Tolerability of iobitridol in patients with non‐immediate hypersensitivity reactions to iodinated contrast media

Hypersensitivity Reactions to Multiple Iodinated Contrast Media

“…The most frequent cross-reactivity associations detected in our study were iodixanol and iomeprol, and iodixanol and iohexol. This pattern agrees with other reports (Vernassiere et al, 2004;Brockow et al, 2009;Hasdenteufel et al, 2011;Torres et al, 2012;Gracia-Bara et al, 2019). Mechanisms underlying the cross-reactivities between ICMs are not fully understood and further studies are necessary.…”

“…DPT is considered the gold standard for diagnosing HSRs to drugs (Aberer et al, 2003), and, in the case of HSRs to ICMs, it is recommended to be performed with the ICM giving negative results in STs for confirming diagnosis or looking for a safe alternative (Rosado Ingelmo et al, 2016;Brockow, 2020). However, its use is controversial as it is a not-risk free procedure (Aberer et al, 2003) and doses administered during the allergological work-up lack of consensus, varying from 10 to 120 cc and being injected on a single day or incrementally increased over several days (Vernassiere et al, 2004;Torres et al, 2012;Prieto-Garcia et al, 2013;Salas et al, 2013;Sese et al, 2016;Lerondeau et al, 2016;Morales-Cabeza et al, 2017;Gracia-Bara et al, 2019;Soria et al, 2019;Trautmann et al, 2019).…”

Cutaneous tests and interest of iobitridol in non‐immediate hypersensitivity to contrast media: a case series of 43 patients

“…5,6 Our results concerning cross-reactivity follow the classification in 3 groups (A-C) proposed by Lerondeau et al confirmed by Schrijvers R et al 4,7 (Table 2). Following this classification, iobitridol was the only intravenous proposal alternative ICM for 77% of our patients and is well tolerated in such cases, as described by Gracia-Bara et al 8,9 As previously reported, ICM agents of the group A were the most frequently involved, with a high rate of cross-reactivity within this group. 4,9 However, cross-reactivities could exceed this classification and concern several groups of ICM (especially in DRESS and AGEP).…”

“…Following this classification, iobitridol was the only intravenous proposal alternative ICM for 77% of our patients and is well tolerated in such cases, as described by Gracia-Bara et al 8,9 As previously reported, ICM agents of the group A were the most frequently involved, with a high rate of cross-reactivity within this group. 4,9 However, cross-reactivities could exceed this classification and concern several groups of ICM (especially in DRESS and AGEP). The choice of ICM agent is currently reduced with the non-availability of ioxaglate in several countries and the restricted use of ioxithalamate and amidotrizoate.…”

Adverse reactions to iodinated contrast media: Safety of a study protocol that includes fast full‐dose parenteral challenge tests searching for an alternative contrast media

“…Cross‐reactivity is particularly strong among iodixanol and iohexol, because the former is a dimer of the latter. On the contrary, iobitridol behaves as the least cross‐reactive ICM . Furthermore, premedication with corticosteroids and antihistamines is now questioned, because there is a 10%‐18% rate of repeated HSR to ICM despite premedication, namely breakthrough reactions …”