Use of Epinephrine To Save Cardiac Arrest Patients May Carry Neurological Risks: Study

The findings of a new study indicate that the use of epinephrine may increase the risk of survival for cardiac arrest patients, but may result in a higher risk of neurological damage for those patients. 

In a report published last month in the New England Journal of Medicine, researchers from the U.K. evaluated “out-of-hospital” use of epinephrine to treat cardiac arrests, to determine whether the medication actually saved cardiac arrest patients from death.

While the researchers did not specifically indicate the use of EpiPen as a delivery system, the study mentions that they looked at parenteral epinephrine administration; meaning it was not given as an oral drug or in anyway that entered the digestive system.

The clinical trial involved 8,014 patients who experienced cardiac arrest, 4,015 of whom were given parenteral epinephrine, and 3,999 of whom were given a saline placebo by paramedics working with five U.K. ambulance services.

The survival rate of cardiac arrest is historically dismal under any circumstances. According to the findings, 3.2% of the group that received epinephrine survived after 30 days, compared to only 2.4% of those given the placebo shot; suggesting a 39% increased chance of survival with the epinephrine treatment.

However, the findings indicate that severe neurologic impairment occurred in more than 31% of the survivors who received epinephrine; compared with just under 18% of those who received the placebo.

“In adults with out-of-hospital cardiac arrest, the use of epinephrine resulted in a significantly higher rate of 30-day survival than the use of placebo, but there was no significant between-group difference in the rate of a favorable neurologic outcome because more survivors had severe neurologic impairment in the epinephrine group,” the researchers concluded.

Mylan has been the subject of Congressional hearings, EpiPen lawsuits and public ridicule and derision since it sextupled the price of the epinephrine shots after purchasing the EpiPen brand in 2007. Critics claim that Mylan is price-gouging consumers by charging $600 for a pack of two EpiPens, which cost about $100 just 10 years ago.

In August, a number of EpiPen class action lawsuits were centralized for pretrial proceedings in the U.S. District Court for the District of Kansas as part of an MDL, or multidistrict litigation, under U.S. District Judge Daniel Crabtree. ALl of the lawsuits raise nearly identical allegations about anticompetitive conduct or unfair marketing practices associated with EpiPens. Most, if not all, of the complaints seek class action status to present claims for various groups of potential consumers who have used or need to use the injections, potentially impacting millions of Americans.