Table 6.

Comparison of Afrezza and INS-LANano.

	Criteria	Afrezza®	INS-LANano
1	Formulation technology	It is a dry powder formulation where recombinant human insulin is adsorbed onto fumaryl diketopiperazine particles as carrier to deliver insulin via the pulmonary route [4]	It is an aqueous formulation where recombinant human insulin is bound to the surface of Arginine-coated nanoglobules as carrier to deliver insulin via nasal route
2	Comparison of Pharmacokinetic Profile	In non-smoking healthy volunteers, the BA (compared to subcutaneous) is about 24.6%, 22.9% and 20.6% and the Tmax is about 12 min, 15 min and 17 min at 25 U, 50 U and 100 U doses, respectively [20]	In diabetic rats the BA and Tmax is about 23.3% and 12.5 min
3	Adverse Effects	Acute bronchospasm in patients with asthma and COPD Decline in pulmonary function over time Cough and throat pain or irritation Not recommended in patients with active lung cancer, have a history or are at risk of lung cancer [4]	Further studies needed to understand; Toxicity to nasal mucosa Physiological and protective function of nasal defensive enzyme Bioavailability on long term use Nasal dryness, irritation, sneezing, congestion [21]
4	Effect of Smoking	Not recommended for smoker patients [4]	Further studies needed to understand it. For Miacalcin Nasal Spray, smoking did not show a contributory effect on the occurrence of nasal adverse reactions)
5	Complexity of delivery device	Complex	Simple