Drug updated on 7/25/2024
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.
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Summary
- Alogliptin (Nesina) is indicated as an adjunct to diet and exercise to improve glycemic control in adults with type 2 diabetes mellitus.
- The information was derived from five systematic reviews/meta-analyses studies comparing alogliptin with other antidiabetic drugs, including canagliflozin, dapagliflozin, empagliflozin, sitagliptin, vildagliptin, omarigliptin, and saxagliptin among others.
- Adherence rates for DPP4 inhibitors like alogliptin were found suboptimal but consistent across the class; adherence at one year was around 56.9%, decreasing over time. Saxagliptin and alogliptin had more frequent switching within the class compared to others.
- In terms of renal outcomes and adverse events (AEs), no significant differences were observed between DPP4 inhibitors like alogliptin and placebo regarding eGFR changes or albuminuria progression. They also showed similar AE profiles without increased risk of all-cause mortality.
- Cardiovascular safety assessments revealed that DPP4 inhibitors do not increase major cardiovascular events (MACE), mortality, or heart failure risks except for saxagliptin, which posed a higher heart failure risk; thus indicating an overall neutral impact on cardiovascular health by drugs such as Nesina (alogliptin).
- Efficacy comparisons highlighted that while most DPP4 inhibitors significantly reduced HbA1c levels, effectively lowering fasting plasma glucose (FPG) and BMI, alogliptin did not show significant reduction in some cases. However, DPP4 inhibitors generally maintained weight neutrality without increasing the incidence of AEs when compared among themselves or against placebos.
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 |