Incidence of adverse drug reaction among 6 iodinated contrast media

Incidence and severity of nonionic low-osmolar iodinated contrast medium-related adverse drug reactions in the Republic of Korea: Comparison by generic

“…First, the injection rate, total dose, and iodine concentration of each contrast agent were not considered. Although no significant relationship was found between the dose or iodine concentration of the contrast agent and the incidence of ICM-related ADRs in previous studies, [ 7 , 12 , 24 , 27 ] further detailed analysis is required. Second, various potential positive or negative risk factors (e.g., individual history of ICM usage and ICM-related ADR, with or without premedication or replacement of contrast media) could not be considered.…”

“…The characteristics of the inclusion criteria—inclusion or exclusion of delayed reactions and immediate reactions, physiologic and allergic-like reactions, and outpatients only or both outpatients and inpatients—varied across studies. [ 7 , 13 , 22 , 23 , 26 ] Although not clearly stated in each study, there may be differences in the premedication protocol among the institutions; also, the proportion of high-risk and pre-medicated patients may have been different. Because systematic reporting and management protocols for ICM-related ADRs were not previously well established, the results may also have been affected by differences in the timing of each study.…”

“…[ 12 ] Therefore, as a single ethnic group, we considered it necessary to report the incidence and severity of ICM-related ADRs using only domestic data from the Republic of Korea. Previous studies on domestic data have reported the incidence of ICM-related ADRs according to ICM generics, but yielded inconsistent results: Koh et al reported that iopromide (1.36%) had the highest ADR incidence, followed by iomeprol (1.27%), iopamidol (1.05%), iobitridol (0.74%), iohexol (0.74%), and ioversol (0.67%), with significant differences among ICMs in overall severity and in each severity category; [ 7 ] Kim et al reported that the immediate ADR incidence was significantly higher with iopromide (1.03%) and lower with iobitridol (0.34%); [ 23 ] Cha et al found that iomeprol (0.95%) and iobitridol (0.89%) resulted in significantly higher incidences of hypersensitivity reactions, whereas iohexol (0.62%) and iopromide (0.37%) were associated with significantly lower incidences of hypersensitivity reactions; [ 12 ] and, Lee et al found no significant difference in the overall immediate hypersensitivity reaction incidences among ICMs. [ 13 ] This inconsistency is thought to be in part to the relatively small study population; therefore, we performed further investigations with a larger population and meta-analysis.…”

“…[ 11 , 12 ] Factors related to ICM itself have also been studied; however, the reported incidences of ADRs for each ICM generic were inconsistent across studies. For instance, Koh et al reported that the incidences of ADRs differed significantly among ICMs, [ 7 ] whereas Lee et al found no significant difference. [ 13 ]…”

“…[5] However, severe ADRs, including anaphylaxis, can be life-threatening. [6,7] Since it is difficult to predict ICM-related ADR occurrence, [8] systematic prevention and management of ICM-related ADRs, by identifying their incidence and associated factors, are essential. [9] Previous studies have reported the incidence of ICM-related ADRs as 0.16% to 7.99% for nonionic low-osmolar ICMs.…”