Failed insulin drug technology may play key role in stemming maternal mortality

Companies working to deliver oxytocin by inhaler in Africa where one in 10 women suffer excessive bleeding after childbirth

A hormone treatment based on technology used in Pfizer’s failed inhalable insulin shows promise in fighting the leading cause of maternal mortality.

Six years after Pfizer pulled Exubera from the market at a cost of more than $2.8 billion, scientists at Melbourne's Monash University are revisiting the inhalable technology to deliver a life-saving medicine to stop post-delivery hemorrhage.

The Bill and Melinda Gates Foundation is backing the effort to produce a better way to give oxytocin, a brain chemical that helps the uterus contract after birth.

The project is one of several testing inhalations to deliver medicines, salvaging the know-how of a product that was taken off the market after just 14 months of lacklustre sales.

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"Exubera was the first generation," said John Patton, one of the original inventors of Pfizer's inhaled insulin technology system. "When you're first, you take a lot of bullets.

“With the developments in the industry, it’s just a matter of time before we will be inhaling lots of medicine.”

The lead scientist for the Monash project, Michelle McIntosh, says her group plans to start testing a dry-powdered form of oxytocin by early 2014.

Patton's company, Dance Biopharm, is working on an inhaled insulin, as is Mannkind, the biotech company founded by billionaire investor Alfred Mann.

Inhalations may not only avoid unpleasant injections. In the case of oxytocin, the need for refrigerated storage and sterile needles has limited the hormone’s use in Africa, where post-partum hemorrhage, the primary cause of almost a quarter of maternal deaths globally, is most frequent.

Inhalers get around that problem.

The Monash Institute of Pharmaceutical Sciences got more than $1 million from the Gates Foundation to develop a method for delivering oxytocin via a disposable inhaler that requires no specific training or refrigeration.

Fewer than half of births in Africa are attended by someone skilled in midwifery, according to the World Health Organization. Oxytocin is an essential medicine that countries should stockpile, says the WHO, which recommends the hormone be offered to all women during childbirth to prevent hemorrhage, or the loss of more than a pint of blood.

The highest prevalence is in Africa, where about 10.5 per cent of women encounter excessive bleeding after childbirth, according to the Geneva-based agency. Scientists’ Challenge

Used preventively, oxytocin can cut the rate of post-delivery bleeding complications by half by causing muscles in the uterus to contract, closing off damaged blood vessels. Patton's former company, Nektar Therapeutics, worked with Pfizer on Exubera until 2007. The 66-year-old scientist is now chief executive officer of Dance Biopharm in San Francisco. – Bloomberg