Douglas P. Mack, a pediatric allergist and assistant clinical professor at McMaster University

 Intranasal Epinephrine Preferred by 88% Over Auto-Injectors, With Douglas Mack, MD

American Academy of Allergy, Asthma & Immunology (AAAAI)

 Annual Meeting 2026 in Philadelphia suggest that patients and caregivers overwhelmingly prefer a needle-free intranasal epinephrine device over traditional auto-injectors for the treatment of 

In a randomized crossover study of 90 participants, 88% preferred the intranasal epinephrine product EURneffy over standard epinephrine auto-injectors. The findings, presented as late-breaking data at the meeting, indicate that device design and usability may play a significant role in whether patients consistently carry and administer epinephrine during severe allergic reactions.

 lead author Douglas P. Mack, a pediatric allergist and assistant clinical professor at McMaster University, said the primary objective of the study was to evaluate user preference between the 2 treatment modalities and better understand what factors drive those preferences. Results showed a strong overall preference for the intranasal option, with nearly 9 in 10 participants selecting it over injectable devices. The team also wanted to see how participants would perform with and without training.

“What was cool with the study is that we had not only patients who had a history of allergy, we had caregivers, we had children, but we also had naive patients who…had no experience whatsoever with auto injectors or with food allergy or any type of allergies,” Mack said. “These were people who had no experience whatsoever. We did absolutely see that almost everybody who was naïve had a preference for the epinephrine auto-injector for the intranasal epinephrine. We still did have about 8% of the population who prefer the epinephrine auto-injection.”

These findings indicate that device familiarity did not impact patient preference. Rather, usability advantages may be particularly meaningful for newly diagnosed patients or those encountering epinephrine therapy for the first time.

Investigators also assessed practical barriers that often limit real-world epinephrine use. Prior research has shown that many individuals prescribed epinephrine do not consistently carry their devices and may hesitate to administer them during an anaphylactic emergency.

According to Mack, several factors, including device size, portability, needle aversion, and concerns about bystander administration, can contribute to these barriers. In the study, participants rated the intranasal device more favorably across multiple usability domains, including ease of carrying, ease of use, and reduced anxiety associated with needle injections.

“I think this is going to hopefully open the door to even further research into…a setting where there [are] no training or [usage] as a stock epinephrine. Our goal is to get this into the patient… having a device that's simple to use, easy to carry, is really what we're looking for. Now, there's always [going to] be people who will still use the auto injector. There's no question. But I think [intranasal epinephrine] provides a choice for families and a choice for patients.”

New data reveals 9 in 10 people prefer EURneffy, a needle-free nasal adrenaline spray, over auto-injectors. BioSpace. Published March 4, 2026. Accessed March 5, 2026. 

https://www.biospace.com/press-releases/new-data-reveals-9-in-10-people-prefer-eurneffy-a-needle-free-nasal-adrenaline-spray-over-auto-injectors

Videos

A randomized crossover study shows that most patients prefer intranasal epinephrine for anaphylaxis due to its ease of use, portability, and the absence of needles.

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Allergy

Allergy condition center page is a comprehensive resource for clinical news and insights on allergic and inflammatory diseases. This page consists of interviews, articles, podcasts, and videos on the research, treatment and development of therapies for food and seasonal allergies, as well as allergic asthma and related conditions.

Anaphylaxis

The HCPLive anaphylaxis page is a comprehensive resource for clinical news and insights on acute allergic reactions. This page consists of interviews, articles, podcasts, and videos on the research, treatment and development of therapies for preventing anaphylaxis, and more.

Conference

 conference coverage page features articles, videos, and expert-led live coverage from major medical meetings throughout the year.

Intranasal Epinephrine Preferred by 88% Over Auto-Injectors, With Douglas Mack, MD

Diana Isaacs, PharmD, is an endocrine clinical pharmacist, director of Education and Training in Diabetes Technology, and codirector of Endocrine Disorders in Pregnancy at the Cleveland Clinic.

ACHIEVE-3: Orforglipron Demonstrates Superiority to Semaglutide in Poorly Controlled T2D

Eli Lilly’s investigational once-daily GLP-1 receptor agonist orforglipron has outperformed oral semaglutide 7 and 14 mg in patients with type 2 diabetes inadequately controlled with metformin. Over 52 weeks, orforglipron resulted in superior improvements in weight and A1C, demonstrating superiority over the primary and all key secondary endpoints. Notably, orforglipron exhibits no food or water restrictions, setting it apart from existing oral GLP-1s.

