Safety of gadobutrol in over 23,000 patients: the GARDIAN study, a global multicentre, prospective, non-interventional study

on behalf of the GARDIAN study group

Research output: Contribution to journalArticlepeer-review

28 Citations (Scopus)


Objectives: To investigate the safety and tolerability of gadobutrol at the recommended dose in patients requiring contrast-enhanced magnetic resonance imaging/angiography (MRI/MRA) in the routine setting. Methods: GARDIAN prospectively enrolled 23,708 patients undergoing routine gadobutrol-enhanced MRI/MRA for approved indications at 272 study centres in Europe, Asia, North America, and Africa and monitored for adverse events. Results: Median gadobutrol dose was 0.11 mmol/kg body weight. The overall incidence of adverse drug reactions (ADRs) was 0.7 % (n = 170 patients), with similar incidences in patients with renal impairment or cardiac disease, from different geographic regions and in different gadobutrol dose groups. Patients at risk for contrast media reaction had an ADR incidence of 2.5 %. Five patients (0.02 %) experienced serious adverse events, four were drug-related. One patient experienced a fatal anaphylactoid shock, assessed to be related to injection of gadobutrol. The contrast quality of gadobutrol-enhanced images was rated by treating physicians as good or excellent in 97 % cases, with similar ratings in all patient subgroups and indications. Conclusions: The GARDIAN study shows that gadobutrol at the recommended dose is well tolerated across a large, diverse patient population.

Original languageEnglish
Pages (from-to)286-295
Number of pages10
JournalEuropean Radiology
Issue number1
Publication statusPublished - 2017 Jan 1
Externally publishedYes

Bibliographical note

Funding Information:
Bayer Pharmaceutical Division provided support in the design and conduct of the study and in the collection, management and analysis of the data. Editorial support for this manuscript was provided by Bill Wolvey of PAREXEL, which was funded by Bayer Pharmaceutical Division. Statistical support was provided by Dr. Christine Windemuth-Kieselbach, Head of Biometry, Alcedis GmbH. The scientific guarantor of this publication is Dr Petra Palkowitsch. Dr Martin Prince has a patent agreement with Bayer related to MR angiography

Publisher Copyright:
© 2016, The Author(s).


  • Adverse drug reaction
  • Contrast media
  • Gadobutrol
  • Magnetic resonance imaging
  • Safety

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging


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