Innovations in the Treatment of Anaphylaxis: A Review of Recent Data

Ann Allergy Asthma Immunol. 2023 Jun 4:S1081-1206(23)00404-0. doi: 10.1016/j.anai.2023.05.033. Online ahead of print.ABSTRACTPURPOSE OF REVIEW: The current standard of first-line emergency treatment of anaphylaxis is intramuscular (IM) epinephrine administered most commonly via epinephrine autoinjector (EAI) in the outpatient setting. However, undercarriage and underuse of EAIs are common, and delayed epinephrine use is associated with increased morbidity and mortality. Patients, caregivers, and healthcare professionals have expressed a strong desire for small, needle-free devices and products that would offer improved carriage, ease of use, and more convenient, less invasive routes of epinephrine administration. Novel mechanisms of epinephrine administration are under investigation to help address several recognized EAI limitations. This review explores innovative nasal and oral products under investigation for the outpatient emergency treatment of anaphylaxis.FINDINGS: Human studies of epinephrine administered via nasal epinephrine spray, a nasal powder spray, and a sublingual film have been conducted. Data from these studies demonstrate promising pharmacokinetic (PK) results comparable to that of the standard of outpatient emergency care (0.3-mg EAI) and/or syringe and needle IM epinephrine administration. Several products have shown maximum plasma concentration values higher than that of the 0.3-mg EAI and manual IM injection, although it remains unclear whether this has ...
Source: Annals of Allergy, Asthma and Immunology - Category: Allergy & Immunology Authors: Source Type: research