Diabetes Dialogue cohosts Diana Isaacs, PharmD, and Natalie Bellini, DNP, discuss the results of ACHIEVE-3 and the promise of orforglipron as an oral GLP-1 with no dietary restrictions.

Check out the full episode on recent GLP-1 trials and results 

In this segment, Isaacs and Bellini discuss the recently published results of the ACHIEVE-3 Trial, a phase 3 study evaluating the investigational oral GLP-1 receptor agonist Orforglipron. Unlike peptide-based GLP-1 therapies, orforglipron is a non-peptide molecule that does not require fasting administration and can be taken alongside food, beverages, and other medications, potentially improving convenience and adherence compared with Semaglutide in its oral form.

The hosts review the head-to-head trial, which enrolled 1,698 patients with type 2 diabetes already taking metformin and compared two doses of orforglipron (12 mg and 36 mg) with oral semaglutide (7 mg and 14 mg). Results showed greater glycemic reductions with orforglipron, with mean A1C decreases of approximately 1.7% and 1.9% for the two doses, compared with reductions of 1.2% and 1.5% with semaglutide. All primary noninferiority comparisons were met, and the investigational agent demonstrated statistical superiority in A1C lowering.

The conversation then turns to tolerability. Gastrointestinal adverse events were reported more frequently with orforglipron, affecting roughly 58–59% of participants compared with 37–45% among those receiving semaglutide. The hosts discuss the nuances of adverse-event reporting in clinical trials, noting that even a single episode of nausea may be recorded as an event, which can inflate incidence rates. Despite higher rates of GI symptoms, discontinuation due to these effects remained relatively low, occurring in approximately 6% of patients receiving orforglipron compared with 3% with semaglutide, suggesting that most patients were able to continue therapy.

The panel highlights the potential clinical implications of these findings. The greater glucose-lowering efficacy may reflect the drug’s potency, but clinicians will need more information on dose-titration strategies and the duration of GI side effects to determine real-world tolerability. They also note that the comparison did not include the highest available dose of semaglutide, representing a limitation when interpreting relative efficacy.

Looking ahead, the hosts discuss the regulatory outlook for orforglipron, which has reportedly been submitted to regulators in more than 40 countries, including the United States, with initial approval efforts focused on obesity. They also emphasize the importance of cardiovascular outcomes data, which are currently available for semaglutide through large trials but not yet for orforglipron, which will likely play a critical role in determining how the therapies are positioned in clinical practice.

The discussion concludes with cautious optimism about expanding oral GLP-1 options. While the convenience and potency of orforglipron are promising, the hosts stress the importance of established cardiovascular evidence when selecting therapies for patients with diabetes and obesity who are at elevated cardiovascular risk.

Editor’s Note: Isaacs reports disclosures with Dexcom, Abbott, Lilly, Novo Nordisk, Medtronic, Insulet, and others. Bellini reports disclosures with Abbott Diabetes Care, MannKind, Povention Bio, and others.

Eli Lilly. Lilly’s oral GLP-1, orforglipron, delivered superior blood sugar control and weight loss compared to oral semaglutide in head-to-head type 2 diabetes trial published in The Lancet. February 26, 2026. Accessed March 5, 2026. 

https://investor.lilly.com/news-releases/news-release-details/lillys-oral-glp-1-orforglipron-delivered-superior-blood-sugar

Rosenstock J, Yabe D, Cox D, et al. Efficacy and safety of once-daily oral Orforglipron compared with oral semaglutide in adults with type 2 diabetes (achieve-3): A multinational, multicentre, non-inferiority, open-label, randomised, phase 3 trial. The Lancet. Published online February 26, 2026. 

Diabetes Dialogue cohosts Diana Isaacs, PharmD, and Natalie Bellini, DNP, cover the recently published trial results and what they mean for Eli Lilly’s newest GLP-1 molecule.

Endocrinology

The HCPLive endocrinology page is a comprehensive resource for clinical news and insights on endocrine system conditions. This page consists of interviews, articles, podcasts, and videos on the research, treatment and development of therapies for diabetes, hormonal disease, and more.

