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Post by letitride on May 22, 2018 8:09:23 GMT -5
Technosin its so good its sinful!
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Post by kball on May 22, 2018 8:37:15 GMT -5
What about Grinsulin? Did bioexec trademark that one?
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Post by mnkdfann on May 22, 2018 8:43:24 GMT -5
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Post by bioexec25 on May 22, 2018 9:05:56 GMT -5
What about Grinsulin? Did bioexec trademark that one? Not yet. :-)). Actually suppose the clinical name should be more like Technosulin. Hehe. Next year bring one of your Ernie's and we'll jam at the ASM dinner.
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Post by agedhippie on May 22, 2018 9:07:55 GMT -5
Afrezza is so different, I am starting to think MNKD should not even be telling people its insulin. IMO, they should be putting the fact its human insulin in microfont on the label so you need a magnifying glass to read it. Its just confusing people.
Everyone knows insulin is bad; needles; hypos; end of the road in treatment. Even long time posters like "Aged" confuse it and want to point to the DAWN study which had nothing to do with afrezza.
That is the issue, Afrezza is insulin. I can understand calling it something else would help, but the FDA and other national regulators would never allow that. The DAWN study was about what people thought of insulin, and Afrezza is an insulin. Distinguishing Afrezza from RAA requires educating the market and that takes time - it was true every time new insulins were introduced (animal -> Human -> RAA). The upside is that you get there in the end!
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Post by centralcoastinvestor on May 22, 2018 9:48:10 GMT -5
Afrezza is so different, I am starting to think MNKD should not even be telling people its insulin. IMO, they should be putting the fact its human insulin in microfont on the label so you need a magnifying glass to read it. Its just confusing people.
Everyone knows insulin is bad; needles; hypos; end of the road in treatment. Even long time posters like "Aged" confuse it and want to point to the DAWN study which had nothing to do with afrezza.
That is the issue, Afrezza is insulin. I can understand calling it something else would help, but the FDA and other national regulators would never allow that. The DAWN study was about what people thought of insulin, and Afrezza is an insulin. Distinguishing Afrezza from RAA requires educating the market and that takes time - it was true every time new insulins were introduced (animal -> Human -> RAA). The upside is that you get there in the end! Aged, I think that you are on to something here. The DAWN study showed that there is an industry wide, diabetics community wide stigma surrounding insulin. I never would have guessed how entrenched that feeling is with both doctors and patients. As the DAWN study showed, its not just about the hypoglycemia concern (which is well founded with current products) its also about the sense that people have that they failed if they have to use insulin. I even think the doctors believe that. Wow. I also believe Dr. Kendall knows this and why he is so focused on building awareness of the science behind Afrezza. With Afrezza, taking insulin first is the new mantra not taking insulin last because a person “failed” to control their diabetes. What a paradigm shift!
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Post by bradmel on May 22, 2018 10:44:16 GMT -5
I have always liked "INSULOUT" Fast in and Fast out! It describes exactly how Afrezza works and differentiates Afrezza from the rest of the pack.
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Post by dreamboatcruise on May 22, 2018 13:32:21 GMT -5
Once upon a time I remember reading the biggest difference between Afrezza and RAAs besides administration thru inhalation was that Afrezza was monomeric and RAAs were Hexomeric and that had alot to do with the PK/PD am I dilusional or did that just get lost somewhere? That is one of the reasons for fast uptake through the lung capillaries, but it's a pretty hard story to tell as most people, even doctors, I've spoken to know nothing about polymers or why a hexamer behaves differently in lung vs pancreas vs subq. It seems the company is instead focusing on the other key aspect of speed that it is the large surface area of the lungs that allows such rapid transport.
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Post by hellodolly on May 22, 2018 15:22:38 GMT -5
Once upon a time I remember reading the biggest difference between Afrezza and RAAs besides administration thru inhalation was that Afrezza was monomeric and RAAs were Hexomeric and that had alot to do with the PK/PD am I dilusional or did that just get lost somewhere? That is one of the reasons for fast uptake through the lung capillaries, but it's a pretty hard story to tell as most people, even doctors, I've spoken to know nothing about polymers or why a hexamer behaves differently in lung vs pancreas vs subq. It seems the company is instead focusing on the other key aspect of speed that it is the large surface area of the lungs that allows such rapid transport. You don't mean that Endos don't understand this?
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Post by dreamboatcruise on May 22, 2018 15:40:32 GMT -5
That is one of the reasons for fast uptake through the lung capillaries, but it's a pretty hard story to tell as most people, even doctors, I've spoken to know nothing about polymers or why a hexamer behaves differently in lung vs pancreas vs subq. It seems the company is instead focusing on the other key aspect of speed that it is the large surface area of the lungs that allows such rapid transport. You don't mean that Endos don't understand this? I would hazard a guess that even with endos far from all actually understand the details... such as why the pancreas that stores and releases insulin primarily in hexamer form can match the pk/pd of Afrezza. Or why RAAs, which supposedly prevented formation of hexamers still have pretty slow profiles. I've talked to doctors and pharmacists that had reasonably good grasp on use of insulin that were basically clueless. Most endos I suspect are more into researching clinical results of drugs rather than the details of why a pk/pd profile is what it is. The latter would really only be useful to those trying to formulate new drugs... or those investors looking at the competitive landscape from a scientific standpoint.
