Iodixanol versus iopromide in cancer patients: Evidence from a randomized clinical trial

I. Terrenato, F. Sperati, F. Musicco, A.F. Pozzi, A. di Turi, M. Caterino, E. de Lutio di Castelguidone, S.V. Setola, M. Bellomi, C.E. Neumaier, L. Conti, G. Cigliana, R. Merola, A. Antenucci, G. Orlandi, A. Giordano, M. Barba, S. Canitano

Research output: Contribution to journalArticle

Abstract

To assess the safety profile of iso-osmolar contrast medium (CM) versus low osmolar CM in cancer patients with an estimated glomerular filtration rate (eGFR) >60 ml/min. In this multicenter, blind trial of patients seeking a chest-abdomen-pelvis contrast enhanced computed tomography (CT) with iodated CM, participants were centrally randomized to iodixanol or iopromide. Contrast induced nephropathy (CIN) at 24 and/or 72 hr were our primary outcomes. We further considered irreversible CIN, average eGFR percentage variation (%Δ), and adverse events (AEs). Overall, 607 patients were enrolled. Among them, 497 eligible patients were randomized to iodixanol (N: 247) or iopromide (N: 250). No differences emerged by descriptive characteristics. Seven and 3 CIN at 24 hr (p = 0.34) and 8 and 2 CIN at 72 hr (p = 0.11) occurred in the iopromide and iodixanol group, respectively. Within the subgroup of individual patients who developed CIN (N: 17), the event rate was higher in the iopromide arm (p = 0.045). No cases of permanent CIN or significant differences in terms of AEs or GFR %Δ were observed. Our results suggest a more favorable safety profile of iodixanol versus iopromide. Adequately sized trials with similar design are warranted to confirm our findings and clarify the underlying biological mechanisms. © 2017 Wiley Periodicals, Inc.
Original languageEnglish
Pages (from-to)2572-2580
Number of pages9
JournalJournal of Cellular Physiology
Volume233
Issue number3
DOIs
Publication statusPublished - 2018

Keywords

  • cancer patients
  • contrast induced nephropathy
  • low-osmolar/iso-osmolar contrast medium
  • iodixanol
  • iopromide
  • contrast medium
  • iodobenzoic acid derivative
  • iohexol
  • abdomen
  • adult
  • aged
  • Article
  • cancer patient
  • clinical assessment
  • contrast enhancement
  • controlled study
  • drug safety
  • estimated glomerular filtration rate
  • female
  • human
  • low risk patient
  • major clinical study
  • male
  • multicenter study
  • outcome assessment
  • pelvis
  • priority journal
  • randomized controlled trial
  • single blind procedure
  • thorax
  • x-ray computed tomography
  • adolescent
  • analogs and derivatives
  • chemically induced
  • clinical trial
  • comparative study
  • diagnostic imaging
  • drug effects
  • glomerulus filtration rate
  • Italy
  • kidney
  • kidney disease
  • middle aged
  • neoplasm
  • pathology
  • pathophysiology
  • patient safety
  • predictive value
  • risk factor
  • time factor
  • young adult
  • Adolescent
  • Adult
  • Aged
  • Contrast Media
  • Female
  • Glomerular Filtration Rate
  • Humans
  • Iohexol
  • Kidney
  • Kidney Diseases
  • Male
  • Middle Aged
  • Neoplasms
  • Patient Safety
  • Predictive Value of Tests
  • Risk Factors
  • Time Factors
  • Tomography, X-Ray Computed
  • Triiodobenzoic Acids
  • Young Adult

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