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Ono
01-27-2006, 05:03 PM
FDA Approves Inhaled Insulin For Diabetics

Friday, January 27, 2006

WASHINGTON — The first inhalable version of insulin won federal approval Friday, giving millions of adult diabetics an alternative to some of the regular injections they now endure.

Inhaled Insulin Appeals to Diabetes Patients

The Food and Drug Administration said the Pfizer Inc. insulin, to be marketed as "Exubera," is the first new way of delivering insulin since the discovery of the hormone in the 1920s. Pfizer jointly developed the drug and dispenser with Sanofi-Aventis and Nektar Therapeutics.

Use of rapid-acting inhaled insulin will not replace the need to occasionally inject the hormone, according to the FDA. And diabetics will have to continue pricking their fingers to test blood sugar levels.

The FDA delayed its decision by three months so it could review chemistry data on the diabetes treatment. The European Commission approved Exubera for use in adults on Thursday.

Analysts have said the inhaled insulin could eventually become a $1 billion-a-year seller for Pfizer, which recently agreed to pay Sanofi-Aventis $1.3 billion to obtain full worldwide rights to the drug for use by both Type 1 and 2 adult diabetics.

"Until today, patients with diabetes who need insulin to manage their disease had only one way to treat their condition," said Dr. Steven Galson, director of the FDA's Center for Drug Evaluation and Research. "It is our hope that the availability of inhaled insulin will offer patients more options to better control their blood sugars."

Clinical trials found that Exubera managed blood sugar levels just as well as injected insulin, but an independent FDA panel in September stressed that use of inhaled insulin will not mean diabetics can toss out the needles, pens or pumps used to inject the hormone.

Inhalable insulin is a welcome advance, said Dr. Nathaniel Clark, the national vice president for clinical affairs for the American Diabetes Association. But he added that needles still will allow a patient to better control dosage.

"Injecting insulin is far more precise in the sense of, what you want to deliver you deliver. You don't have to deal with any questions of how much is delivered through the lungs," Clark said.

The FDA review panel also expressed concern about the bulkiness of the Exubera dispenser and about some patients who experienced coughing or a slight decrease in lung capacity when using the drug. Pfizer will conduct studies on the long-term effects of Exubera on the lungs, as well as the safety and effectiveness of the drug on patients with lung disease, the FDA said.

The American Diabetes Association estimated that nearly 21 million people in the U.S. have diabetes, although about one-third do not know it. The number of people with diabetes is believed to have tripled in the past quarter-century.

Diabetics with either type of the disease could use the rapid-acting inhaled insulin before or after meals to manage their blood sugar levels. However, the drug would not replace the longer-acting insulin injections that some diabetics, particularly those with Type 1 diabetes, need to take in the morning or before bed.

"You're not going to eliminate the needles in Type 1. For Type 2, it really depends on the stage," said Dr. Will Cefalu, a clinical investigator for both Pfizer and Eli Lilly and Co., which is developing its inhalable insulin system with Alkermes Inc.

Most diabetics have Type 2, a condition linked to obesity that occurs when the body cannot effectively use the insulin it makes. Sometimes the disease can be treated with pills instead of injections when matched with a diet, exercise and weight-management plan.

Pfizer believes Exubera will encourage diabetics who are squeamish about needles to take the insulin they need to tightly control their blood sugar levels. About 15 percent of diagnosed diabetics do not take the insulin or pills they should, according to American Diabetes Association estimates. Better control of blood sugar levels allows diabetics to ward off other serious complications, including diseases of the eye, kidneys and nerves. The latter can lead to ulcers and infections in the legs and feet and, in some cases, amputations.

The Exubera device is about the size of an eyeglass case. It delivers insulin, as a dry powder packaged in one- or three-milligram inhalable capsules, to the lungs through the mouth, according to Pfizer.

Diabetics with poorly controlled or unstable lung disease, or who smoke or recently quit, shouldn't use Exubera, the FDA said. And patients should have their lungs checked before using the drug, as well as at six to 12 month intervals after that.

