Beyond the Needle: Promoting Prompt Anaphylaxis Treatment - Episode 6
Oral Food Challenge (OFC) Study with Epinephrine Nasal Spray
A panelist discusses how a study of Neffy (epinephrine nasal spray) in Japan demonstrated effectiveness in treating 15 pediatric patients who experienced grade 2 allergic reactions during oral food challenges, with these moderate reactions including symptoms like abdominal pain, vomiting, wheezing, and mild cardiovascular effects according to the updated grading system from professional allergy societies.
Video content above is prompted by the following:
The availability of specific data on oral food challenges using epinephrine products has historically been limited, with most published research consisting of case series and retrospective studies. However, a significant advancement came with the launch of Nephi (epinephrine nasal spray), which included a dedicated study conducted in Japan examining its effectiveness during oral food challenge procedures. This Japanese study provided valuable clinical evidence by observing 15 pediatric patients who underwent oral food challenges and experienced grade two allergic reactions or worse, though the majority of participants specifically presented with grade two symptoms.
The study's significance becomes clearer when viewed through the updated allergic reaction grading system introduced by professional allergy, asthma, and immunology societies two years prior. This revised classification system ranges from grade zero (no reaction) to grade four (death), with grade three representing severe reactions. Grade two reactions, which comprised the majority of cases in the Nephi study, represent moderate but clinically significant allergic responses that cause considerable patient distress and require immediate medical intervention.
Patients experiencing grade two allergic reactions during oral food challenges face substantial symptoms including abdominal pain, recurrent vomiting and diarrhea, persistent coughing, chest tightness, and audible wheezing detectable through auscultation. Additional manifestations may include mild hypotension and tachycardia, creating a genuinely distressing and potentially dangerous clinical scenario. The Japanese study's focus on these grade two reactions demonstrates the real-world effectiveness of epinephrine nasal spray in managing moderate allergic reactions during controlled oral food challenge procedures, providing crucial evidence for clinical practice and patient safety protocols.
