Drug updated on 4/24/2024
| Dosage Form | Tablet (oral; 6.25 mg, 12.5 mg, 25 mg) |
| Drug Class | Dipeptidyl peptidase-4 inhibitors |
| Ongoing and Completed Studies | ClinicalTrials.gov |
Indication
- Indicated as an adjunct to diet and exercise to improve glycemic control in adults with type 2 diabetes mellitus.
Summary
- Alogliptin (Nesina) is recommended alongside diet and exercise to enhance glycemic control in adults with type 2 diabetes mellitus, especially when metformin is not suitable due to contraindications or intolerance.
- Five studies, including retrospective cohorts, randomized clinical trials (RCTs), systematic reviews, and meta-analyses, were analyzed.
- In evaluating safety and efficacy, alogliptin did not show significant deterioration in eGFR rates or progression of albuminuria compared to placebos and other antidiabetics, indicating renal safety over time. Although it was not the most effective in reducing hemoglobin A1c levels or fasting plasma glucose compared to placebo, it proved to be effective.
- Treatment adherence with alogliptin was found to be suboptimal compared to other medications within its class, with factors beyond drug choice playing more significant roles in patient adherence.
- Unlike saxagliptin, which increased the risk for hospitalization due to heart failure, alogliptin does not increase the risk for major cardiovascular events (MACE), mortality, and heart failure, demonstrating its relative safety among DPP4 inhibitors regarding cardiovascular considerations.
- The evidence indicates that while DPP4 inhibitors, including alogliptin, are effective second-line treatments for T2DM, the differences within the class are marginal yet noteworthy, such as fasting plasma glucose reduction favoring linagliptin slightly over others, along with slight variations in adherence rates, suggesting nuanced differences that guide individual treatment decisions.
Product Monograph / Prescribing Information
| Document Title | Year | Source |
|---|---|---|
| Nesina (alogliptin) Prescribing Information. | 2022 | Takeda Pharmaceuticals America, Inc., Lexington, MA |
Systematic Reviews / Meta-Analyses
| Document Title | Year | Source |
|---|---|---|
| Adherence to newer second-line oral antidiabetic drugs among people with type 2 diabetes-A systematic review. | 2024 | Pharmacology Research & Perspectives |
| Effects of DPP4 inhibitors on renal outcomes in diabetes mellitus: a systematic review and meta-analysis. | 2021 | Indian Journal of Endocrinology and Metabolism |
| Cardiovascular events and all-cause mortality in patients with type 2 diabetes treated with dipeptidyl peptidase-4 inhibitors: An extensive meta-analysis of randomized controlled trials. | 2021 | Nutrition, Metabolism & Cardiovascular Diseases |
| Real‑world adherence, persistence, and in‑class switching during use of dipeptidyl peptidase‑4 inhibitors: a systematic review and meta‑analysis involving 594,138 patients with type 2 diabetes. | 2020 | Acta Diabetologica |
| The efficacy and safety of dipeptidyl peptidase-4 inhibitors for type 2 diabetes: a Bayesian network meta-analysis of 58 randomized controlled trials. | 2019 | Acta Diabetologica |
Clinical Practice Guidelines
| Document Title | Year | Source |
|---|---|---|
| 2019 ESC Guidelines on diabetes, pre-diabetes, and cardiovascular diseases developed in collaboration with the EASD. | 2020 | European Heart Journal |