What if a simple spray could save a life? Researchers are testing a new alternative to adrenaline injection against anaphylactic shock. The first results suggest a revolution in emergency care.
When every second counts in front of anaphylaxis
Anaphylaxis is one of the most dreaded medical emergencies. A severe allergy can trigger a chain reaction in a few seconds: swelling of the throat, sudden fall in blood pressure, respiratory distress. In these extreme cases, adrenaline is the only effective treatment, and its administration must be immediate.
Today, the answer is based on adrenaline self-injectors like Epipen®, which patients at risk should always keep on them. But fear of needles, the complexity of use in panic situations, or the constraint of having to replace the device every 12 to 18 months are major obstacles.
It is in this context that a team of researchers explored a needle -free solution: adrenaline by nasal spray.
Successful nasal sprays tested
Dr. Danielle Furness, while finishing her medical studies at the University of Buckingham in the United Kingdom, carried out a systematic review of five studies carried out in Israel, Canada, Thailand, the United States and Japan. This work compared adrenaline administered by intramuscular injection (Epipen® and equivalent devices) to that delivered by nasal spray.
The results are striking. The absorption of adrenaline by nasal spray has proven to be comparable, even faster, than by injection: from 2.5 to 20 minutes to reach sufficient blood levels, against 9 to 45 minutes for intramuscular injection. The plasma concentrations were similar, sometimes higher with the spray, while the physiological effects (heart rate and blood pressure) remained equivalent. The side effects reported were light and passengers.
As Danielle Furness sums up: “Our results show that adrenaline in nasal spray is issued quickly and effectively in the bloodstream“. She adds:”This is the first time that a study has demonstrated that adrenaline administered by nasal spray can reach therapeutic levels“.
The scientific interest of this work also is due to their magnitude. The study tested both liquid and dry powder sprays, compared directly to injections, and evaluated not only the absorption speed, but also the cardiovascular effects.
A more practical and less restrictive alternative
In addition to efficiency, the nasal spray has major practical advantages. The devices tested are much more compact than an EPIPEN®: the Spray Neffy®, for example, is barely six centimeters long, against more than 15 cm for the auto-injector.
Portability is therefore better, as is discretion. Another essential point: the shelf life. While an EPIPEN® must be replaced every 12 to 18 months, the nasal spray keeps about two years. This longevity reduces the cost and the risk of ending up with an expired device during an emergency.
Finally, the absence of a needle removes a large psychological barrier. For many patients and relatives/relatives, the prospect of an injection remains a real obstacle. This is what Felix Lorang explains: “The idea of an alternative without needle could reduce a large part of the anxiety which accompanies the port and the use of an adrenaline self-injector“.
A future without needles? Between hope and prudence
If the idea of a nasal spray changes the game, the researchers call for caution. All the studies analyzed were of phase I, carried out on small groups of healthy adults, and not on patients in the midst of anaphylactic crisis. The doses and devices varied according to the tests, and there is not yet long -term security data. It is also known how these sprays would work in real emergency conditions, with the stress and variability of situations.
Despite these limits, the potential is immense. For Felix Lorang, the stake is clear: “A nasal spray, easier to administer and transport, could improve access to emergency treatment and save lives“.
Researchers are now calling for greater trials, conducted on diverse populations and in conditions close to reality. If the results are confirmed, the nasal spray could represent a real revolution in the management of anaphylaxis, offering patients a less intimidating, more durable and more accessible treatment.