5-Period, 5-Treatment Crossover Study to Compare the Pharmacokinetics of Intranasal and Intramuscular Epinephrine Administration in Healthy Adult Participants

Abstract

The resolution of food protein induced enterocolitis syndrome (FPIES) is confirmed by an oral challenge (OC). The COVID-19 pandemic has delayed scheduling of OC, due to lockdown barriers to inperson care. Assessing parental attitudes on the possibility of supervised remote at-home OCs may lay the groundwork of selected low risk home OCs in facilitating early reintroduction of FPIES allergenic foods METHODS: A 12 point questionnaire was collected from FPIES parents between the ages of 2-4 years to assess attitudes towards their toddlers' FPIES status. Questions addressed FPIES re-assessment during the pandemic, parental consideration for an home oral challenge from start to finish or the option of a hybrid in-office/ home model. RESULTS: Thirty-six parents (n536) of toddlers with FPIES replied. In five children, FPIES resolved from initial diagnosis. Forty-eight percent (15/31) of parents stated that they would proceed with an FPIES OC during a pandemic, with 52% (16/31) choosing to delay. Eleven of these 16 (69%) parents agreed to proceed with a supervised at-home OC, with 2 preferring a hybrid in-office-home model. Thirteen of 15 (87%) parents agreeing to proceed with an FPIES OC ASAP would also agree for home challenge. CONCLUSIONS: The majority of FPIES families preferred the choice of an in-home OC, 77% (24/31) due to the current pandemic, with a hybrid model being less desired. Resolution of FPIES occurred in 14%. With significant familial interest in home OC for diagnosis of continued FPIES, further research into appropriate selection and monitoring, for home FPIES OC is needed.