Adrenaline Auto-Injectors: New Devices and Improving Anaphylaxis Treatment

Anaphylaxis, a potentially life-threatening allergic reaction, requires prompt treatment with adrenaline. However, current adrenaline auto-injectors (AAIs) have limitations, leading to underuse and prompting research into improved devices. A recent European survey highlights the needs and priorities for next-generation adrenaline delivery systems.

Understanding Anaphylaxis and the Role of Adrenaline

Anaphylaxis is a severe, rapid-onset allergic reaction that can affect multiple organ systems, potentially causing respiratory or cardiovascular collapse. Adrenaline is the first-line treatment, recommended by major guidelines including the British Society for Allergy and Clinical Immunology (BSACI), Resuscitation Council UK, and the European Academy of Allergy and Clinical Immunology (EAACI). Intramuscular administration of adrenaline is crucial, but optimal prescribing and usage rates remain a concern.

Survey Reveals Clinician Perspectives on AAI Improvements

Researchers from the European Anaphylaxis Registry and the Allergy-Vigilance Network conducted a survey between March and April 2025, gathering input from 175 physicians, with allergists representing 59.4% of respondents. The survey assessed the importance of features and challenges related to current and future AAI technologies using a Likert scale.

Prioritized Features for Next-Generation Devices

The survey identified several key areas for improvement:

• Longer Shelf Life: A longer product shelf life was highly prioritized, receiving a median importance score of 9.
• Improved Storage Conditions: Improved storage conditions also received a median importance score of 9.
• Pharmacokinetic and Pharmacodynamic Data: More detailed data on how adrenaline is absorbed and affects the body was deemed significant, with a median score of 8.
• Dose Optimization: Improving the accuracy of adrenaline dosage received a median score of 8.
• Practical Considerations: Portability, availability in public spaces, and needle-free devices were also considered important design goals.

Barriers to Adopting New Adrenaline Devices

The survey also explored factors that might hinder the adoption of new devices. Physicians indicated that patients with a history of severe anaphylaxis requiring multiple adrenaline injections, or those who have been admitted to intensive care, presented the most significant barriers to switching to newer delivery systems.

Approximately 75% of respondents emphasized that recommendations from allergy societies and stronger clinical evidence would be essential for supporting the uptake of emerging technologies. Guideline endorsement and real-world patient data are seen as crucial for facilitating the transition to innovative treatment options.

Future Directions and Clinical Research

Although the study relied on physician opinions, the findings provide valuable insights into designing future adrenaline devices to better support emergency allergy care. Further clinical research involving patients with anaphylaxis will be necessary to determine if these innovations translate into improved accessibility and treatment outcomes.

Available Adrenaline Auto-Injectors in the UK

Currently, the AAIs available in the UK are EpiPen® and Jext®, designed for self-administration in emergency situations.

Disclaimer: This article provides general information and should not be considered medical advice. Always consult with a healthcare professional for diagnosis and treatment of medical conditions.