Changing Gadolinium-Based Contrast Agents to Prevent Recurrent Acute Adverse Drug Reactions: 6-Year Cohort Study Using Propensity Score Matching.

IF 4.4 2区医学 Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING Korean Journal of Radiology Pub Date : 2024-09-01 DOI:10.3348/kjr.2024.0248

Min Woo Han, Chong Hyun Suh, Pyeong Hwa Kim, Seonok Kim, Ah Young Kim, Kyung-Hyun Do, Jeong Hyun Lee, Dong-Il Gwon, Ah Young Jung, Choong Wook Lee

{"title":"Changing Gadolinium-Based Contrast Agents to Prevent Recurrent Acute Adverse Drug Reactions: 6-Year Cohort Study Using Propensity Score Matching.","authors":"Min Woo Han, Chong Hyun Suh, Pyeong Hwa Kim, Seonok Kim, Ah Young Kim, Kyung-Hyun Do, Jeong Hyun Lee, Dong-Il Gwon, Ah Young Jung, Choong Wook Lee","doi":"10.3348/kjr.2024.0248","DOIUrl":null,"url":null,"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; P = 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; P = 0.04). A history of an ADR to iodinated contrast media (OR: 1.14, 95% CI: 0.68-1.90; P = 0.62) and premedication (adjusted OR: 2.09, 95% CI: 0.93-4.68; P = 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; P < 0.01).Conclusion: Changing GBCAs may reduce the risk of GBCA-associated acute ADR recurrence.","PeriodicalId":17881,"journal":{"name":"Korean Journal of Radiology","volume":null,"pages":null},"PeriodicalIF":4.4000,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11361800/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Korean Journal of Radiology","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.3348/kjr.2024.0248","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING","Score":null,"Total":0}

引用次数: 0

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; P = 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; P = 0.04). A history of an ADR to iodinated contrast media (OR: 1.14, 95% CI: 0.68-1.90; P = 0.62) and premedication (adjusted OR: 2.09, 95% CI: 0.93-4.68; P = 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; P < 0.01).

Conclusion: Changing GBCAs may reduce the risk of GBCA-associated acute ADR recurrence.

查看原文

微信好友朋友圈 QQ好友复制链接

本刊更多论文

更换钆基造影剂以预防急性药物不良反应复发：使用倾向得分匹配的 6 年队列研究。

目的确定更换钆基造影剂（GBCA）对减少 GBCA 相关急性药物不良反应（ADRs）复发的预防效果：这项回顾性、观察性、单中心研究于 2016 年 1 月至 2021 年 12 月间进行，包括 238743 例连续 GBCA 增强 MRI 检查。我们重点研究了在其中任何一次检查中出现急性 GBCA 相关 ADR，并在 2023 年 7 月之前接受后续 GBCA 增强 MRI 检查的患者亚群。与最初导致急性 ADR 的 GBCA 相比，后续检查涉及相同（无变化组）或不同（有变化组）的 GBCA。我们对参与者的基线特征、GBCA 的通用概况、用药前情况、既往碘化造影剂 ADR 史以及 GBCA 相关急性 ADR 的症状进行了回顾性分析。研究采用了带有广义估计方程的多变量逻辑回归法和倾向得分匹配法：共报告了 1042 例急性 ADR（0.44%；95% 置信区间 [CI]：0.41%-0.46%）。373名患者在研究期间出现与GBCA相关的急性ADR后接受了GBCA增强磁共振成像检查；31.9%的患者（119/373）在任何一次随访检查中再次出现急性ADR。根据多变量逻辑回归（调整后的几率比 [OR]：0.35；95% CI：0.13-0.90；P = 0.03）和倾向得分匹配分析（分别为 14.3% [6/42] vs. 36.9% [31/84]；OR：0.32；95% CI：0.11-0.94；P = 0.04），GBCA 更改组的 ADR 复发率明显低于未更改组。碘化造影剂 ADR 史（OR：1.14，95% CI：0.68-1.90；P = 0.62）和用药前过敏史（调整后 OR：2.09，95% CI：0.93-4.68；P = 0.07）与 GBCA 相关急性 ADR 复发无显著相关性。对复发性过敏样超敏反应的单独分析显示了类似的结果（调整后OR：0.20，95% CI：0.06-0.65；P < 0.01）：结论：更换 GBCA 可降低 GBCA 相关急性 ADR 复发的风险。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文去求助

来源期刊

Korean Journal of Radiology 医学-核医学

CiteScore

10.60

自引率

12.50%

发文量

141

审稿时长

1.3 months

期刊介绍： The inaugural issue of the Korean J Radiol came out in March 2000. Our journal aims to produce and propagate knowledge on radiologic imaging and related sciences. A unique feature of the articles published in the Journal will be their reflection of global trends in radiology combined with an East-Asian perspective. Geographic differences in disease prevalence will be reflected in the contents of papers, and this will serve to enrich our body of knowledge. World''s outstanding radiologists from many countries are serving as editorial board of our journal.