Hypophosphatemia is Associated with the Serial Administration of Triple‐Dose Gadolinium to Patients for Brain MRI. Issue 3 (13th April 2015)

• Record Type: Journal Article
• Authors: Wolansky, Leo J.; Cadavid, Diego; Punia, Vineet; Kim, Soyeon; Cheriyan, Jojy; Haghighi, Mershad; Cook, Stuart D.
• Is Part Of: Journal of neuroimaging. Volume 25:Issue 3(2015)
• Page Start: 379
• Page End: 383
• Publication Date: 2015-04-13
• Subjects: Diagnostic imaging -- Periodicals; Nervous system -- Diseases -- Diagnosis -- Periodicals; Imagerie pour le diagnostic -- Périodiques; Système nerveux -- Maladies -- Diagnostic -- Périodiques; Imagerie médicale; Neuroimagerie; Neurologie; Système nerveux; Périodique électronique (Descripteur de forme); Ressource Internet (Descripteur de forme); 616.804754
• DOI: 10.1111/jon.12241
• Languages: English
• ISSNs: 1051-2284

Abstract

<abstract abstract-type="main"> <title>ABSTRACT</title> <sec id="jon12241-sec-0010" sec-type="section"> <title>BACKGROUND AND PURPOSE</title> <p>The purpose of this study is to report a metabolic abnormality associated with frequent, triple‐dose Gadolinium (TdGd) use in MS patients during BECOME trial.</p> </sec> <sec id="jon12241-sec-0020" sec-type="section"> <title>METHODS</title> <p>Potential clinical adverse events and lab abnormalities were monitored at each monthly MRI visit. Hypophosphatemia was defined as phosphate <2.5 mg/dL. Statistical analysis included McNemar's test for pairwise comparisons across visits and generalized estimating equations (GEE) to fit models over time.</p> </sec> <sec id="jon12241-sec-0030" sec-type="section"> <title>RESULTS</title> <p>Eight hundred seventy seven phosphate values were analyzed from the first 12 months. Compared with 4% of subjects at screening, an average of 15.1% (95% confidence interval (CI): 11.4%‐19.7%) of patients had hypophosphatemia at visits from months 1 to 12, during which subjects received serial TdGd. Forty four of seventy five (59%) patients developed hypophosphatemia at least once. We also found a significant increasing trend in hypophosphatemia by visit when treatment groups were evaluated together or separately (p < .001). There was a statistically significant decrease in frequency to 9.8% (95% CI: 4.6‐19.8%) by month 24 (p = .005) coinciding with a period of less frequent gadolinium administration.</p> </sec> <sec id="jon12241-sec-0040" sec-type="section"> <title>CONCLUSIONS</title> <p>Serial TdGd in MS patients, unrelated to immunomodulatory treatment, was associated with increased frequency of hypophosphatemia that progressed with cumulative triple‐dose and markedly decreased in second year, with less frequent triple‐dose administration.</p> </sec> </abstract>