Trial reportAllergy2026
Effect of Intramuscular Adrenaline on Histamine-Induced Hypotension: A Randomised Placebo-Controlled Pilot Trial.
Trial report in Allergy, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
2 citing papers in PubMed.
- RECOVER Guidelines: First Aid. Evidence, Treatment Recommendations, Knowledge Gap Analysis, and Clinical Guidelines for Acute Allergy and Anaphylaxis in Dogs and Cats.Journal of veterinary emergency and critical care (San Antonio, Tex. : 2001) · 2026Article
- Recombinant human diamine oxidase prevents histamine-induced hypoxia, shock and death in guinea pigs.Inflammation research : official journal of the European Histamine Research Society ... [et al.] · 2026Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
13 authors.
Funding
Abstract
backgroundIntramuscular adrenaline (epinephrine) is the first-line treatment for anaphylaxis. This recommendation is based purely on consensus, not randomised controlled trials. In humans, hypotension and shock strongly correlate with plasma histamine concentrations. The efficacy of intramuscular adrenaline in reversing histamine-induced hypotension remains unproven. This trial evaluated whether intramuscular adrenaline reverses histamine-induced shock.
methodsWe conducted an exploratory open-label trial and a confirmatory randomised, double-blind, placebo-controlled, crossover trial. Healthy volunteers received a 15-min continuous intravenous histamine infusion to induce hypotension. At 5 min, participants received either intramuscular adrenaline (300-500 μg) or placebo. A second adrenaline dose was administered if the mean arterial pressure (MAP) remained below 60 mmHg at 10 min. The primary endpoint was area under the effect curve for change in MAP.
resultsDuring histamine-induced hypotension, intramuscular adrenaline failed to produce a pressor response and was indistinguishable from placebo in the majority of participants. Excluding two subjects who needed a simultaneous dose reduction of histamine, only 5 of 20 participants (25%; 95% CI 8.7%-49.1%) demonstrated a transient MAP recovery after a single dose. A second adrenaline dose administered to participants who did not reach a MAP > 60 mmHg also failed to reverse hypotension. The primary outcome in the confirmatory cohort, excluding two subjects with histamine dose adjustments, was not different between treatments (adrenaline-placebo: 7 mmHg·min, 95% CI -2 to 25; p = 0.06).
conclusionIn this study of a limited number of healthy human subjects, intramuscular adrenaline injections did not provide a sustained response in severe histamine-mediated hypotension in a majority of recipients.
trial registrationCTIS (2022-003591-16) and ISRCTN (Nr. 11335622; https://doi.org/10.1186/ISRCTN11335622).
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