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Post by mnholdem on May 22, 2018 16:06:41 GMT -5
So, in other words, publications should lay it out in laymen's terms - excellent TIR control with statistically significant reduction of severe hypos - and back it up with the scientific detail for those HCPs who are so inclined to dig into the science.
One thing I've noticed about seasoned thought leaders, like Dr. Kendall, is that they can simplify complex analysis. I'm sure that the attendees at the ASM noticed that MannKind's CMO has that skill.
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Post by centralcoastinvestor on May 22, 2018 16:45:46 GMT -5
So, in other words, publications should lay it out in laymen's terms - excellent TIR control with statistically significant reduction of severe hypos - and back it up with the scientific detail for those HCPs who are so inclined to dig into the science. One thing I've noticed about seasoned thought leaders, like Dr. Kendall, is that they can simplify complex analysis. I'm sure that the attendees at the ASM noticed that MannKind's CMO has that skill. From Barnstormers post in this thread: Dr. Kendall stated the following: “Other insulins are ancient, barbaric and unreliable.” Yes he said that I am not making it up. He has been contacted by the CMO (his predecessor) at the ADA to discuss Afrezza. He has convened a group of 13 of the top doctors in the endocrinology field to review some of the gold. He has mined from the existing MNKD studies to advise on how to improve awareness. “No new studies need to be done” we have what we need and don’t need to incur the cost of more studies. In addition to the STAT study the post for the hypoglycemic study that will be at ADA has 18K data points 10% of which match Afrezza against Novolog. (Please not that I was doing my best to follow and take notes so there may be some inaccuracies here). Dr. Kendall covers a lot of ground fast He created a new Advisory Board which also includes top medical professionals. He has created a group of 4 medical liaisons soon growing to 7 that will be working to get into institutions that won’t see sales reps. Dr. Kendall was very good at speaking in terms that the average person could understand. He is going to help everyone understand what Afrezza can do and why.
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Post by dreamboatcruise on May 22, 2018 17:07:38 GMT -5
So, in other words, publications should lay it out in laymen's terms - excellent TIR control with statistically significant reduction of severe hypos - and back it up with the scientific detail for those HCPs who are so inclined to dig into the science. One thing I've noticed about seasoned thought leaders, like Dr. Kendall, is that they can simplify complex analysis. I'm sure that the attendees at the ASM noticed that MannKind's CMO has that skill. Can also be a bit of a give and take with other KOL, so that company messaging starts lining up with voices amplifying it. But, absolutely, that is where someone like Dr. Kendall and the Medical Affairs team will earn their keep. There are a lot of different stakeholders that may require different, but consistent, messaging. I do like the fact it seems they are beefing up Medical Affairs. Sales reps can't talk about science that isn't on the label... the Medical Affairs team can. "Healthcare providers can receive evidence-based, scientific responses to their questions about MannKind products by using the link to the left (Healthcare Professionals)."Right now we're early in the process of new era of CGMs with doctors looking at it from different perspectives, as can be seen by all the different views expressed in this article... diatribe.org/cgm-and-time-range-what-do-diabetes-experts-think-about-goals
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Post by sayhey24 on May 22, 2018 18:37:50 GMT -5
The short coming of this article is most of the "experts" interviewed have no inexperience with afrezza - got to love Edelman. It would be like going back to 1922 and Banting and Best who are driving a Model T and asking them what they think of a Ferrari 488.
Aged got me thinking so I conducted my own "Un-scientific" study today. I asked 20 people their view of insulin and about T2s using it. It was like the Dawn Study results all over again but worse. 100% viewed going on insulin as bad and most viewed it as a failure on the part of the T2.
I guess I knew insulin was seen some what negatively but not that bad. Mike is going to need an awesome marketing campaign where insulin is the last word mentioned and its buried on the label in microfont as "active ingredient - human insulin".
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Post by dreamboatcruise on May 22, 2018 19:01:08 GMT -5
The short coming of this article is the "experts" interviewed have no inexperience with afrezza. It would be like going back to 1922 and Banting and Best who are driving a Model T and asking them what they think of a Ferrari 488. Aged got me thinking so I conducted my own "Un-scientific" study today. I asked 20 people their view of insulin and about T2s using it. It was like the Dawn Study results all over again but worse. 100% viewed going on insulin as bad and most viewed it as a failure on the part of the T2. I guess I knew insulin was seen some what negatively but not that bad. Mike is going to need an awesome marketing campaign where insulin is the last word mentioned and its buried on the label in microfont as "active ingredient - human insulin". I suspect more of them than you would guess are aware of Afrezza. Docs are conservative and many view things strictly from the evidence based perspective. There are fairly recent papers looking at the issue of PPG spikes and clinical outcomes that have been less than conclusive. It may be that these knowledge leaders in diabetes are total unaware of Afrezza, but it may also be that they are aware but as yet unconvinced by the small amount of data linking TIR/PPG-excursions to the important clinical outcomes. Now that we have easy access to CGMs I think that situation will change... but I think some of these KOLs are going to require clinical studies not just pretty CGM pictures. Whereas others will get on board quicker. That's what I see in this discussion. Of course hypos is an area where you can see the agreement is strong. As for car analogies (as flawed as most analogies usually are)... back in 1922 one would would have been spot on to have said anyone would be out of their mind to buy such a car to drive on public roads if the specs of a Ferrari 488 were given to them.
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