Auvi-Q (epinephrine auto-injector) / Sanofi, Kaleo, Valeo Pharma - LARVOL DELTA

AUVI-Q vs. Other Epinephrine Auto-Injector Prescription Was Associated With Reduced Inpatient Hospitalizations for Anaphylaxis in a US Retrospective Commercial Claims Analysis (ISPOR 2025) - "Inpatient hospitalizations for anaphylaxis were lower among patients prescribed AUVI-Q vs. Other EAIs in this cohort of US patients in a commercial claims database."

Retrospective data • Infectious Disease • Septic Shock

Epinephrine Delivered via Sublingual Film (AnaphylmTM) Elicits Rapid and Consistent Pharmacokinetic and Pharmacodynamic Responses (AAAAI-WAO 2025) - "Results After single dose administration, the T max variability as reflected by interquartile range (IQR) was 5.0 minutes (min) for Anaphylm (median T max 12 min), 23.5 min for EpiPen (median T max 20 min), 32.0 min for Auvi-Q (median T max 30 min), and 15.0 min for manual IM injection (median T max 50 min)...Moreover, Anaphylm's PD profile showed clinically relevant increases in SBP, DBP, and HR. These results further support the development of sublingual epinephrine film as a reliable needle-free alternative for the treatment of Type I allergic reactions, including anaphylaxis."

PK/PD data • Allergy • Immunology

Integrated Phase I Pharmacokinetics and Pharmacodynamics of Epinephrine Administered via Sublingual Film, Autoinjector, or Manual Injection. (PubMed, Ann Allergy Asthma Immunol) - "AQST-109 delivered epinephrine with PK and PD results within the bracketed range of approved IM products. AQST-109 shows promise as an innovative, needle-free, non-device, portable and orally delivered alternative for the first-line treatment of Type I allergic reactions, including anaphylaxis."

Journal • P1 data • PK/PD data • Allergy

An epinephrine nasal spray (neffy) for anaphylaxis. (PubMed, Med Lett Drugs Ther) - No abstract available

Journal

Pharmacokinetics and Pharmacodynamics of Epinephrine Following Administration via Sublingual Film, Autoinjector, or Manual Injection (AAAAI 2024) - "The final formulation of AQST-109 was compared with epinephrine delivered by two different approved autoinjectors (EpiPen and Auvi-Q) or by manual injection (IM)... The PK and PD of AQST-109 delivered epinephrine within range of the approved epinephrine manual IM and EAI products. These results demonstrate that the sublingual administration of the novel prodrug in AQST-109 shows promise as a viable needle-free alternative for treatment of Type I allergic reactions."

PK/PD data • Allergy

Managing Food Allergy: Findings from a Nationwide US Survey of Practicing Allergists (ACAAI 2023) - "Challenges included allergen avoidance and diet modification, and barriers included assessing risk of accidental exposure. Tailored educational tools for patients may provide a valuable resource in patient-allergist conversations."

Allergy • Asthma • Atopic Dermatitis • Dermatitis • Dermatology • Food Hypersensitivity • Immunology • Pediatrics • Pulmonary Disease • Respiratory Diseases

Improving the Management of Pediatric Anaphylaxis in the Emergency Department at a Tertiary Care Hospital (ACAAI 2023) - "The revised order set includes pediatric specific dosing, prioritization of epinephrine over adjunctive medications, and medications which are readily available in the emergency room. Our outcome measures will include the percentage of patients meeting anaphylaxis criteria who received epinephrine, timing of epinephrine administration, and percentage of patients discharged with an epinephrine auto-injector."

Clinical • Pediatrics

Impact of Multi-language Anaphylaxis Plans in an Outpatient Pediatric Allergy Clinic (ACAAI 2023) - "We identified gaps in knowledge and confidence regarding anaphylaxis management in LOE vs. English-speaking families. These results underscore the importance of ongoing advocacy to improve access to IgE-FA management resources for LOE families."

