When gadolinium is in the bloodstream, medical imaging devices produce clearer, more defined images of the patient’s blood vessels. Since gadolinium is extremely toxic to human tissue, it must first be coated with a benign chemical before being injected into the patient. Over the course of time, the body expels the metal through the kidneys.

Patients with poor kidneys, however, experience a buildup of the toxic metal in their body. The protective coating on the gadolinium eventually breaks down and the patient begins to experience the symptoms of Nephrogenic Systemic Fibrosis (NSF).

Currently, 391 lawsuits have been filed in state and federal courts against manufacturers of the gadolinium based contrast dyes. 287 cases pending in Multidistrict Litigation are now moving forward in the U.S. District Court for the Northern District of Ohio. The remaining 104 NSF lawsuits are pending in state courts. The U.S. Judicial Panel on Multidistrict Litigation designated the Northern District of Ohio to handle all NSF lawsuits pending in federal courts. Last week, the presiding judge established ground rules for the consolidated cases now moving forward.

Defendants named in the suits are GE Healthcare, Bayer Healthcare Pharmaceuticals, Bracco Diagnostics, and Mallinckrodt.

The very first cases of NSF were identified in 1997. NSF is a debilitating disease for which there is currently no known cure. Symptoms include fibrosis of the skin, eyes, joints, and internal organs, hardened skin, limited movement, high blood pressure, dark patches, redness, itchiness, burning, and swelling of skin, soreness of hips and ribs, muscle weakness and limited movement. Progression of the disease can lead to severe rigidity in the joints and death.

SOURCE: Gadolinium and NSF › Gadolinium federal lawsuits move ahead

The FDA’s move on Friday finalizes its announcement in May that it would add the labeling warning to the MRI contrast agents.

The final warning notes that the agent boosts the risk of a potentially fatal side effect in patients with certain kidney and liver conditions. The skin disease called nephrogenic systemic fibrosis, or NSF, can occur in some patients, the companies said in a joint letter to health-care professionals, posted on the FDA’s Web site on Friday.

Such gadolinium-based imaging agents are made by Bayer AG’s Bayer Schering Pharma, General Electric Co’s GE Healthcare, Tyco International Ltd.’s Mallinckrodt unit, and Bracco Diagnostics Inc.

The FDA has said there have been no reports of nephrogenic systemic fibrosis among patients with normal kidney function or those with mild-to-moderate kidney insufficiency.

Agency officials first alerted doctors to the potential risk in 2006, following reports that patients who received the injectable agents developed NSF.

Although the risk of NSF from any one agent is unknown, the letter cited a study that found an estimated risk in patients with severe renal insufficiency at 4 percent.

The condition triggers thickening of the skin, organs and other tissues that makes it difficult to move and can lead to broken bones. There is no effective treatment.

Patients should be screened for kidney problems before use of such agents, the letter said, adding that the recommended dose should not be exceeded.

October 18th, 2007

SOURCE: Gadolinium and NSF › MRI contrast agents get strong kidney-risk warning