Iodixanol
| Evidence Level: L5 | Predicted Indications: 2 |
Table of Contents
Iodixanol: From Radiographic Contrast Imaging to Osteoarthritis
One-Sentence Summary
Iodixanol is an iodinated, iso-osmolar radiographic contrast agent, marketed in Canada under four licences. The TxGNN model predicts it may be useful for osteoarthritis, but the data compiled for this report contain 0 clinical trials and 5 publications, and none of them tests iodixanol as a treatment. They describe it only as an imaging tool.
Quick Overview
| Item | Content |
|---|---|
| Original Indication | Not stated in the licence records |
| Predicted New Indication | Osteoarthritis |
| TxGNN Prediction Score | 0.9907 |
| Evidence Level | L5 |
| Canada Market Status | Marketed (marketed DINs: 4 of 4) |
| Number of DINs | 4 (marketed: 4) |
| Recommended Decision | Hold |
Why is This Prediction Reasonable?
Detailed mechanism of action data is not available. Iodixanol is known as an iodinated, iso-osmolar contrast agent. It has no known disease-modifying pharmacology.
The literature links iodixanol to osteoarthritis only as an imaging and research tool. The studies cover contrast-enhanced CT of cartilage, diffusion of solutes and nanoparticles across cartilage and the bone–cartilage interface, and compatibility of iodine contrast agents with platelet-rich plasma. None shows a therapeutic effect.
The high score (0.9907) comes from the TxGNN model (deep learning) and may reflect similarities the model learned between related diseases, not biological evidence, given that the drug is used in joint imaging. It should not be read as evidence of a treatment effect. In my assessment, no therapeutic mechanism is currently supported.
Clinical Trial Evidence
Currently no related clinical trials registered.
Literature Evidence
| PMID | Year | Type | Journal | Key Findings |
|---|---|---|---|---|
| 39012563 | 2024 | Preclinical imaging study | Ann Biomed Eng | Nanoparticle diffusion CT with finite element modelling to reveal cartilage function |
| 40155520 | 2025 | Preclinical imaging study | Ann Biomed Eng | Dual-contrast agent in photon-counting CT to assess articular cartilage health |
| 28063646 | 2017 | Ex vivo transport study | J Biomech | Iodixanol used as a CT tracer to study permeability of the cartilage–subchondral bone interface |
| 27793406 | 2016 | Computational model | J Biomech | Finite element model of neutral solute transport across the osteochondral interface |
| 30374787 | 2018 | In vitro study | J Exp Orthop | Iodine contrast agents did not affect platelet-rich plasma function at an early time point |
Canada Market Information
| DIN | Product Name | Dosage Form | Approved Indication |
|---|---|---|---|
| 02145766 | VISIPAQUE 270 | Not listed | Not listed |
| 02145774 | VISIPAQUE 320 | Not listed | Not listed |
| 02553953 | IODIXANOL INJECTION 270 | Not listed | Not listed |
| 02553961 | IODIXANOL INJECTION 320 | Not listed | Not listed |
Safety Considerations
- Drug Interactions: The interaction screening returned 100 records. The main ones are listed below.
- Major interactions include metformin, amphotericin B (several formulations), mesalazine, balsalazide, olsalazine, sulfasalazine, vancomycin, and the aminoglycosides kanamycin, neomycin and streptomycin, as well as polymyxin B.
- Mannitol is rated Moderate.
For warnings and contraindications, please refer to the package insert.
Conclusion and Next Steps
Decision: Hold
Rationale: The prediction rests on model output alone. The available studies use iodixanol as an imaging agent, not as a treatment, and no trials are registered. For rheumatoid arthritis, the second prediction, the only publication is a case report on desensitization to a related contrast agent (iohexol). It offers no evidence of efficacy either.
To proceed, the following is needed:
- Evidence that iodixanol has a therapeutic effect in osteoarthritis, such as preclinical efficacy data
- Mechanism of action data
- Health Canada package insert warnings, contraindications and approved indication text
- A review of route and formulation compatibility, since the available products are injectable contrast preparations
Disclaimer
This content is for research purposes only and does not constitute medical advice. Clinical validation is required before any clinical application.