Alogliptin for the treatment of Type 2 diabetes

Abstract

Type 2 diabetes mellitus is a chronic progressive disease, and over time patients often need to be treated with more than one type of antidiabetic agent in order to maintain control of blood glucose levels. Dipeptidyl peptidase-4 inhibitors are one of the newer classes of antidiabetic drugs used in the treatment of diabetes. These oral incretin-based therapies are effective at improving glycemic control, have a low risk of hypoglycemia, are weight neutral, and can be administered in combination with other antidiabetic agents. This article summarizes the pharmacological and pharmacokinetic properties of alogliptin, a dipeptidyl peptidase-4 inhibitor, and also evaluates its clinical efficacy, safety and tolerability in the treatment of patients with Type 2 diabetes.

Keywords::

• alogliptin
• dipeptidyl peptidase-4 inhibitors
• incretin therapies
• Type 2 diabetes

Financial & competing interests disclosure

This work was supported by Takeda pharmaceutical company Ltd. Editorial assistance was kindly provided by ContentEdNet and Takeda Pharmaceutical Co. Ltd. Takeda sponsored medical writing and helped to identify key supporting material. Kathy Croom and Steve Clissold from Content Ed net provided medical writing assistance. Y Seino has received consultancy fees or lecture fees from Eli Lilly and Co., Sanofi, Novo Nordisk Pharma Ltd., GlaxoSmithKline, Taisho Pharmaceutical Co. Ltd., Astellas Pharma Inc., BD (Becton, Dickinson and Co.), Boehringer Ingelheim, Johnson & Johnson, Ono Pharmaceutical. Co. Ltd., Kyowa Kirin, MSD and Takeda Pharmaceutical Co. Ltd., and has indicated no other conflicts of interest regarding the content of this article. D Yabe has received speaker fees from Eli Lilly, MSD, Sanofi, Novo Nordisk, Boehringer Ingelheim, Takeda and Taisho pharmaceutical, and has indicated no other conflicts of interest regarding the content of this article. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

Key issues

• Dipeptidyl peptidase-4 (DPP-4) inhibitors prevent the degradation of glucagon-like peptide-1 and GIP which are released in response to food and stimulates insulin secretion.

• Alogliptin is a potent and highly selective DPP-4 inhibitor that improves glycemic control when used alone or as add-on therapy in patients with Type 2 diabetes inadequately controlled on diet/exercise or existing drug therapy.

• Like other DPP-4 inhibitors, alogliptin has a low risk of hypoglycemia episodes and is weight neutral.

• Alogliptin remains effective and well tolerated after 2 years of therapy.

• DPP-4 inhibitors exert greater HbA1c-lowering effects among diabetic patients in east Asian countries, who are generally non-obese and have reduced beta cell function.

• Alogliptin has no adverse effect on cardiovascular outcomes and may exert an antiatherosclerotic effect.