxis in a Korean study conducted in a tertiary hospital [1].…”

Section: Clinical Manifestations and Risk Factorsmentioning

confidence: 99%

“…As well as a history of atopy or pollinosis, specific pollinosis period (February to April) in which RCM was exposed significantly increased delayed reactions [8]. …”

Section: Delayed Reactionsmentioning

confidence: 99%

Radiocontrast media hypersensitivity in the Asia Pacific region

Lee

Lim

Chang

2014

Asia Pacific Allergy

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Radiocontrast media (RCM) is a major cause of drug hypersensitivity reactions as the medical application of RCM is increasing recently. RCM induced hypersensitivity reactions are considered as unpredictable type B reactions. Underlying mechanism of RCM induced hypersensitivity was previously regarded as nonimmunological mechanisms but recent studies suggest that immunological mechanisms could also be involved. As a result, the roles of skin tests and premedication are revisiting. As there has been no report that comprehensively summarized and analyzed the results of the studies on RCM hypersensitivity in the Asia Pacific region, we aimed to review the literatures on hypersensitivity reactions to RCM in terms of prevalence clinical manifestations, diagnostic approach, and preventive measures in the Asia Pacific region.

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A prospective survey of delayed adverse reactions to iohexol in urography and computed tomography

Cited by 47 publications

References 12 publications

Post-marketing surveillance study with iodixanol in 20 185 Chinese patients from routine clinical practices

Post-marketing surveillance study with iodixanol in 20 185 Chinese patients from routine clinical practices

Management of hypersensitivity reactions to iodinated contrast media

Radiocontrast media hypersensitivity in the Asia Pacific region

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