Clinical • Allergy • Food Hypersensitivity • Immunology • Pediatrics

Adolescents demonstrate improved comfort with self-management of food allergies with implementation of tailored education visit (ACAAI 2023) - "Conclusion Less than half of all teens feel comfortable with their epinephrine injector or managing their food allergies . Participants reported increased comfort with epinephrine auto-injector use and managing food allergies following a patient-tailored education visit suggesting that a transitions of care curriculum and guidelines may be beneficial for improved outcomes in this age group."

Allergy • Food Hypersensitivity • Immunology

A Single-Period, Single-Dose Study of the Pharmacokinetics of Epinephrine After Administration ARS-1 to Pediatric Subjects (ACAAI 2023) - "All other TEAEs were mild. Conclusion In pediatric allergy subjects, a 2.0 mg intranasal epinephrine spray resulted in a pharmacokinetic profile comparable to what has been observed in adults and is expected to be a safe and effective option for the treatment of severe allergic reactions and anaphylaxis in pediatric patients."

Clinical • PK/PD data • Allergy • Immunology • Pediatrics

Repetitive Food-Independent Exercise-Induced Anaphylaxis (ACAAI 2023) - "He was started on daily loratadine and given an epinephrine autoinjector to use for anaphylaxis...This case highlights the importance of a thorough history and wide differential as the patient had previously been prescribed albuterol with no resolution of symptoms. He responded completely to an oral antihistamine."

Pulmonary Disease

Using Instagram to Provide High-Quality Food Allergy Education and Awareness (ACAAI 2023) - "Conclusion In three weeks and with only 21 posts and reels, this advocacy project was able to reach over 2,000 individuals on Instagram and present validated, evidence-based food allergy information. This presents thousands of future opportunities to provide evidence-based education on food allergies, address misconceptions, and provide a safe resource for patients."

Allergy • Food Hypersensitivity • Immunology

Why Do Those Who Need an Epinephrine Autoinjector Not Carry It?: A Customer Discovery Approach (ACAAI 2023) - "Conclusion The customer exploration process allowed real-world insights into the barriers to carrying and using EAI in those who require its use or are responsible for the administration. Opportunities to improve access to EAI need to incorporate the perspectives of key stakeholders."

Allergy • Food Hypersensitivity • Immunology

Characteristics of an Adult Cohort with Shellfish Allergy: Comparison by Race (ACAAI 2023) - "White patients were more likely to have presented to medical care or used an epinephrine auto-injector with prior SA reactions (26.1 % vs 10.0 %) Conclusion Black patients with SA have a higher rate of DM sensitization which has been hypothesized to contribute to the higher prevalence of SA in this population. Other patient characteristics should be compared in future studies to further elucidate patient-level and/or socioenvironmental factors contributing to SA."

Clinical • Allergy • Asthma • Food Hypersensitivity • Immunology • Pulmonary Disease • Respiratory Diseases

Assessment of Pediatrics Resident Knowledge Regarding Epinephrine Autoinjectors (ACAAI 2023) - "Conclusion Though more than half of the residents know how to use Epinephrine autoinjectors, a significant amount is still not confident in giving instructions to patients. Further assessment of Epinephrine autoinjector administration accuracy is recommended."

Clinical • Pediatrics

Lost in Translation: Pharmacy Translation Software Mounts an Unexpected Barrier to School Medications (ACAAI 2023) - "The pharmacy translation software is not the only thing to blame for this case of a delay in securing a potentially life-saving medication in the school setting. Communication between the family, the physician, the school nurse, and the pharmacy is essential to ensure safety and success of students with allergies."

Allergy • Immunology

Allergist Access as a Potential Driver of Socioeconomic Disparities in Food Allergy (ACAAI 2023) - "Conclusion Allergists are critical for FA care; yet many historically marginalized communities lack access. Expedited allergist access is necessary to ensure guideline-based FA care for all."

Allergy • Dermatology • Food Hypersensitivity • Immunology

Lentils, An Uncommon Food Causing Food Dependent Exercise Induced Anaphylaxis (ACAAI 2023) - "Symptoms resolved after stopping exercise and taking diphenhydramine...Prophylactic treatment with Omalizumab has been used in refractory cases. FDEIA is a serious condition; it's imperative to have a high index of suspicion, especially in the absence of positive testing."

