How Did the Insulin Inhaler Do in Clinical Trials?

Recently approved for the US market is the inhaled insulin Afreeza, an inhaler that uses "Technosphere Insulin Inhalation Powder."

Diabetes patients understandably have their reservations: will an inhaler be as effective as other methods? Will blood sugar be less controlled by an inhaler? On the other end of the spectrum, the idea of not having to pierce the flesh with a syringe, pen or pump appeals to virtually every diabetic who goes through that ritual multiple times each day.

So what does the clinical trial data say about Afreeza?

The data was presented at the most recent meeting of the American Diabetes Association by Bruce W. Bode, MD., and Julio Rosenstock, MD., for both type 1 and type 2 diabetes.

Type 1

"Technosphere Insulin Inhalation Powder showed equivalent HbA1c reduction for patients with type 1 diabetes compared with subcutaneous rapid acting analog insulin," the researchers reported. "And [it] demonstrated significant differences in total hypoglycemia and weight gain."

They elaborated that the inhaler "provided effective glycemic control to subjects with type 1 diabetes" and determined that it was "not inferior in HbA1c reduction vs. insulin aspart." Furthermore, fewer hypoglycemic events occurred in the group using the inhaler.

Type 2

Results among type 2 patients were similar, although not quite as good.

"Technosphere Insulin Inhalation Powder as the initial prandial insulin in patients with type 2 diabetes compared with one or more oral agents effectively reduced postprandial glucose excursion consistent with its time-action profile."

The drawback—patients using the inhaler experienced more hypoglycemic events than the group receiving a sulfonylurea like Glipizide.

Photo: Diabetes Mine, Clinical Correlations

An example of an insulin inhaler with insulin powder refill packs.