Edwin H. Kim, MD: Advantages, Challenges of Intranasal Epinephrine Spray Administration

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This segment of Dr. Kim’s interview featured a discussion on the potential advantages and disadvantages of the new ARS-1 epinephrine nasal spray being considered by the FDA.

This interview segment with HCPLive featured a talk with Edwin H. Kim, MD, further exploring both potential advantages, disadvantages, and general outlook on the future of allergy treatment with the potential new intranasal epinephrine spray ARS-1 (Neffy).

Kim serves as an Associate Professor of Pediatrics at University of North Carolina’s School of Medicine, as well as the director of the UNC Food Allergy Initiative research group.

Initially, Kim was asked to explain the potential advantages and challenges of administering epinephrine intranasally in emergency situations as opposed to using traditional intramuscular injection with the EpiPen, for example.

“I think this is going to be a critical part of these next 6 - 12 months and the discussion about Neffy,” he said. “Assuming that it is approved by the FDA, it is going to be a big, big, big change for our field. So all the allergists that are out there, emergency workers, all of us are very familiar with how the injectable epinephrine works. We know how to give it, we know exactly how to expect symptoms to get better when to redo it.”

Kim then added that there will likely be a learning curve for all allergists that begin to use if it should be approved, as well as the aspect of gaining trust.

“So again, when we're talking about allergic reactions that could potentially be life and death for people, there is no sort of margin for error here,” he said. “So people need to have something that they know will work, and this early period will be really important for people to just get comfortable with it and build that trust with this new product. The idea that this is given in the nose, of course, is going to be much more benign than a needle in your leg.”

Kim noted that there could be other questions raised should the FDA approve the product such as if it absorbs at the same pace, or what could happen if you have someone who has a lot of new symptoms.

“So as part of an allergic reaction, if they have a runny nose, or if they're completely congested and swollen, will the product work as well?” he said. “They have some data that seems to suggest that's the case. And so I’m very optimistic, but it's not quite the same as real world experience there.”

He later commented on potential implications for existing guidelines and practices.

“I do think that it has the chance to change practice,” he said. “And in that, again, the injections have been sort of considered only for more severe reactions and sort of later on in a reaction if it's not responding to earlier treatments. I do think one very tangible change will be that there will probably be advertising to use epinephrine much earlier in an allergic reaction. So I think that's probably the most tangible experience that we would have from this.”

Additionally, Kim explained that in the food allergy field specifically, as researchers have been moving forward with new treatments for food allergy, some of these treatments could themselves bring the risk of allergic reaction and the knowledge that clinicians would have something like Neffy that would be readily available could even help to push food allergy treatments forward as well.

For further information, view Kim’s full interview segment posted above.

The quotes contained in this article were edited for clarity.