1. N-(2,3-dihydroxypropyl) carbamoyl side chain: a potentially significant factor for recurrent iodinated contrast medium-related adverse drug reactions.
- Author
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Kim, Pyeong Hwa, Suh, Chong Hyun, Jang, Eun Bee, Kim, Seonok, Park, Kye Jin, Park, Hyo Jung, Kim, Ah Young, Do, Kyung-Hyun, Lee, Jeong Hyun, Kim, Jin Hyoung, Jung, Ah Young, and Lee, Choong Wook
- Subjects
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DRUG side effects , *CONTRAST media , *PROPENSITY score matching , *ODDS ratio , *TOMOGRAPHY - Abstract
Purpose: To determine whether switching to contrast media based on the sharing of N-(2,3-dihydroxypropyl) carbamoyl side chain reduces the recurrence of iodinated contrast media (ICM)-associated adverse drug reactions (ADRs). Materials and methods: This single-center retrospective study included 2133 consecutive patients (mean age ± SD, 56.1 ± 11.4 years; male, 1052 [49.3%]) who had a history of ICM-associated ADRs and underwent contrast-enhanced CT examinations. The per-patient and per-exam-based recurrence ADR rates were compared between cases of switching and non-switching the ICM from ICMs that caused the previous ADRs, and between cases that used ICMs with common and different carbamoyl side chains from ICMs that caused the previous ADRs. Downgrade rates (no recurrence or the occurrence of ADR less severe than index ADRs) were also compared. Propensity score matching (PSM) and inverse probability of treatment weighting (IPTW) analysis were additionally performed. Results: In per-patient analysis, switching of ICM showed a lower recurrence rate (switching, 10.4% [100/965] vs. non-switching, 28.4% [332/1168]), with the adjusted odds ratio (OR) of 0.27 (95% CI: 0.21, 0.34; p < 0.001). The result was consistent in PSM (OR, 0.29 [95% CI: 0.22, 0.39]; p < 0.001), IPTW (OR, 0.28 [95% CI: 0.22, 0.36]; p < 0.001), and in per-exam analysis (5.5% vs. 13.8%; OR, 0.32 [95% CI: 0.27, 0.37]; p < 0.001). There was lower per-exam recurrence (5.0% [195/3938] vs. 7.8% [79/1017]; OR, 0.63 [95% CI: 0.47, 0.83]; p = 0.001) and higher downgrade rates (95.6% [3764/3938] vs. 93.3% [949/1017]; OR, 1.51 [95% CI: 1.12, 2.03]; p = 0.006) when using different side chain groups. Conclusion: Switching to an ICM with a different carbamoyl side chain reduced the recurrent ADRs and their severity during subsequent examinations. Clinical relevance statement: Switching to an iodinated contrast media with a different carbamoyl side chain reduced the recurrent adverse drug reactions and their severity during subsequent examinations. Key Points: Patients who experience adverse drug reactions from iodinated contrast media (ICM) may need to undergo contrast-enhanced studies again. Switching of ICM away from the ICM that caused the previous adverse drug reactions showed significantly lower recurrence rates. Compared to common side chain groups, there were significant differences in the per-exam recurrence rates and downgrade rates when using ICMs with different side chains. [ABSTRACT FROM AUTHOR]
- Published
- 2024
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