AI Article Synopsis
- The study aimed to investigate whether switching gadolinium-based contrast agents (GBCAs) can help reduce the recurrence of acute adverse drug reactions (ADRs) associated with their use during MRI exams.
- From nearly 239,000 MRI exams between January 2016 and December 2021, 1,042 cases of acute ADRs were identified, with follow-up evaluations showing a recurrence rate of 31.9% among patients who experienced ADRs.
- Results indicated that patients who switched to different GBCAs had a significantly lower recurrence of ADRs (14.3%) compared to those who remained on the same agent (36.9%), suggesting that changing
Article Abstract
Objective: To determine the preventive effect of changing gadolinium-based contrast agents (GBCAs) to reduce the recurrence of GBCA-associated acute adverse drug reactions (ADRs).
Materials And Methods: This retrospective, observational, single-center study-conducted between January 2016 and December 2021-included 238743 consecutive GBCA-enhanced MRI examinations. We focused on a subgroup of patients who experienced acute GBCA-associated ADRs during any of these examinations and subsequently underwent follow-up GBCA-enhanced MRI examinations up until July 2023. The follow-up examinations involved either the same (non-change group) or different (change group) GBCAs compared to the ones that initially caused the acute ADR. Baseline participant characteristics, generic profile of the GBCAs, administration of premedication, history of prior ADR to iodinated contrast media, and symptoms of GBCA-associated acute ADRs were retrospectively analyzed. Multivariable logistic regression with generalized estimating equations and propensity score matching were used.
Results: A total of 1042 instances of acute ADRs (0.44%; 95% confidence interval [CI]: 0.41%-0.46%) were reported. Three-hundred and seventy-three patients underwent GBCA-enhanced MRI examinations after experiencing GBCA-associated acute ADRs within the study period; 31.9% (119/373) reexperienced acute ADRs at any of the follow-up examinations. The ADR recurrence was significantly lower in the GBCA change group than in the non-change group according to multivariable logistic regression (adjusted odds ratio [OR]: 0.35; 95% CI: 0.13-0.90; = 0.03) and analysis with propensity score matching (14.3% [6/42] vs. 36.9% [31/84], respectively; OR: 0.32, 95% CI: 0.11-0.94; = 0.04). A history of an ADR to iodinated contrast media (OR: 1.14, 95% CI: 0.68-1.90; = 0.62) and premedication (adjusted OR: 2.09, 95% CI: 0.93-4.68; = 0.07) were not significantly associated with GBCA-associated acute ADR recurrence. A separate analysis for recurrent allergic-like hypersensitivity reactions demonstrated similar results (adjusted OR: 0.20, 95% CI: 0.06-0.65; < 0.01).
Conclusion: Changing GBCAs may reduce the risk of GBCA-associated acute ADR recurrence.
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|---|---|
| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC11361800 | PMC |
| http://dx.doi.org/10.3348/kjr.2024.0248 | DOI Listing |
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