Aspectos básicos de la insulina aspart: ventajas potenciales derivadas de su mayor estabilidad fisicoquímica

Javier Ampudia-Blasco, F.

doi:10.1016/S1134-3230(12)70018-2

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Resumen

Bibliografía

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Resumen

La análogos de insulina de acción rápida (AIAR; aspart, lispro, glulisina) presentan un perfil farmacocinético más parecido a la secreción fisiológica de insulina que la insulina regular humana, con un mejor control de la glucemia posprandial y menor riesgo de hipoglucemia. Aunque, en general, se admite que los AIAR presentan una eficacia y seguridad similares, sus diferencias en la estructura molecular y formulación hacen que su estabilidad fisicoquímica sea distinta. Aspart ha demostrado tener mayor estabilidad molecular, menor tendencia a la agregación y formación de fibrillas insolubles de insulina y, en consecuencia, un menor riesgo de oclusión de catéter en usuarios de bombas de insulina. Por ello, aspart es el único AIAR aprobado para ser usado hasta 6 días en perfusión subcutánea continua de insulina (ISCI). Además, aspart ha sido evaluado en todo tipo de pacientes y ha sido aprobado para ser utilizado en pacientes pediátricos mayores de 2 años y también, específicamente, en aquellos en tratamiento con ISCI.

Palabras clave:

Diabetes mellitus

Análogos de insulina de acción rápida

Fibrilación

Estabilidad molecular

Aspart

Lispro

Glulisina

Perfusión subcutánea continua de insulina

Abstract

Rapid-acting insulin analogues (RAIA) – aspart, lispro, glulisine – have a more similar pharmacokinetic profile to physiological insulin secretion than human regular insulin, improving control of postprandial hyperglycemia and reducing the risk of hypoglycemia. Although it is generally accepted that the efficacy and safety of RAIA are similar, their differences in molecular structure and formulation lead to distinct physical-chemical stability. Aspart has been demonstrated to have greater molecular stability and a lower tendency to aggregation and formation of insoluble insulin fibrils and, consequently, a lower risk of catheter occlusion in insulin pump users. Therefore, aspart is the only RAIA approved to be used for up to 6 days in continuous subcutaneous insulin infusion (CSII). In addition, aspart has been evaluated in all types of patient populations and has been approved for pediatric patients older than 2 years old and, specifically, in patients under CSII therapy.

Key words:

Diabetes mellitus

Rapid-acting insulin analogues

Fibrillation

Molecular stability

Aspart

Lispro

Glulisine

Continuous subcutaneous insulin infusion

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