Addiction (Opioid and Alcohol) • Dermatology • Immunology • Pruritus • Urticaria

13.2 mg Intranasal Epinephrine Treatment In Congestion Shows Increased Bioavailability Without Pharmacokinetic And Pharmacodynamic Correlation (ACAAI 2023) - "AE incidence was lower following NAC. Conclusion • NDS1C in congestion demonstrated enhanced absorption vs IM treatments and NDS1C without NAC • PD treatment effects on HR, SBP, and DBP were minimal with no correlation between PK concentration and PD effects • NDS1C appeared safe and well-tolerated"

PK/PD data • Allergy • Immunology • Pain

Anaphylaxis After Ingestion Of Batter Fried Catfish Despite Tolerance To Finned Fish (ACAAI 2023) - "He drove to ER and was treated with intravenous diphenhydramine, famotidine and methylprednisolone with rapid resolution of symptoms...His skin prick test was strongly positive to catfish, flounder, salmon and trout, subsequently confirmed by serum specific IgE. Prick-prick test was only positive to raw, but not cooked salmon suggesting that his reaction was caused by the undercooked core of the fried catfish, which indicates sensitization to thermo-labile, conformational rather than linear allergen epitopes."

Allergy • Cough • Dermatology • Food Hypersensitivity • Immunology • Pruritus • Pulmonary Disease • Respiratory Diseases • Urticaria

Idiopathic Anaphylaxis: A Medical Dilemma (ACAAI 2023) - "She was treated as an allergic reaction with ondansetron, dexamethasone, diphenhydramine and was discharged home...Once results obtained, elevated tryptase suggests IA as most likely diagnosis, but during ED management remained a challenge to diagnose clinically. Patient was discharged on cetirizine, prednisone and epinephrine auto-injector with close follow-up with Allergist."

Allergy • Dermatology • Immunology • Pruritus • Urticaria • TPSAB1

Exploring the Interplay of Epinephrine and Needle Phobia: Implications and Strategies (ACAAI 2023) - "More educational interventions to overcome needle phobia on platforms like TikTok are needed. A follow-up analysis following FDA approval of needle-free epinephrine products may provide insights into whether needle-free options will reduce the fear of using epinephrine promptly for anaphylaxis."

Allergy • Asthma • Immunology • Pulmonary Disease • Respiratory Diseases

Indolent Systemic Mastocytosis: An Incidental Diagnosis (ACAAI 2023) - "Several treatments are available including antihistamines, steroids and epinephrine auto injector. Recently, avapritinib has been approved for treating ISM."

Colonic Polyps • Fatigue • Gastroenterology • Gastrointestinal Disorder • Infectious Disease • Novel Coronavirus Disease • Oncology • CD20 • CD34 • IL2RA • ISG20 • KIT

Delayed-Type Hypersensitivity Reaction Following Pegfilgrastim Exposure (ACAAI 2023) - "Case Description A 76-year-old male with a history of pancreatic neuroendocrine carcinoma on carboplatin, etoposide plus pegfilgrastim presented to the emergency department for progressive rash and hypotension...However, his history, the prolonged time course, and especially the delayed recurrence on subsequent IV challenge demonstrate a delayed-type hypersensitivity response. This type of reaction is consistent with either direct antigen presentation to skin-homing cytotoxic lymphocytes, but we cannot rule out direct covalent binding of the pegfilgrastim to MHC class I antigens."

Endocrine Cancer • Hypotension • Immunology • Neuroendocrine Tumor • Oncology • Pancreatic Cancer • Solid Tumor

A Shot To Live: Anaphylaxis Curriculum Enhances Efficacy of Epinephrine Administration for Unassigned Administrators (ACAAI 2023) - "96/98 (98%) of participants were comfortable recognizing signs/symptoms of anaphylaxis, 94/98 (96%) correctly differentiated anaphylaxis from non-anaphylaxis food reactions, 90/98 (92%) were comfortable with administering epinephrine, and 96/98 (98%) correctly identified the 4 essential steps of epinephrine administration. Conclusion Provision of in-person training for school staff increases comfort and effectiveness of anaphylaxis recognition and management."

Clinical • Allergy • Food Hypersensitivity • Immunology