Nuffer Wesley, Trujillo Jennifer M, Ellis Samuel L
University of Colorado Skaggs School of Pharmacy and Pharmaceutical Sciences, Aurora, CO, USA
University of Colorado Skaggs School of Pharmacy and Pharmaceutical Sciences, Aurora, CO, USA.
Ann Pharmacother. 2015 Jan;49(1):99-106. doi: 10.1177/1060028014554648. Epub 2014 Oct 13.
To review the pharmacology, pharmacokinetics, safety, and efficacy of Technosphere insulin (TI), a new inhaled insulin product.
Searches were conducted in PubMed/MEDLINE, Scientific Citation Index, and abstracts from both the American Diabetes Association (ADA) and the European Association for the Study of Diabetes (EASD) meetings from 2005 to August 2014, utilizing the search terms Afrezza, Technosphere, Afresa, and inhaled insulin. References were reviewed to identify additional sources.
Studies with adequate sample sizes, evaluating clinically relevant end points were included.
TI is approved by the Food and Drug Administration as a bolus insulin to treat patients with type 1 and type 2 diabetes. Its glucose-lowering properties are less than that of rapid-acting insulins, but it does demonstrate less hypoglycemia. TI's kinetics make it the fastest absorbed of any insulin available, although its overall onset of action appears similar to insulin lispro. It represents an alternative to bolus injections but would likely be used concomitantly with injected basal insulin. Major adverse effects are respiratory in nature, with cough being the most prominent. There is a small decrease in the forced expiratory volume in 1 s (FEV1) with TI; this appears to be consistent, nonprogressive, and reversible. Patients using TI must receive pulmonary function tests periodically throughout therapy. TI is contraindicated in patients with chronic lung disease and should be used with caution in patients who smoke.
TI is a novel inhaled insulin that provides prandial coverage to patients with diabetes, representing an alternative to bolus insulin injections.
综述新型吸入式胰岛素产品Technosphere胰岛素（TI）的药理学、药代动力学、安全性及疗效。
于2005年至2014年8月期间，在PubMed/MEDLINE、科学引文索引以及美国糖尿病协会（ADA）和欧洲糖尿病研究协会（EASD）会议的摘要中进行检索，检索词为Afrezza、Technosphere、Afresa和吸入式胰岛素。对参考文献进行回顾以确定其他来源。
纳入样本量充足且评估临床相关终点的研究。
TI已获美国食品药品监督管理局批准，作为一种餐时胰岛素用于治疗1型和2型糖尿病患者。其降血糖特性不如速效胰岛素，但低血糖发生率较低。TI的动力学特性使其成为现有胰岛素中吸收最快的，尽管其总体起效时间似乎与赖脯胰岛素相似。它是皮下注射餐时胰岛素的一种替代选择，但可能需与皮下注射的基础胰岛素联合使用。主要不良反应为呼吸道相关，咳嗽最为突出。使用TI后1秒用力呼气量（FEV1）略有下降；这似乎是持续、非进行性且可逆的。使用TI的患者在整个治疗过程中必须定期接受肺功能检查。慢性肺病患者禁用TI，吸烟者应慎用。
TI是一种新型吸入式胰岛素，可为糖尿病患者提供餐时血糖覆盖，是皮下注射餐时胰岛素的一种替代选择。
