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

Allergy ◽  
2018 ◽  
Vol 74 (1) ◽  
pp. 195-197 ◽  
Author(s):  
Maria Teresa Gracia‐Bara ◽  
Esther Moreno ◽  
Elena Laffond ◽  
Francisco Muñoz‐Bellido ◽  
Milagros Lázaro ◽  
...  
Keyword(s):  
Contrast Media ◽  
Hypersensitivity Reactions ◽  
Iodinated Contrast Media ◽  
Immediate Hypersensitivity ◽  
Iodinated Contrast

scholarly journals Premedication for Iodinated Contrast Media Induced Immediate Hypersensitivity Reactions

2019 ◽  
Vol 6 (4) ◽  
pp. 538-553
Author(s):  
Rik Schrijvers ◽  
Pascal Demoly ◽  
Anca Mirela Chiriac
Keyword(s):  
Contrast Media ◽  
Skin Test ◽  
Diagnostic Delay ◽  
Initial Reaction ◽  
Number Needed To Treat ◽  
Type I ◽  
Hypersensitivity Reactions ◽  
Iodinated Contrast Media ◽  
Immediate Hypersensitivity ◽  
Iodinated Contrast

Abstract Purpose of the review Premedication using antihistamines and/or corticosteroids has been widely used to prevent reoccurrence of immediate hypersensitivity reactions (iHR) after iodinated contrast media (ICM). However, efficacy has been debated, especially in high-risk patients. Novel findings on the role and risks of premedication and preventive strategies are summarized. Recent findings The rate and severity of iHR occurring despite premedication indicate that premedication is not a panacea and the intensity usually reflects that of the initial reaction. Next, the number needed to treat (NNT) to prevent one serious ICM-mediated event using corticosteroid-based premedication is high and associated with a diagnostic delay. Randomly changing the ICM has been suggested as an additional preventive measure, whilst others used a skin test–based approach to identify a subgroup of ICM allergic patients and negative skin test–based alternatives with a high negative predictive value. Summary Growing evidence indicates the need to discriminate between non-allergic iHR that are most likely non-obligatory and susceptible to premedication, and rare type I allergic iHR that can be identified using skin testing, especially in those with a severe iHR. Although premedication reduces reoccurrence of mild iHR, it is not always efficacious and should be balanced against side effects, a high NNT and an uncertain efficacy physicians should not blindly rely on. Future work should evaluate combined approaches of an allergy-driven ICM selection and endotype-driven premedication regimens in patients with non-allergic iHR.

scholarly journals Pharmacologic and non-pharmacologic interventions to prevent hypersensitivity reactions of non-ionic iodinated contrast media: a systematic review protocol

BMJ Open ◽  
2020 ◽  
Vol 10 (3) ◽  
pp. e033023
Author(s):  
Hiroyasu Umakoshi ◽  
Takashi Nihashi ◽  
Hironori Shimamoto ◽  
Takehiro Yamada ◽  
Hiroaki Ishiguchi ◽  
...  
Keyword(s):  
Contrast Media ◽  
Assessment Tools ◽  
Average Risk ◽  
Cochrane Central Register ◽  
Hypersensitivity Reactions ◽  
Iodinated Contrast Media ◽  
Preventive Interventions ◽  
Validity Assessment ◽  
Iodinated Contrast ◽  
Standard Design

IntroductionIodinated contrast media are commonly used in medical imaging and can cause hypersensitivity reactions, including rare but severe life-threatening reactions. Although several prophylactic approaches have been proposed for severe reactions, their effects remain unclear. Therefore, we aim to review systematically the preventive effects of pharmacologic and non-pharmacologic interventions and predictors of acute, hypersensitivity reactions.Methods and analysisWe will search the PubMed, EMBASE and Cochrane Central Register of Controlled Trials databases from 1 January 1990 through 31 December 2019 and will examine the bibliographies of eligible studies, pertinent review articles and clinical practice guidelines. We will include prospective and retrospective studies of any design that evaluated the effects of pharmacological and non-pharmacological preventive interventions for adverse reactions of non-ionic iodinated contrast media. Two assessors will independently extract the characteristics of the study and intervention and the quantitative results. Two independent reviewers will assess the risk of bias using standard design-specific validity assessment tools. The primary outcome will be reduction in acute contrast media-induced hypersensitivity reactions. The secondary outcomes will include characteristics associated with the development of contrast media-induced acute hypersensitivity reactions, and adverse events associated with specific preventive interventions. Unique premedication regimens (eg, dose, drug and duration) and non-pharmacological strategies will be analysed separately. Average-risk and high-risk patients will be considered separately. A meta-analysis will be performed if appropriate.Ethics and disseminationEthics approval is not applicable, as this will be a secondary analysis of publicly available data. The results of the analysis will be submitted for publication in a peer reviewed journal.PROSPERO registration numberCRD42019134003

scholarly journals Severe hypersensitivity reactions to iodinated contrast media: clinical and immunological features in a cohort of patients

2014 ◽  
Vol 4 (S3) ◽  
Author(s):  
Daniela Rivero Paparoni ◽  
Ana Fiandor ◽  
Rosario Cabañas ◽  
Hoi Yan-Tong ◽  
Elena Ramirez ◽  
...  
Keyword(s):  
Contrast Media ◽  
Hypersensitivity Reactions ◽  
Iodinated Contrast Media ◽  
Iodinated Contrast

scholarly journals Hypersensitivity Reactions to Iodinated Contrast Media.

2015 ◽  
Vol 10 (11-12) ◽  
pp. 269-273
Author(s):  
Zeljko Plazonic ◽  
Tanja Batinac ◽  
Marija Bukvic
Keyword(s):  
Contrast Media ◽  
Hypersensitivity Reactions ◽  
Iodinated Contrast Media ◽  
Iodinated Contrast
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