Type 2 Diabetes

Diabetes Dialogue

Diabetes Dialogue: Technology, Therapeutics, & Real-World Perspectives is a monthly podcast hosted by Diana Isaacs, PharmD, and Natalie Bellini, DNP, aimed at providing a regular roundup of the latest clinically applicable insights across diabetes and metabolic diseases, with a focus on leveraging technology to improve care.

Strategic Alliance Partnership

Stefani Tica, MD, MPH, is an assistant professor of pediatrics in the Division of Gastroenterology, Hepatology, and Nutrition at Washington University School of Medicine in St Louis.

When Does MASLD Risk Begin? New Research on Early-Life Factors

As rates of metabolic dysfunction-associated steatotic liver disease (MASLD) continue to rise, experts are increasingly examining how risk for metabolic disease may develop earlier in life than previously recognized, with emerging evidence suggesting that factors shaping MASLD risk may extend beyond an individual’s current metabolic health to include early-life exposures and parental health.

A new analysis of data from the UK Avon Longitudinal Study of Parents and Children (ALSPAC) offers additional insight into how risk for MASLD may begin far earlier in life than previously recognized, potentially even before a child is born. In an interview discussing the study, study author Stefani Tica, MD, MPH, an assistant professor of pediatrics in the Division of Gastroenterology, Hepatology, and Nutrition at Washington University School of Medicine in St Louis, explained that the work was motivated by the complex and multifactorial nature of metabolic disease.

“One of the things that I always counsel my MASLD patients about is that usually problems with our metabolism are really complex, and there's no one single thing that has gone awry,” Tica said. “One of the inspirations for this project was really kind of leaning into these complex interactions with not only what we're eating or how we're using these energy stores, but also our genetics, our environment, stress, kind of the realities of our life.”

The study approached MASLD through a population health lens, aiming to better understand how early-life and family-level factors might shape long-term risk. Rising MASLD incidence across both pediatric and adult populations prompted the team to look beyond individual health markers at the time of diagnosis and instead consider a broader life-course perspective.

In pediatric populations, recent research examining National Health and Nutrition Examination Survey (NHANES) 2011-2020 data estimated the overall prevalence of suspected MASLD in the adolescent population was 11.3%.

In the present study, investigators included 1933 offspring from the ALSPAC to assess the associations between parental pre-pregnancy BMI and odds of offspring MASLD at age 24 years, with MASLD defined as hepatic steatosis on transient elastography and ≥1 cardiometabolic risk factors.

Results showed that at age 24 years, 10.4% of offspring had MASLD. Pre-pregnancy maternal and paternal obesity were independently associated with an increased odds of offspring MASLD, with each 1 kg/m2 increase in maternal BMI increasing the odds of MASLD by 10% (odds ratio [OR], 1.10; 95% CI, 1.06 to 1.14), while each 1 kg/m2 increase in paternal BMI raised the odds by 9% (OR, 1.09; 95% CI, 1.04 to 1.13).

Further analysis revealed biparental overweight or obesity was associated with 3.73 times the odds of offspring MASLD (OR, 3.73; 95% CI, 2.43 to 5.73) compared with parents with a normal BMI, with 67% of this association mediated by cumulative excess childhood BMI.

For clinicians, particularly pediatric hepatologists and pediatric providers, these findings underscore the importance of earlier conversations about metabolic risk. Tica noted that framing these discussions around family health and long-term outcomes may help engage both children and parents in preventive efforts.

“I think this is quite interesting in the sense that it's not necessarily the person who we're seeing right then and there and what their BMI is and what their other metabolic health markers are looking like, but that sort of risk for disease might develop much earlier on,” Tica explained. “I think having this more longitudinal life course perspective on it reinvigorates efforts from a public health standpoint to intervene earlier on in life and potentially have a much bigger impact if you can successfully do that.”

She also noted that the research raises several important unanswered questions. As an observational study, it cannot establish the biological mechanisms underlying these associations. However, emerging preclinical evidence suggests potential roles for epigenetic changes and alterations in the gut microbiome, particularly in infants exposed to maternal obesity or dietary differences during early development.

According to Tica, further mechanistic research will be essential to determine whether interventions, such as parental weight loss or metabolic improvements, can meaningfully alter MASLD risk in future generations.

