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Alogliptin

(Nesina®)

Nesina®

Drug updated on 12/11/2024

Dosage FormTablet (oral; 6.25 mg, 12.5 mg, 25 mg)
Drug ClassDipeptidyl peptidase-4 (DPP-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.

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Summary
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  • This summary is based on the review of five systematic review(s)/meta-analysis(es). [1-5]
  • Carotid Intima-Media Thickness (cIMT) Progression: Alogliptin slowed cIMT progression with a mean difference (MD) of -0.08 (95% confidence interval (CI): -0.13, -0.02), indicating effectiveness compared to placebo; however, exenatide was more effective (MD: -0.13, 95% CI: -0.25, -0.01) while metformin was slightly less effective (MD: -0.05, 95% CI: -0.09, -0.02).
  • Adherence to Oral Antidiabetic Drugs (OADs): Alogliptin demonstrated an adherence level with a medication possession ratio (MPR) of 61.7%-94.9%, similar to sodium-glucose cotransporter-2 (SGLT2) inhibitors (29%-44% discontinuation rate) but lacking direct comparisons with older OADs.
  • Glycemic Control: Alogliptin showed comparable reduction in hemoglobin A1C (HbA1c) to the active control group (MD: 0.06%, 95% CI: -0.03 - 0.16) but was inferior in lowering fasting blood glucose (MD: +6.98 mg/dl, 95% CI: 2.55-11.42).
  • Adverse Events (AEs) Associated with Alogliptin: The risk of AEs within 52 weeks was risk ratio (RR) 0.93 (95% CI 0.80 to 1.08), and beyond 52 weeks was RR 0.98 (95% CI 0.97 to 1.00), indicating comparable safety to other DPP4 inhibitors; severe adverse events had a risk ratio of RR 1.75 (95% CI 0.90-3.40).
  • Fracture Risk: Alogliptin showed no significant increase in fracture risk, while trelagliptin presented an increased fracture risk with RR 3.51 (95% CI 1.58-13.70), in contrast to albiglutide and voglibose, which showed decreased fracture risks with RR 0.29 (95% CI 0.04-0.93) and RR 0.03 (95% CI 0-0.11), respectively.
  • All studies included patients with Type 2 Diabetes Mellitus (T2DM), with adherence studies specifically noted to be from European retrospective cohorts; general trends indicated better adherence to newer second-line oral antidiabetic drugs, although no direct comparisons to older medications were made.