#2-54E. Overcoming Needle Hesitancy: Efficacy of Intranasal Epinephrine in Anaphylaxis (JAIP, 2025)

Anaphylaxis is a life-threatening emergency, and rapid administration of epinephrine is the standard of care for immediate treatment. However, physician listeners know that fear of the needle frequently leads to significant delays or failure in administering epinephrine autoinjectors, compromising patient outcomes. This Phase 3 open-label trial evaluated neffy (epinephrine nasal spray), the first approved needle-free option, for treating moderate to severe anaphylaxis symptoms induced by oral food challenge (OFC) in pediatric patients (n=15). The key finding is that neffy successfully resolved OFC-induced allergic symptoms in all participants, with the median time to resolution of Grade 2 symptoms being 16 minutes. This crucial data provides clinical evidence that the needle-free device works during an allergic reaction. However, critical appraisal must consider the small sample size of n=15 and the potential confounding of efficacy results due to the use of adjunctive medications during the trial. Nonetheless, the availability of this needle-free option has profound implications for clinical practice, potentially reducing dosing hesitancy among patients and caregivers and promoting faster treatment adherence for severe allergic reactions.

Citation: Motohiro Ebisawa, et al. Epinephrine Nasal Spray Improves Allergic Symptoms in Patients Undergoing Oral Food Challenge, Phase 3 Trial. Journal of Allergy and Clinical Immunology: In Practice. 2025. DOI: 10.1016/j.jaip.2025.06.038

Disclaimer: This audio summary is based on personal interpretation and does not guarantee the exact content of the original paper. Please refer to the original article for details.