Editor’s note: Tica reports no relevant disclosures.

Tica S, Luo C, Ren D, et al. Parental obesity and risk of metabolic dysfunction associated steatotic liver disease in adult offspring: UK birth cohort study. 

. Published online February 24, 2026. doi:10.1136/gutjnl-2025-336165

Brooks A. Up to 11% of US Adolescents Have Suspected MASLD, Study Finds. HCPLive. February 17, 2025. Accessed March 5, 2026. 

https://www.hcplive.com/view/an-estimated-11-us-adolescents-have-suspected-masld-study-finds

New research suggests MASLD risk may develop early in life, highlighting the impact of parental factors and cumulative childhood adiposity.

Hepatology

MASH / MASLD

The HCPLive MASH & MASLD page is a comprehensive resource for clinical news and insights on metabolic dysfunction-associated steatotic liver disease and steatohepatitis. This page consists of interviews, articles, podcasts, and videos on the research, treatment and development of therapies for fatty liver disease, steatohepatitis, and more.

Understanding Intergenerational Risk Factors for MASLD, With Stefani Tica, MD, MPH

Adam DeVore, MD, MHS, is an associate professor of medicine in the division of cardiology at the Duke University School of Medicine and medical director of the Duke Heart Transplant program.

Laura Peters, DNP, is an assistant professor of medicine in the Advanced Heart Failure and Cardiac Transplant at the University of Colorado, as well as director of the Children’s Hospital Colorado and UCHealth Heart Transplant Transition Program.

HFSA/AAHFN Tech in Heart Failure: How AI Can Help Heart Failure Care

A joint statement by the Heart Failure Society of America (HFSA) and the American Association of Heart Failure Nurses (AAHFN), published on January 27, 2026, emphasizes the value of integrating technology into all facets of 

 care. The statement aims to provide clinicians with suggestions for a more team-based, forward-thinking, and actionable system of care.

Integrated health technologies (IHTs) have become extremely prominent in heart failure care of late, allowing for timely clinical intervention and facilitating care coordination between disciplines. However, widespread challenges, including suboptimal engagement from patients, digital literacy and access disparities, and poor interoperability, have stymied the uptake process. This document guides clinicians in overcoming these challenges to optimize care.

, Adam DeVore, MD, MHS, and Laura Peters, DNP, come together to discuss the intrinsic value of including recent technological advancements in standard clinical care.

During the discussion, panelists highlighted the growing role artificial intelligence (AI) may play in helping clinicians manage this influx of information. Rather than requiring providers to manually interpret dozens—or even hundreds—of incoming data points, AI-driven platforms may soon be capable of filtering and prioritizing signals that warrant clinical attention. By identifying patterns or thresholds that indicate potential decompensation, these tools could present clinicians with concise, actionable insights rather than raw data streams, helping transform information overload into targeted clinical decision support.

Beyond supporting clinicians, AI may also serve as a bridge between patients and care teams. The panelists discussed the possibility of integrating institutional treatment protocols—such as guideline-directed medical therapy (GDMT) titration frameworks—into AI-supported systems that incorporate patient-specific metrics in real time. For example, individualized thresholds based on a patient’s weight trends, hemodynamic measurements, or other physiologic markers could trigger automated guidance. If a patient’s daily weight exceeds a personalized threshold, the system could prompt predefined actions, such as medication adjustments or clinician notification, ensuring earlier intervention while empowering patients to participate more actively in their own care.

The conversation also emphasized the expanding role of emerging technologies for patients with advanced heart failure who are not yet candidates for heart transplantation or left ventricular assist device (LVAD) therapy. For individuals in this transitional stage—where disease progression is evident but not yet severe enough for advanced mechanical support—technology-driven monitoring and intervention strategies may offer an opportunity to slow disease progression. By identifying subtle physiologic changes earlier and enabling proactive care adjustments, digital tools may help clinicians delay the need for advanced interventions, potentially improving both longevity and quality of life.

As the discussion concluded, the panelists reflected on the collaborative effort behind the statement and the importance of ongoing dialogue about how technology can be implemented thoughtfully in heart failure care. They expressed hope that the insights shared would encourage clinicians and healthcare leaders to consider how emerging tools—from AI-assisted analytics to remote monitoring platforms—might be integrated into their own institutions.

