Differences in Adverse Reactions Among Iodinated Contrast Media: Analysis of the KAERS Database

An, Jin; Jung, Hee-Won; Kwon, Oh Young; Kang, Yewon; Lee, Ji‐Hyang; Won, Ha-Kyeong; Song, Woo-Jung; Kwon, Hyouk‐Soo; Cho, You Sook; Moon, Hee‐Bom; Kim, Tae‐Bum

doi:10.1016/j.jaip.2019.02.035

Cited by 32 publications

(36 citation statements)

References 28 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Much of the work in Asia on RCM DHR come from Korea where epidemiological studies have revealed no difference in the rate of RCM DHR among various RCMs [93][94][95]. A recent publication from the KAERS (Korea Adverse Event Reporting System) where immediate reactions were more commonly reported was based on reports from hospitals where it is possible that delayed reactions were missed and hence not reported [96]. The use of low/iso-osmolar ionic reagents e.g., iodixanol has reduced the prevalence of RCM hypersensitivity to iodinated contrast media used in contrasted computed tomographic scans.…”

Section: Drug Hypersensitivity In Asiamentioning

confidence: 99%

Drug hypersensitivity reactions in Asia: regional issues and challenges

Thong

Lucas

Kang

et al. 2020

Asia Pacific Allergy

View full text Add to dashboard Cite

There are geographical, regional, and ethnic differences in the phenotypes and endotypes of patients with drug hypersensitivity reactions (DHRs) in different parts of the world. In Asia, aspects of drug hypersensitivity of regional importance include IgE-mediated allergies and T-cell-mediated reactions, including severe cutaneous adverse reactions (SCARs), to beta-lactam antibiotics, antituberculous drugs, nonsteroidal anti-inflammatory drugs (NSAIDs) and radiocontrast agents. Delabeling of low-risk penicillin allergy using direct oral provocation tests without skin tests have been found to be useful where the drug plausibility of the index reaction is low. Genetic risk associations of relevance to Asia include human leucocyte antigen (HLA)-B*1502 with carbamazepine SCAR, and HLA-B*5801 with allopurinol SCAR in some Asian ethnic groups. There remains a lack of safe and accurate diagnostic tests for antituberculous drug allergy, other than relatively high-risk desensitization regimes to first-line antituberculous therapy. NSAID hypersensitivity is common among both adults and children in Asia, with regional differences in phenotype especially among adults. Low dose aspirin desensitization is an important therapeutic modality in individuals with cross-reactive NSAID hypersensitivity and coronary artery disease following percutaneous coronary intervention. Skin testing allows patients with radiocontrast media hypersensitivity to confirm the suspected agent and test for alternatives, especially when contrasted scans are needed for future monitoring of disease relapse or progression, especially cancers.

show abstract

Section: Drug Hypersensitivity In Asiamentioning

confidence: 99%

Drug hypersensitivity reactions in Asia: regional issues and challenges

Thong

Lucas

Kang

et al. 2020

Asia Pacific Allergy

View full text Add to dashboard Cite

show abstract

“…The pattern of cross-reactivity of different RCMs has been analyzed and cross-reactivity of iobitridol to other RCM has been reported to be low in NIHR [32•, 33, 34•], which may be related to its R1 chain being different from that of other RCMs [35]. For IHR, the isoosmolar RCM iodixanol appears to have a low rate of IHRs, and among low osmolar RCM, some agents (e.g., iomeprol) have recently been associated with higher reaction rates than others (e.g., iohexol) [36,37].…”

Section: Skin Testing Of Patientsmentioning

confidence: 99%

Diagnosing and Managing Patients with Reactions to Radiocontrast Media

Brockow

2021

Curr Treat Options Allergy

View full text Add to dashboard Cite

Purpose of the review Iodinated radio contrast media (RCM) belong to the most common elicitors of drug hypersensitivity reactions (HR). Urticaria or anaphylaxis may occur ≤ 1(−6) hour(s) (immediate HR) and exanthems (non-immediate HR) develop > 6 h after application of RCM. Evidence for an immunologic mechanism of RCM HR against the different RCM benzene ring molecules and the benefit of allergological testing in patients with previous hypersensitivity reactions is progressively increasing. Recent findings Positive skin tests can confirm allergy in patients with previous reactions to RCM and help to select alternative better tolerated RCMs. Severe hypersensitivity reactions are mainly caused by an allergic mechanism, whereas the majority of non-severe reactions appear to be non-allergic. Skin testing is highly recommended to help identify allergic hypersensitivity reactions and to select alternatives. Using structurally different RCM is more effective than premedication for the prevention of future reactions. Drug provocation tests to RCM have been increasingly used, but are not yet standardized among different centers. Summary In patients with previous severe hypersensitivity reactions to RCM, skin testing is recommended. For future RCM-enhanced examinations in patients with previous reactions, structurally different, skin test-negative preparations should be applied. Drug provocation tests do confirm or exclude RCM hypersensitivity or may demonstrate tolerability of alternative RCMs.

show abstract

“…Most practitioners prefer non-ionic ICM because adverse reactions have been less severe than with ionic ICM [7], but with no guarantee all reactions can be avoided. Hypersensitivity reactions are sometimes observed, but unpredictably [8].…”

Section: Introductionmentioning

confidence: 99%

“…Late hypersensitivity reactions occur one hour to seven days after ICM administration [21,22] and appear to be less frequent than IHRs. In one report from Korea, after 11,712,796 ICM injections performed over the study period (2014 to 2016), there were 44,467 cases of IHR versus 5,725 late reactions [8].…”

Section: Introductionmentioning

confidence: 99%

Immediate Reactions to Iodinated Contrast Media Prevalence of IgE-mediated Hypersensitivity

Caron

Seynave

GRAF

et al. 2020

Preprint

View full text Add to dashboard Cite

BackgroundAfter administration of iodinated contrast media (ICM) some patients develop an immediate hypersensitivity reaction (IHR). A specific allergic IgE-mediated mechanism may be involved. ObjectiveTo determine the prevalence of allergic patients among ICM reactors and to evaluate the negative predictive value (NVP) of skin testing for ICM.MethodsAll patients who attended a single center for an allergy work-up between 2010 and 2019 due to a prior IHR after an ICM injection were included retrospectively. ICM allergy was diagnosed if prick tests or intradermal tests were positive. Further information concerning secondary exposure to ICM was obtained from all patients with negative skin tests to determine whether ICM re-exposure led to an IHR.ResultsSkin tests identified ICM allergy in 7 out of 85 patients (8.2%). Frequency of IgE-mediated hypersensitivity among patients increased with increasing reaction severity. The NPV of skin testing for ICM allergy was 87.8% [95%CI 75.2;95.4.ConclusionThe low prevalence of IgE-mediated hypersensitivity among patients with IHR to ICM should not delay allergy workup. Earlier skin tests and provocation tests with skin-test negative ICM may help allergists to find a reliable alternative ICM.

show abstract

Differences in Adverse Reactions Among Iodinated Contrast Media: Analysis of the KAERS Database

Cited by 32 publications

References 28 publications

Drug hypersensitivity reactions in Asia: regional issues and challenges

Drug hypersensitivity reactions in Asia: regional issues and challenges

Diagnosing and Managing Patients with Reactions to Radiocontrast Media

Immediate Reactions to Iodinated Contrast Media Prevalence of IgE-mediated Hypersensitivity

Contact Info

Product

Resources

About