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Post by sayhey24 on Aug 16, 2016 17:32:52 GMT -5
I sure had hoped that it would have already become the Gold Standard - boy, was I wrong. I really thought by now the biggest issue would be manufacturing capacity and we are not even getting 300 scripts a week. I don't understand it. Now we have 70 sales dogs. You would think that if each one visited 5 endos a week they should be able to get at least 2 new scripts per endo per week. Assuming 2000 prescribing endo's if each one wrote 2 new scripts a week thats 4000. It make no sense to me. Even if afrezza was just an OK "inhaled" product each endo should be writing 1 script a week just for their patients who would rather inhale but afrezza is the greatest advancement in diabetes treatment in 90 years. Man, I just don't get it. As a diabetic my insulin keeps me alive, if it screws up there is a good chance it's not a survivable experience for me and really fast. As a Type 1 that's somethink you live with every day. From and endo's standpoint it's the combination of non-inferiority and the black box warning. Why change someone onto a drug that has more side effects than the one they are on for no better result? The Endos are not going to believe salesmen but they are going to believe trial data, their own experience, and a few trusted colleagues. The best the sales force is going to achieve is to get an endo to agree to prescribe it for a couple of patients. The endo has to find someone who they knows is an early adopter, where they feels justified in changing the patients insulin, or asks (Sweedee's dad for example) then they are going to wait and see what happens. If all goes well they will add a few more people and wait. Rinse and repeat. Rome wasn't built in a day. As you said if it screws up there is a good chance it's not a survivable. If the endo has the opportunity to reduce the risk of severe hypoglycemia and even save one life. I would think that is reason enough. If the endo has the opportunity to help improve the quality of life for his patients I would think thats another reason. If they want to do some homework and see that the 20% in the 171 study who took a second dose of afrezza after 90 minutes had a significant improvement in A1c they may figure out why the label reads as it does. I watched my cousin die from hypoglycemia and my father go through T2 hell from pills to 1 shot a day to multiple shots and then have the massive heart attack. You want to talk about side effects? If afrezza was available back then I would have them both on it. After more than a dozen years I am sure they had a few buildings in Rome. I sure hope the Romain army of new sales dogs start hounding those endos and if they need to carry around 171 with them and explain it to them then do so.
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Post by mnholdem on Aug 16, 2016 18:02:47 GMT -5
Becoming a new Gold Standard takes a lot of evidence...and even empirical evidence doesn't always sway the medical community, who have been following basically the same protocols - with the addition of a few potentially dangerous new drugs - for over two decades. Why should Afrezza be taken seriously and considered as a first-line treatment? The late Alfred E. Mann had some thought-provoking information on the subject of diabetes treatment when he was interviewed by Amy Tenderich in November 2009: Al Mann: What we have is a different form of insulin. It's powder so we deliver it into the lungs. But that's an advantage because it's delivered in the arterial blood system instead of the capillary system. We're actually delivering insulin monomers (molecules). Nobody ever did that before.
It behaves much like normal pancreatic insulin does. Normal people don't get hypos, and people taking Afrezza don't either, even if they dose and don't eat.
DiabetesMine: How is that possible?
Al Mann: Other insulins create an enormous period of hypoglycemia because there's an excess of insulin after you've digested your meal.
What happens is that if you eat a meal on regular insulins, Lantus and Humalog for example, 80% of the insulin remains in your body for up to 10-12 hours after your meal, which causes hypoglycemia.
With Afrezza, there's no complex meal titration. You take a set amount, matched to your body mass and insulin resistance, determined with your doctor. You take that same amount every time you eat a meal. Then it's not important whether you eat 50 grams of carbs or 100 grams or even zero. Afrezza essentially "turns off glucogenesis" so no glucose is secreted from the liver in reaction to food. Our trial studies are showing that patients are having no more glucose highs than normal non-diabetic people, and no more lows.
DiabetesMine: That sounds pretty magical. Does this work for Type 2s only, or is it an option for Type 1s now taking basal and bolus insulin?
Al Mann: Both could use it. Afrezza is for prandial control — mealtime only - not basal doses. For about 70% of Type 2s, all you'll need is a regular set dose of Afrezza. This will work for everyone except the "late-stage" Type 2s, who will need to take basal insulin as well.