Ultimately, as heart failure care continues to evolve, thoughtful implementation of technology may help clinicians better manage complex data streams, deliver more personalized treatment, and support patients across the full continuum of disease—particularly those navigating the challenging transition toward advanced heart failure.

is an associate professor of medicine in the division of cardiology at Duke University School of Medicine, as well as the medical director of the Duke Heart Transplant program.

 is an assistant professor of medicine in the advanced heart failure and cardiac transplant section within the division of cardiology at the University of Colorado, as well as a senior clinical instructor in the University of Colorado College of Nursing and the director of the Children’s Hospital Colorado and UCHealth Heart Transplant Transition Program.

Editors’ Note: Peters and DeVore report no relevant disclosures.

Cajita M, Peters L, Rao VN, et al. Integrated Health Technologies in heart failure: A scientific statement from the Heart Failure Society of America and the American Association of Heart Failure Nurses. Journal of Cardiac Failure. Published online January 27, 2026. 

Heart Failure Society of America. Integrated Health Technologies in Heart Failure: A Scientific Statement from the Heart Failure Society of America and American Association of Heart Failure Nurses. January 27, 2026. Accessed March 5, 2026. 

https://hfsa.org/integrated-health-technologies-heart-failure-scientific-statement-heart-failure-society-america-and

In the final part of this 6-part HCPLive Special Report, experts discuss the recently released HFSA/AAHFN joint statement on tech integration in heart failure care.

Cardiology

Cardiology condition center page is a comprehensive resource for clinical news and insights on cardiovascular and cardiometabolic diseases. This page consists of interviews, articles, podcasts, and videos on the research, treatment and development of therapies for heart disease and cardiovascular events, as well as associated diabetes, renal failure, and more...

Heart Failure

The HCPLive heart failure page is a resource for medical news and expert insights on HF. This page features expert-led coverage, articles, videos and research on the therapies and development of treatments for heart disease, reduced and preserved ejection fraction, and more.

How AI Can Help Heart Failure Care

HFSA/AAHFN Tech in Heart Failure: What Needs to Change in the Face of New Tech

As heart failure management evolves, many clinicians are questioning whether traditional care models—anchored by fixed follow-up intervals and episodic clinic visits—are sufficient for the complexity of modern treatment strategies. In a recent panel discussion on the implementation of technology in heart failure care, experts explored how digital tools and emerging technologies may help health systems address the practical challenges of delivering guideline-directed medical therapy (GDMT) in a timely and patient-centered way.

One of the key themes raised by the panel was the limitation of conventional care schedules. Historically, patients with heart failure have often been managed through structured follow-up intervals—return visits every several weeks or months. However, as panelists noted, this model may not align with the realities of optimizing therapy in today’s guideline-driven landscape. Achieving target doses of GDMT frequently requires rapid titration and close monitoring, which can be difficult to accomplish within traditional clinic workflows.

The challenge becomes even more apparent during the vulnerable post-discharge period. Current recommendations often call for follow-up within a week after hospitalization for heart failure, yet evidence consistently shows that initiating and optimizing GDMT within the first 1–2 months can significantly reduce rehospitalizations and mortality. Translating these recommendations into practice can be logistically demanding for health systems, clinicians, and patients alike.

Technology may offer a pathway to bridge this gap. Remote monitoring platforms, digital communication tools, and virtual care models can allow clinicians to assess patient status and adjust therapies without requiring frequent in-person visits. By extending care beyond the walls of the clinic, these solutions may help preserve valuable appointment slots for new patients or those with complex needs who require direct evaluation.

Looking ahead, panelists emphasized that the next frontier in heart failure technology may involve the integration of artificial intelligence (AI). Although AI applications remain relatively limited in many health systems today, experts agree that adoption is accelerating. In the context of heart failure care, AI has the potential to assist clinicians in identifying early warning signals, predicting decompensation, and supporting medication titration strategies based on real-time patient data.

In part 5 of this 6-part HCPLive Special Report, experts discuss the recently released HFSA/AAHFN joint statement on tech integration in heart failure care.

What Needs to Change in the Face of New Tech in Heart Failure

In part 4 of this 6-part HCPLive Special Report, experts discuss the recently released HFSA/AAHFN joint statement on tech integration in heart failure care.

