Schmid, Adrian A; Hungerbühler, Martin N; Lombardo, Paolo; Boehm, Ingrid B (2024). Intradermal testing of iodinated contrast media: Should we test up to pure or with diluted compounds only? (In Press). Fundamental & clinical pharmacology Blackwell Science 10.1111/fcp.12998
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Fundamemntal_Clinical_Pharma_-_2024_-_Schmid_-_Intradermal_testing_of_iodinated_contrast_media__Should_we_test_up_to_pure.pdf - Published Version Available under License Creative Commons: Attribution-Noncommercial-No Derivative Works (CC-BY-NC-ND). Download (1MB) | Preview |
BACKGROUND
Intradermal testing (IDT) with iodinated contrast media (ICMs) is an established diagnostic tool in patients with ICM hypersensitivity. Currently, it is unclear which test concentration is the more useful one, up to pure or up to 1:10 diluted ICMs.
METHODS
We searched the literature database PubMed for eligible papers dealing with ICM allergy and their IDT results. We analyzed the data presented by the papers and compared the pooled groups tested with diluted and undiluted ICMs.
RESULTS
We identified 29 eligible original papers, and extracted data of 1137 patients that formed the study population. Although in the cohort tested with diluted ICMs the number of tested ICMs was greater, the percentage of positive tests was significantly less (9.0% vs. 24.7%; P < 0.0001; OR 0.30 [0.26-0.34]). The frequency of positive tested culprit ICMs was also lesser in the group tested with diluted ICMs (31.0% vs. 72.5%; P < 0.0001; OR 0.17 [0.12-0.23]). The number of drug provocation tests (DPTs) was greater in patients with diluted IDTs (374 vs. 89; P < 0.0001; OR 2.54 [1.93-3.36]). We detected an increased sensitivity in patients with undiluted tests (0.774 vs. 0.282) and a nearly identical specificity in both groups (1 vs. 0.983).
CONCLUSIONS
For the first time, we show that IDT up to pure ICM concentrations is superior to using diluted ICMs only. Possibly, we can reduce the number of DPTs when performing IDTs with pure ICMs. In the undiluted group, there were no hints for skin irritations or unspecific test reactions.
Item Type: |
Journal Article (Original Article) |
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Division/Institute: |
04 Faculty of Medicine > Department of Radiology, Neuroradiology and Nuclear Medicine (DRNN) > Institute of Diagnostic, Interventional and Paediatric Radiology 04 Faculty of Medicine > Department of Haematology, Oncology, Infectious Diseases, Laboratory Medicine and Hospital Pharmacy (DOLS) > Clinic of Medical Oncology |
UniBE Contributor: |
Hungerbühler, Martin Nils, Lombardo, Paolo, Böhm, Ingrid |
Subjects: |
600 Technology > 610 Medicine & health |
ISSN: |
0767-3981 |
Publisher: |
Blackwell Science |
Language: |
English |
Submitter: |
Pubmed Import |
Date Deposited: |
14 Mar 2024 13:28 |
Last Modified: |
15 Mar 2024 05:59 |
Publisher DOI: |
10.1111/fcp.12998 |
PubMed ID: |
38481365 |
Uncontrolled Keywords: |
drug hypersensitivity drug provocation test intradermal testing (IDT) iodinated contrast medium (ICM) test concentration |
BORIS DOI: |
10.48350/194269 |
URI: |
https://boris.unibe.ch/id/eprint/194269 |
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