Odegard Peggy Soule, Capoccia Kam L
School of Pharmacy, University of Washington, Seattle, WA 98195-7630, USA.
Ann Pharmacother. 2005 May;39(5):843-53. doi: 10.1345/aph.1E522. Epub 2005 Apr 12.
To review the pharmacology, pharmacokinetics, efficacy, and safety of Exubera, a novel, dry-powder formulation of insulin for inhalation, and describe patient satisfaction and quality-of-life data.
A MEDLINE search (1966-November 2004) was conducted using the key words inhaled insulin and Exubera for clinical trials limited to human research published in English. BIOSIS Previews and the American Diabetes Association Scientific Abstracts were used for published abstract information.
All available human studies of Exubera were selected for review. References of identified articles were used for additional citations.
Exubera is a rapid-acting insulin administered by oral inhalation before meals with long-acting insulin administered subcutaneously once or twice daily for type 1 or 2 diabetes mellitus. Exubera provides similar efficacy and improved patient satisfaction compared with standard subcutaneous insulin therapy (ie, NPH twice daily with regular insulin before meals). Efficacy has also been demonstrated for Exubera when used as adjunctive therapy with oral medications for type 2 diabetes. The onset of Exubera is more rapid and its duration of action is similar to that of regular insulin. To date, Exubera administered before meals with a once-daily long-acting subcutaneous insulin (usually Ultralente) has been compared with standard subcutaneous NPH/regular insulin regimens. Comparison of premeal Exubera plus a basal long-acting insulin analog (eg, glargine) with a regimen of premeal subcutaneous rapid-acting insulin analog (eg, lispro or aspart) plus a basal long-acting insulin analog (eg, glargine) is needed to fully evaluate Exubera. Pulmonary safety appears to be maintained for up to 4 years, although there are no data, as of this writing, on the use of this agent in patients with pulmonary conditions.
Exubera is an effective inhaled insulin for preprandial use in type 1 or 2 diabetes. Improved patient satisfaction over injected insulin increases its potential for use earlier in the treatment of type 2 diabetes.
综述新型吸入式干粉胰岛素Exubera的药理学、药代动力学、疗效及安全性，并描述患者满意度和生活质量数据。
使用关键词“吸入式胰岛素”和“Exubera”对MEDLINE（1966年 - 2004年11月）进行检索，纳入限于以英文发表的人体研究的临床试验。BIOSIS Previews和美国糖尿病协会科学文摘用于已发表的摘要信息。
选取所有可用的Exubera人体研究进行综述。已识别文章的参考文献用于额外引用。
Exubera是一种速效胰岛素，用于1型或2型糖尿病时，于餐前经口腔吸入给药，长效胰岛素则每日皮下注射1次或2次。与标准皮下胰岛素治疗（即每日2次中性鱼精蛋白锌胰岛素，餐前加用正规胰岛素）相比，Exubera疗效相似且患者满意度更高。Exubera作为2型糖尿病口服药物的辅助治疗时，疗效也已得到证实。Exubera起效更快，作用持续时间与正规胰岛素相似。迄今为止，已将餐前使用Exubera加每日1次长效皮下胰岛素（通常为超长效胰岛素）与标准皮下中性鱼精蛋白锌胰岛素/正规胰岛素方案进行了比较。需要将餐前Exubera加基础长效胰岛素类似物（如甘精胰岛素）与餐前皮下速效胰岛素类似物（如赖脯胰岛素或门冬胰岛素）加基础长效胰岛素类似物（如甘精胰岛素）方案进行比较，以全面评估Exubera。肺部安全性似乎可维持长达4年，不过截至撰写本文时，尚无该药物在肺部疾病患者中使用的数据。
Exubera是一种有效的吸入式胰岛素，可用于1型或2型糖尿病的餐前治疗。与注射用胰岛素相比，患者满意度提高，增加了其在2型糖尿病治疗早期使用的可能性。
