In 2006, Pfizer’s inhaled insulin product, Exubera, was approved by the FDA. One year later, Pfizer discontinued the drug/device combination due to slow sales. This was an unprecedented move considering that the drug was considered to be as efficacious as its injected insulin counterparts.

In 2014, Mannkind introduced its own inhaled insulin drug/device combination called Affreza. This device was significantly smaller than the cumbersome Exubera delivery platform, which was sited as one of the main reasons Pfizer’s version never gained acceptance, but Affreza still didn’t catch on like Mannkind hoped.

Inhaled insulin, although effective and possibly preferable to injected insulin therapy, has a questionable future due to its inability to completely replace injectable insulin. It is unclear, however, why it did not catch on as a form of emergency therapy.

Tricia Santos Cavaiola, MD
Division of Endocrinology, Diabetes, and Metabolism: University of California San Diego