Aerosolized GLP-1 for Treatment of Diabetes Mellitus and Irritable Bowel Syndrome

Abstract

Diabetes is a global burden and the prevalence of the disease, in particular diabetes mellitus type 2 is rapidly increasing worldwide. After introduction of insulin into clinical therapy about 90 years ago a major number of pharmaceuticals has been developed for treatment of diabetes mellitus type 2. One of these, the incretin glucagon-like peptide 1 (GLP-1), like insulin, needs subcutaneous administration causing inconvenience to patients. However, administration of GLP-1 plays also a role for treatment of irritable bowel syndrome (IBS). To improve patient convenience inhaled insulin (Exubera(®)) was developed and approved but failed market acceptance some years ago. Recently, another inhalative insulin (Afrezza(®)) received market approval and GLP-1 may serve as another candidate drug for inhalative administration. This review analyzes the current literature investigating alternative administration of GLP-1 and GLP-1 analogs focusing on inhalation. Several formulations for inhalative administration of GLP-1 and analogs were investigated in animal studies, whereas there are only few clinical data. However, feasibility of GLP-1 inhalation has been shown and should be further investigated as such type of drug administration may serve for improvement of therapy in patients with diabetes mellitus or irritable bowel syndrome.

Technosphere Inhaled Insulin: Is Faster Better?

“…Also, fear of lung toxicity or tumor development has been lessened somewhat by in vitro cytotoxic (2) and in vivo clearance (3) studies, plus a 2-year clinical trial showed no differences in pulmonary imaging or function in Technospheretreated and untreated subjects with diabetes (4). In addition, aerosolized medicines that have effective absorption into the bloodstream are well established (5), with numerous agents having been tried including glucagonlike peptide 1 (6).…”