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":"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。","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":"<p><strong>Objective: </strong>To determine the preventive effect of changing gadolinium-based contrast agents (GBCAs) to reduce the recurrence of GBCA-associated acute adverse drug reactions (ADRs).</p><p><strong>Materials and methods: </strong>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.</p><p><strong>Results: </strong>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; <i>P</i> = 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; <i>P</i> = 0.04). A history of an ADR to iodinated contrast media (OR: 1.14, 95% CI: 0.68-1.90; <i>P</i> = 0.62) and premedication (adjusted OR: 2.09, 95% CI: 0.93-4.68; <i>P</i> = 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; <i>P</i> < 0.01).</p><p><strong>Conclusion: </strong>Changing GBCAs may reduce the risk of GBCA-associated acute ADR recurrence.</p>","PeriodicalId":17881,"journal":{"name":"Korean Journal of Radiology","volume":"25 9","pages":"824-832"},"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":"{\"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\":\"<p><strong>Objective: </strong>To determine the preventive effect of changing gadolinium-based contrast agents (GBCAs) to reduce the recurrence of GBCA-associated acute adverse drug reactions (ADRs).</p><p><strong>Materials and methods: </strong>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.</p><p><strong>Results: </strong>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; <i>P</i> = 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; <i>P</i> = 0.04). A history of an ADR to iodinated contrast media (OR: 1.14, 95% CI: 0.68-1.90; <i>P</i> = 0.62) and premedication (adjusted OR: 2.09, 95% CI: 0.93-4.68; <i>P</i> = 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; <i>P</i> < 0.01).</p><p><strong>Conclusion: </strong>Changing GBCAs may reduce the risk of GBCA-associated acute ADR recurrence.</p>\",\"PeriodicalId\":17881,\"journal\":{\"name\":\"Korean Journal of Radiology\",\"volume\":\"25 9\",\"pages\":\"824-832\"},\"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}","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}
Changing Gadolinium-Based Contrast Agents to Prevent Recurrent Acute Adverse Drug Reactions: 6-Year Cohort Study Using Propensity Score Matching.
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.
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.
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