Exploring Alternatives to Injectable Adrenaline for Anaphylaxis Treatment

This article provides an overview of the study published in Clinical & Experimental Allergy. You can read the full study here.

Adrenaline is the first-line treatment for anaphylaxis, a severe and potentially life-threatening allergic reaction. It is typically administered through injectable devices, called adrenaline auto-injectors (AAIs), which deliver adrenaline into the muscle during emergencies. However, challenges with using AAIs have led researchers to explore alternative delivery methods.

Why Are Alternatives Being Considered?

Adrenaline auto-injectors save lives, but some barriers limit their use:

• Fear of Needles: Many people hesitate to use injectors because of needle anxiety.
• Design Limitations: Concerns about using devices correctly, including needle length and safety for certain groups like infants or overweight individuals.
• Limited Access: Adrenaline injectors may not be widely available in public places, and supply issues or cost can make them harder to obtain.
• Training Gaps: Many users are unsure how to recognise anaphylaxis or administer adrenaline quickly and effectively.

These challenges drive the need for alternative methods of delivering adrenaline.

What Are the Alternatives?

Researchers are investigating new ways to deliver adrenaline that don’t rely on needles.

These include:

1. Nasal Sprays
   • A nasal spray called Neffy has been approved in the US and Europe. This device delivers adrenaline through the nose and has shown similar effectiveness to AAIs in clinical trials.
2. Sublingual Films and Tablets
   • These dissolvable films or tablets are placed under the tongue, where they release adrenaline into the bloodstream. While they show promise, they are still being studied in Phase 1 trials and are not yet available.
3. Transcutaneous Patches
   • These patches could potentially deliver adrenaline through the skin. Still in the early experimental stages, they aim to provide a non-invasive option for those uncomfortable with injections.

Are These Options Available in the UK?

It’s important to note that these alternatives are not available in the UK. New treatments must go through a rigorous process before being approved for use in the NHS. The Medicines and Healthcare products Regulatory Agency (MHRA) reviews safety and effectiveness, while the National Institute for Health and Care Excellence (NICE) assesses cost-effectiveness and clinical benefits. Without this approval, these treatments might never become available in the UK.

What’s Next?

While these alternatives show promise, injectable adrenaline remains the gold standard due to its proven reliability and effectiveness. New methods may complement existing treatments, offering options better suited for specific populations or situations, especially for those with needle phobia or logistical challenges.

Experts emphasise the importance of ongoing education and training to improve the use of adrenaline auto-injectors (AAIs) while expanding access to emerging technologies. Addressing affordability and ensuring widespread availability will be critical as these alternatives enter the market.

The search for alternative ways to deliver adrenaline is an important step forward in making life-saving treatment for anaphylaxis more accessible and user-friendly. These advancements could improve outcomes for individuals at risk of severe allergic reactions. However, adherence to current medical guidelines and timely administration will remain vital, regardless of the delivery method. Education on recognising and treating anaphylaxis will continue to be essential in saving lives.

As always, Anaphylaxis UK is here to support your anaphylaxis education. Our low-cost training course, AllergyWise, provides all the resources you need to learn how to use AAIs correctly, recognise allergic reactions, and respond with confidence. We are committed to ensuring that individuals and communities are equipped with the knowledge and skills to manage anaphylaxis effectively.

To learn more about the research, you can access the full study in Clinical & Experimental Allergy here.