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钆布醇二葡甲胺急性不良反应发生率评估:7.5年超过130,000次给药的回顾。

Assessment of rates of acute adverse reactions to gadobenate dimeglumine: review of more than 130,000 administrations in 7.5 years.

作者信息

Fakhran Saeed, Alhilali Lea, Kale Hrishikesh, Kanal Emanuel

机构信息

1 All authors: Department of Radiology, University of Pittsburgh Medical Center, 200 Lothrop St, Presby S Tower, 8th Fl, 8 N, Pittsburgh, PA 15213.

出版信息

AJR Am J Roentgenol. 2015 Apr;204(4):703-6. doi: 10.2214/AJR.14.13430.

Abstract

OBJECTIVE

The purpose of this study was to determine the incidence of adverse events associated with gadobenate dimeglumine over 7.5 years in a major hospital system consisting of both academic and community hospitals.

SUBJECTS AND METHODS

As part of a regular and continuous prospective quality assurance project, MRI technologists contemporaneously recorded all gadolinium-based contrast administrations and any associated adverse reactions, including type of reaction and treatment rendered, between August 1, 2005, and March 14, 2013. Weekly data review was performed by the director of MRI services, who evaluated data both by individual site and by comparison among the participating hospitals and sites within the hospital system. Comparison between reaction rates at different sites was performed with a chi-square test.

RESULTS

Over 7.5 years, 132,252 doses of gadobenate dimeglumine were administered, and 236 reactions were recorded (0.18% of contrast-enhanced examinations). Of these, 133 (56.4% of all adverse reactions) required treatment and 12 (5.1%) qualified as serious. Reaction rates were significantly different between academic (0.23%) and community (0.07%) hospitals (p<0.001). Reaction rates were higher in the initial years of the study, tapering to a lower baseline rate, which was maintained over more than 5 years. The findings were consistent with the Weber and Lalli effects reported in the literature on other pharmaceutical agents.

CONCLUSION

Rates of adverse reactions to gadobenate dimeglumine recorded over 7.5 years were comparable to those reported for other gadolinium-based contrast agents examined over smaller time ranges and populations. The findings reinforce the relatively robust safety profile of this agent.

摘要

目的

本研究旨在确定在一个由学术医院和社区医院组成的大型医院系统中,钆布醇在7.5年期间相关不良事件的发生率。

受试者与方法

作为一项定期持续的前瞻性质量保证项目的一部分,MRI技术人员同时记录了2005年8月1日至2013年3月14日期间所有基于钆的造影剂给药情况以及任何相关不良反应,包括反应类型和所采取的治疗措施。MRI服务主任每周进行数据审查,其通过各个站点以及医院系统内参与医院和站点之间的比较来评估数据。不同站点反应率之间的比较采用卡方检验。

结果

在7.5年期间,共给药132,252剂钆布醇,记录到236例反应(占增强造影检查的0.18%)。其中,133例(占所有不良反应的56.4%)需要治疗,12例(占5.1%)为严重反应。学术医院(0.23%)和社区医院(0.07%)的反应率存在显著差异(p<0.001)。研究最初几年的反应率较高,随后逐渐降至较低的基线水平,并在超过5年的时间里保持稳定。这些发现与文献中报道的其他药物的韦伯效应和拉利效应一致。

结论

7.5年期间记录的钆布醇不良反应发生率与在较短时间范围和较小人群中检查的其他基于钆的造影剂所报告的发生率相当。这些发现强化了该药物相对可靠的安全性。

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