Alogliptin

(Nesina®)

Nesina®

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Drug updated on 4/24/2024

Dosage FormTablet (oral; 6.25 mg, 12.5 mg, 25 mg)
Drug ClassDipeptidyl 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
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  • 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.