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KMID : 1149020170190020017
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Journal of Korean Society of Computed Tomographic Technology
2017 Volume.19 No. 2 p.17 ~ p.26
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Comparative analysis of adverse reactions to different non-ionic contrast media
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Kim Kyeong-Min
Im Sang-Muk
Kim Sang-Gyun
Oh Geun-Taek
Lee Kwang-Won
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Abstract
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Purpose : This study aimed to compare the prevalence of adverse effects of the composition of non-ionic contrast media currently in use and to describe the characteristics of the adverse reactions to the agents based on the examined intensity and manifestation patterns thereof.
Materials and Methods : The study involved 592 participants who were among the 93,057 patients who underwent contrast-enhanced computed tomography at a single institution between January 1, 2014 and December 31, 2016. The participants developed adverse reactions to the contrast media and had had reports of adverse drug effects. The drugs used for the comparative analysis were Iobitridol, Iohexol, Iomeprol, Iopamidol, and Iodixanol. Based on the chemical composition of these five agents, the prevalence rates of adverse effects caused by the adverse effect-inducing risk factors listed in the medical reports were compared. Furthermore, the intensities and patterns of the manifested adverse effects were analyzed.
Results : The prevalence of adverse effects caused by the contrast agents was found to be highest when 2.9% Iodixanol was used (p<0.00). Regarding the intensity of the adverse effects of Iobitridol, the prevalence of effects that were moderate and seriousness in intensities were high at 72.7% and 6.1%, respectively (p=0.031). No significant differences were found in the prevalence of gender-specific adverse effect (p=0.808). The prevalence of age-specific adverse reactions of Iobitridol was found to be highest (72.7%) in cohorts aged 50?69 years (p=0.005). In terms of medical history, the prevalence of adverse effects did not show any significant differences in terms of the composition of the contrast media (p=0.029), Iodixanol (60%) and Iohexol (55.4%) had the highest prevalence rates of adverse reactions in the patients who had Pre-existing diseases (p=0.003). Iopamidol (32.6%) was found to cause adverse reactions in the respiratory system, while Iobitridol and Iomeprol caused digestive system-related adverse effects at prevalence rates of 48.5% and 54.2%, respectively (p=0.019).
Conclusion : Iodixanol had the highest incidence of adverse reactions, but the mild symptoms were the most common and the risk was relatively low. Iobitridol and Iomeprol have a high incidence of moderate to seriousness, so they should be used with caution, and their digestive system side effects are markedly higher. Individual components, categorized according to the chemical properties of the contrast media, showed differences in the probable incidence of adverse effects induced by them. This may influence the safety of the contrast media. Thorough consideration and systematic monitoring of these components, and the risk factors for the adverse effects of contrast media, is required for ensuring patient safety and optimal usage.
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KEYWORD
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adverse reactions to contrast media, risk factor, chemical properties
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