It's different for Type 1's because there's a very big therapeutic window for them; their insulin needs are so differing. They can use Afrezza to cover meals, yes, but they'll still have the issue that if they dose and don't eat anything, they'll get hypo, and if they eat a large meal, they'll need a larger dose.
The advantage for all patients is that they won't have to do carb counting or anything, because Afrezza does not have to be so precisely matched to food intake.
...
DiabetesMine: So can you explain the details of dosing Afrezza?
Al Mann: The cartridges come in [multiple] units. Again, for Type 2s, their doctor will help them select a regular dose based on their body mass and level of insulin resistance. If a person is already on insulin, you'll multiply the amount of rapid-acting insulin analog you're now taking by three, and that's where you'll start for your original dose. You need about three times as much Afrezza as you do for an insulin injection.*
DiabetesMine: Aren't most Type 2s currently treated with a basal insulin only, instead of mealtime dosing?
Al Mann: Yes, but that's the wrong way around. The correct therapy should be a good prandial insulin and not long-term insulin — Afrezza in particular because it turns off glucose production and delivery from the liver. Our latest trials of 600 patients are showing even more significant benefits from the product than our original trials; the most recent trial appears to show that this should replace frontline treatment for all Type 2 patients.
Source: www.healthline.com/diabetesmine/the-truth-about-afresa-inhalable-insulin-a-chat-with-al-mann#2
* NOTE: Because of advancements in the design of both the Technosphere particle and the inhaler that have occurred since this interview was published (2009), the ratio of Afrezza to injected insulin has changed from the 3:1 ratio stated by Al Mann. However, it seems clear that Al considered the most important feature of Afrezza to be that it doesn't result in "an excess of insulin after you've digested your meal". The new term "OUTsulin" very much fits what Al Mann was trying to teach the medical community about his new Technosphere insulin.
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Post by peppy on Oct 2, 2016 18:21:08 GMT -5
Is this outsulin?
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Post by sla55 on Oct 2, 2016 18:27:38 GMT -5
Is this outsulin?
This is Olaf from the extremely popular Disney movie "Frozen". Every children these days know very well who he is. en.wikipedia.org/wiki/Olaf_(Disney)
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Post by kball on Oct 2, 2016 18:27:43 GMT -5
Is this outsulin?
Looks like we found Hakan!!!!
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Post by sportsrancho on Oct 2, 2016 18:55:41 GMT -5
Is this outsulin?
Looks like we found Hakan!!!! Ok, that was really funny!
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Post by broncolife on Oct 3, 2016 9:18:22 GMT -5
What bigger endorsement for the use in pediatrics than Disney and Olaf. 😉
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Post by corpplanner on Oct 3, 2016 16:00:09 GMT -5
Did MNKD have to pay to license "Olaf?"
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Deleted
Deleted Member
Posts: 0
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outsulin
Oct 3, 2016 16:07:10 GMT -5
via mobile
Post by Deleted on Oct 3, 2016 16:07:10 GMT -5
Did MNKD have to pay to license "Olaf?" I am assuming Olaf was just present in the event and happened to stop by. It wasn't Mannkind
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Post by mannmade on Oct 3, 2016 16:10:14 GMT -5
It's likely the character walked the grounds of the event to take pictures with all participants...
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Post by corpplanner on Oct 3, 2016 16:12:43 GMT -5
Looks like Olaf is holding an Afrezza inhaler in his hand? Works for me if MNKD gets the benefit of Olaf without licensing!
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Post by goyocafe on Oct 3, 2016 17:00:15 GMT -5
Looks like Olaf is holding an Afrezza inhaler in his hand? Works for me if MNKD gets the benefit of Olaf without licensing! They had to sign an agreement that gave Olaf 65% of future profits to stand there. 😁
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Post by twibs66 on Oct 3, 2016 18:33:59 GMT -5
Looks like Olaf is holding an Afrezza inhaler in his hand? Works for me if MNKD gets the benefit of Olaf without licensing! They had to sign an agreement that gave Olaf 65% of future profits to stand there. 😁
haha, no doubt we'd have had better results with Olaf than the french feckers !!!!
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