Interdisciplinary Integration in Heart Failure

In part 3 of this 6-part HCPLive Special Report, experts discuss the recently released HFSA/AAHFN joint statement on tech integration in heart failure care.

Bridging Trials and Clinical Practice in Heart Failure

In part 2 of this 6-part HCPLive Special Report, experts discuss the recently released HFSA/AAHFN joint statement on tech integration in heart failure care.

Adapting to the Pace of Tech Implementation in Heart Failure

In part 1 of this 6-part HCPLive Special Report, experts discuss the recently released HFSA/AAHFN joint statement on tech integration in heart failure care.

Why Tech Integration Matters in Heart Failure

Sayantani Sindher, MD, is a clinical associate professor at the Sean N. Parker Center for Allergy and Asthma Research, Stanford University School of Medicine.

COMBINE trial data show dupilumab added to omalizumab-assisted OIT improved desensitization and reduced GI symptoms, despite no sustained response benefit.


Food Allergy

Dupilumab Reduces GI Symptoms During Multi-Allergen OIT, With Sayantani Sindher, MD

Sayna Norouzi, MD, is an assistant professor of medicine and clinical nephrologist at Loma Linda University Medical Center

FDA-approved iptacopan and pegcetacoplan offer new complement-targeted therapies for C3 glomerulopathy.

Nephrology

The HCPLive nephrology page is a resource for medical news and expert insights on kidney disease. This page features expert-led coverage, articles, videos and research on the therapies and development of treatments in nephrology, and more.

C3 Glomerulopathy

The HCPLive C3 glomerulopathy page is a resource for medical news and expert insights on C3G. This page features expert-led coverage, articles, videos and research on the therapies and development of treatments in C3G, and more.

Complement Inhibitors Reshape Treatment Landscape for C3 Glomerulopathy, With Sayna Norouzi

This segment of the latest episode of The Medical Sisterhood podcast highlights the value of a supportive partner among those who are physician parents.

Dermatology

The HCPLive dermatology page is a resource for medical news and expert insights on skin disease. This page features expert-led coverage, articles, videos and research on the therapies and development of treatments for dermatologic conditions, and more.

How Important is a Supportive Spouse as a Physician Mother?

Nancy Reau, MD, is Professor of Internal Medicine, Richard B. Capps Chair of Hepatology, Associate Director of Solid Organ Transplantation, and Section Chief of Hepatology at Rush University Medical Center.

Podcasts

Hosts are joined by Su Wang, MD, MPH, to discuss the evolving management of hepatitis B and how to move care beyond silos with expanded treatment and provider empowerment.

Hepatitis C

Hepatitis C page, resources on the topics of medical news and expert insight into HCV can be found. Content includes articles, interviews, videos, podcasts, and breaking news on hepatitis C virus research, treatment, and drug development.

Liver Lineup: Updates & Unfiltered Insights

Introducing Liver Lineup: Updates & Unfiltered Insights — an exciting new podcast delivering timely, candid perspectives on the most pressing topics in the fast-moving world of hepatology. Created by Nancy Reau, MD, and Kimberly Brown, MD, and hosted by HCPLive, this series dives into the cutting edge of liver disease research, clinical care, and real-world practice.

Liver Lineup: Breaking Down Barriers in Hepatitis B Management

Han discusses late-breaking phase 2 VIBRANT data at AAAAI 2026, which showed that quarterly TSLP receptor blockade reduced the need for CRSwNP by 76%.


Verekitug Cuts Polyp Size in Severe CRSwNP, With Joseph Han, MD

Alex Hillenbrand is an assistant editor for 

. She earned her BA in English from Lafayette College in 2023 and went on to write for pop culture, entertainment, and sports media outlets before joining MJH Life Sciences in 2025. In her free time, Alex enjoys cooking, going on walks, and meeting new people. Contact her at mjhlifesciences.com.

Articles

The nephrology field continued to see advances in February 2026, with 5 headlines clincians may have missed.

Latest News

Intranasal Epinephrine Preferred by 88% Over Auto-Injectors, With Douglas Mack, MD

ACHIEVE-3: Orforglipron Demonstrates Superiority to Semaglutide in Poorly Controlled T2D

Understanding Intergenerational Risk Factors for MASLD, With Stefani Tica, MD, MPH

How AI Can Help Heart Failure Care

What Needs to Change in the Face of New Tech in Heart Failure