TY - JOUR
T1 - Pharmacologic and non-pharmacologic interventions to prevent hypersensitivity reactions of non-ionic iodinated contrast media
T2 - A systematic review protocol
AU - Umakoshi, Hiroyasu
AU - Nihashi, Takashi
AU - Shimamoto, Hironori
AU - Yamada, Takehiro
AU - Ishiguchi, Hiroaki
AU - Takada, Akira
AU - Hirasawa, Naoki
AU - Ishihara, Shunichi
AU - Takehara, Yasuo
AU - Naganawa, Shinji
AU - Davenport, Matthew
AU - Terasawa, Teruhiko
N1 - Funding Information:
Funding TT was supported in part by the Ministry of Education, Culture, Sports, Science and Technology, Japan (JSPS KAKENHI Grant numbers: 26460755 and 19K07877).
Funding Information:
Competing interests For complete transparency outside the submitted work, SI reports personal fees from Bayer Yakuhin, Ltd.; YT is an endowed chair sponsored by HIMEDIC Co. He does not receive any financial support from the corporation for conducting the research and writing this paper. He also reports personal fees from Daiichi Sankyo company, Ltd., Bayer Yakuhin, Ltd., GE Healthcare, Medi-Physics Co Ltd., Mitsubishi Tanabe Pharma Corporation, National Cancer Center; SN reports personal fees from Daiichi Sankyo Company, Ltd., Kowa Company, Ltd., Bayer Yakuhin, Ltd., Fuji Pharma Co Ltd., Bracco-Eisai Co Ltd., FUJIFILM Toyama Chemical Co Ltd., Canon Medical Systems Corporation, Siemens Healthineers Japan, Trust Clinic, Nagoya Jhohoku Radiology Clinic, Gakken Medical Shujunsha Co Ltd, Neuryon AG; and MD reports royalties from Wolters Kluwer and uptodate.com.
PY - 2020/3/9
Y1 - 2020/3/9
N2 - Introduction: Iodinated contrast media are commonly used in medical imaging and can cause hypersensitivity reactions, including rare but severe life-threatening reactions. Although several prophylactic approaches have been proposed for severe reactions, their effects remain unclear. Therefore, we aim to review systematically the preventive effects of pharmacologic and non-pharmacologic interventions and predictors of acute, hypersensitivity reactions. Methods and analysis: We will search the PubMed, EMBASE and Cochrane Central Register of Controlled Trials databases from 1 January 1990 through 31 December 2019 and will examine the bibliographies of eligible studies, pertinent review articles and clinical practice guidelines. We will include prospective and retrospective studies of any design that evaluated the effects of pharmacological and non-pharmacological preventive interventions for adverse reactions of non-ionic iodinated contrast media. Two assessors will independently extract the characteristics of the study and intervention and the quantitative results. Two independent reviewers will assess the risk of bias using standard design-specific validity assessment tools. The primary outcome will be reduction in acute contrast media-induced hypersensitivity reactions. The secondary outcomes will include characteristics associated with the development of contrast media-induced acute hypersensitivity reactions, and adverse events associated with specific preventive interventions. Unique premedication regimens (eg, dose, drug and duration) and non-pharmacological strategies will be analysed separately. Average-risk and high-risk patients will be considered separately. A meta-analysis will be performed if appropriate. Ethics and dissemination: Ethics approval is not applicable, as this will be a secondary analysis of publicly available data. The results of the analysis will be submitted for publication in a peer reviewed journal. PROSPERO registration number CRD42019134003.
AB - Introduction: Iodinated contrast media are commonly used in medical imaging and can cause hypersensitivity reactions, including rare but severe life-threatening reactions. Although several prophylactic approaches have been proposed for severe reactions, their effects remain unclear. Therefore, we aim to review systematically the preventive effects of pharmacologic and non-pharmacologic interventions and predictors of acute, hypersensitivity reactions. Methods and analysis: We will search the PubMed, EMBASE and Cochrane Central Register of Controlled Trials databases from 1 January 1990 through 31 December 2019 and will examine the bibliographies of eligible studies, pertinent review articles and clinical practice guidelines. We will include prospective and retrospective studies of any design that evaluated the effects of pharmacological and non-pharmacological preventive interventions for adverse reactions of non-ionic iodinated contrast media. Two assessors will independently extract the characteristics of the study and intervention and the quantitative results. Two independent reviewers will assess the risk of bias using standard design-specific validity assessment tools. The primary outcome will be reduction in acute contrast media-induced hypersensitivity reactions. The secondary outcomes will include characteristics associated with the development of contrast media-induced acute hypersensitivity reactions, and adverse events associated with specific preventive interventions. Unique premedication regimens (eg, dose, drug and duration) and non-pharmacological strategies will be analysed separately. Average-risk and high-risk patients will be considered separately. A meta-analysis will be performed if appropriate. Ethics and dissemination: Ethics approval is not applicable, as this will be a secondary analysis of publicly available data. The results of the analysis will be submitted for publication in a peer reviewed journal. PROSPERO registration number CRD42019134003.
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U2 - 10.1136/bmjopen-2019-033023
DO - 10.1136/bmjopen-2019-033023
M3 - Review article
C2 - 32156762
AN - SCOPUS:85081579794
VL - 10
JO - BMJ Open
JF - BMJ Open
SN - 2044-6055
IS - 3
M1 - e033023
ER -