REAL WORLD DATA ON THE EFFECTIVENESS OF EPINEPHRINE NASAL SPRAY IN CLINICAL PRACTICE-UPDATE

Casale, T. et al. Annals of Allergy, Asthma & Immunology, Volume 135, Issue 5, S2

Abstract

Introduction

Intranasal epinephrine spray 2 mg (IN) is the first FDA-approved needle-free epinephrine product for the treatment of severe allergic reactions, including anaphylaxis. Intranasal epinephrine efficacy and safety are supported by extensive pharmacokinetic and pharmacodynamic data, a Phase 3 study in Oral Food Challenge (OFC) patients, and a series of case reports. To evaluate “real world” performance, health care providers (HCP) were surveyed regarding treatment outcomes following IN use.

Methods

Product was provided through an experience program to HCPs for use in their clinics and were surveyed regarding 1) the number of patients dosed; 2) the number of patients requiring a second dose of epinephrine to treat their allergic reactions; and 3) ease of use on a scale of 1-7. Data was collected by the company.

Results

Among 2947 participating HCPs, 375 responded that they had used IN in a total of 680 patients. Indications for use included anaphylaxis following treatment with an OFC or allergen immunotherapy. Of 680 patients who received IN, 603 patients (88.7%) were effectively treated with a single dose of IN, similar to injectable epinephrine rate. 77 patients (11.3%) required a second dose of epinephrine, comparable to what has been reported following food-induced anaphylaxis (11.1%) and lower than what has been reported following allergen immunotherapy (30.5%). Ease of use ratings were 6.6/7 (HCPs) and 6.5/7 (patients).

Conclusion

Intranasal epinephrine demonstrated clinical efficacy comparable to that expected for epinephrine injection products and was judged easy to use by both HCPs and patients. Thus, it is an effective alternative to injectable epinephrine.

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