Head-to-head evidence
Afrezza vs insulin icodec
Same mechanism, same race: design-graded trial evidence for both assets, with the grading rationale shown. Grades describe the quality of the evidence, never the merits of either security.
Type 2 Diabetes
Shared mechanism: Insulin receptor (basal) · full Type 2 Diabetes pipeline
Afrezza
Marketed by MannKind Corporation
NCT00332488 · Phase 3 · completed
The trial randomized 528 participants across three treatment groups and used an active comparator, but it was open-label rather than blinded and its primary endpoint was the surrogate measure HbA1c. The primary comparison was not met: HbA1c decreased by 0.70% with inhaled insulin plus metformin versus 0.78% with metformin plus secretagogue (p=0.420).
insulin icodec · Awiqli
Marketed by Novo Nordisk
NCT04760626 · Phase 3 · completed
The study was randomized and actively controlled, but it was open-label, with 542 participants assigned to insulin icodec and 543 to once-daily basal insulin analogues. The primary HbA1c endpoint was met for non-inferiority, but HbA1c is a surrogate measure rather than a hard clinical or endoscopic endpoint, supporting a moderate evidence grade.
Next expected readout: October 2027 · NCT07747402 (registry estimate)
The full competitive landscape for each asset (every same-race competitor with aligned evidence, sortable) is on the asset pages: Afrezza's landscape · insulin icodec's landscape