The world's largest pharmaceutical company initially will have the inhaled insulin market to itself.

"We will be the first out there and for a while," said John LaMattina, president of global research and development for Pfizer. Eli Lilly and Co., Kos Pharmaceuticals Inc., MannKind Corp. and Novo Nordisk A/S all are developing their own versions.

"It's not going to be an overnight sensation," said Dr. Robert Goldstein, chief scientific officer for the Juvenile Diabetes Research Fund International. "My concern is that people will assume they are now free of insulin shots."

http://www.foxnews.com/story/0,2933,183045,00.html

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Electric
01-27-2006, 06:49 PM
Inhalable insulin looks like fabulous news for diabetics - This was almost as good as the 'prickless' or bloodless glucometers, to test blood sugars*. Meanwhile, this new drug needs very careful monitoring, once it's out there used by the public. Some of these "miracle" drugs are too good to be true, or have horrid side effects. Amaryl for instance, was touted as a great new diabetic drug. Indeed, it worked very well, and quickly became a prescription of choice. Trouble is, like 'Fen-fen" a diet drug, Amaryl had a deleterious effect on the heart valves. Users of new drugs should always be carefully monitored. Hopefully, family members would be given good info, as they are the primary eyes and ears for their diabetic loved ones.

* ON LESS INVASIVE GLUCOMETERS - http://www.diabetesmonitor.com/other-3a.htm#NIVM

Topics on the page linked above include:
Blood Glucose Meters | Non-invasive and Minimally-invasive Glucose Monitors | Devices that measure Glycohemoglobin | Computer Software | Other Devices and Products

*Blood Glucose Meters [They have a good list of products, marked with stars or X's]

*The following are at the DiabetesMonitor:
factors in selecting a blood glucose meter
how accurate is the reading my meter gives me?
lag time in alternativeland
meter memories
meters & management
navigating lows and highs
noninvasive blood glucose monitors
stripping down the cost of testing
third-generation meters
why bother to calibrate?
troubleshooting for the blood glucose meter
which blood glucose meter to get?

*Non-Invasive and Minimally-invasive Glucose Monitors...long list, below is newest...
.....
Continuous Monitoring Technology (http://www.diabetesnet.com/diabetes_technology/new_monitoring.php) "Work is advancing on easier testing technologies, currently a $3 billion yearly market, as companies try to capture a dominant share of this lucrative monitoring market. To be a player, testing has to be easy, accurate, and forego painful finger-sticks."

Animas (http://www.animascorp.com/products/pr_glucosesensor.shtml) "Animas is developing a long-term (>5 years), implantable, optical sensor, which will provide continuous and accurate monitoring of blood glucose levels. This sensor will be equipped with alarms to give warnings of impending hypoglycemia and hyperglycemia. Ultimately this sensor will be tied into an insulin infusion pump to provide closed-loop control of blood glucose levels. The Company believes that this sensor will be available commercially in 2003. The Animas sensor measures the near-infrared absorption of blood. The sensor will be implanted across a vein with readings transmitted via radio waves (RF telemetry) to a small Display Unit worn on the wrist. Hence, there will be no percutaneous (through the skin) wires. The Display Unit will be about the size of a wrist-watch and the implanted sensor about the size of a pager."
Forthcoming Non-Invasive Meters at Blood Glucose Meters, part of On-line Diabetes Resources, by David Mendosa.

LifeTrac Systems, Inc. (http://www.sugartrac.com) "Will soon be launching the next generation of non-invasive glucose monitoring systems - Sugartracâ - a bloodless technology that is accurate, painless and user friendly."

go to What's New page Guardian® RT Continuous Glucose Monitoring System (http://minimed.com/products/guardianrt/index.html) From Medtronic MiniMed. [Link added 12Aug2005.]

**They have information on other devices and computer software too!
http://www.diabetesmonitor.com/other-3a.htm#NIVM
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The Main Page for Diabetes Monitor is:
http://www.diabetesmonitor.com/index.htm

*You don't even have to sign in! :beer: (non-alcoholic, sugar free root-beer!)