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% CI (confidence interval): -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 SGLT2 inhibitors (29%-44% discontinuation rate) but lacking direct comparisons with older OADs.
• Glycemic Control: Alogliptin showed comparable reduction in 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 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.