Data Mining of Adverse Reactions to Iodinated Contrast Media Based on a Municipal Spontaneous Reporting System in China

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OBJECTIVE: Iodinated contrast media (ICM) are widely used in medical imaging, particularly in computed tomography (CT) and magnetic resonance imaging (MRI) examinations, to increase image quality and improve diagnostic accuracy. Despite their clinical utility, ICM are associated with various adverse drug reactions (ADRs), including allergic reactions and other systemic effects. This study aimed to evaluate ICM-related ADRs through the Chinese spontaneous reporting system (SRS) and provide reference information for clinical practice. METHODS: We analyzed ADRs related to ICM on the basis of data from the SRS in Wuhan, China, from January 1, 2018, to December 31, 2023. RESULTS: A total of 2,166 ADR reports related to four ICM (iodixanol, iohexol, ioversol, and iomeprol) were analyzed to assess the proportion and severity of adverse reactions. The results revealed that the majority of the ADRs were mild, with the most common symptoms being rash (54.76%) and itching (35.18%). Gastrointestinal and respiratory symptoms were also noted, although less frequently. Anaphylactic shock was documented in 48 patients, accounting for 9.69% of severe adverse reactions. The incidence of ADRs was greater in summer. Circulatory system diseases were the most prevalent underlying conditions in patients who experienced ADRs. Treatment primarily involved symptomatic management, including corticosteroids and antihistamines, with adrenaline administered in severe cases. CONCLUSIONS: This study highlights the importance of monitoring high-risk patients, especially elderly patients and those with preexisting conditions, and underscores the need for timely intervention in severe reactions. Future prospective studies are necessary to facilitate the selection of more appropriate ICM for individual patients.

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