Alogliptin for the treatment of type 2 diabetes

This study examined whether alogliptin is safe and effective as an add-on therapy to metformin in patients with type 2 diabetes who require more intense control of blood glucose levels. The authors concluded that patients with type 2 diabetes who fail metformin single treatment are more likely to achieve better control of blood glucose levels with alogliptin compared to glipizide.

Patients with type 2 diabetes (T2D) may be treated with medication to reduce blood glucose (sugar) levels. Patients are initially treated with metformin (Glucophage). However, the effectiveness of metformin may decrease over time. Patients may then be treated with glipizide (Glucotrol) in addition to metformin. However, glipizide treatment can result in weight gain and dangerously low blood glucose levels.

Alogliptin (Nesina), another drug used to treat T2D, may be equally as effective as glipizide when used in combination with metformin, and may have fewer side effects and less weight gain compared to glipizide.

This study aimed to determine whether alogliptin is more effective than glipizide as an add-on treatment to metformin in T2D patients.

This study involved 2639 T2D patients. Participants were divided into 3 groups. One group received 12.5 mg alogliptin daily. Another group received 25 mg alogliptin daily. The remaining group received less than 20 mg glipizide daily. All patients also received metformin.

Patients were treated for 2 years. HbA1c levels (average blood glucose levels over 3 months) were measured before and after the study.

Patients were more likely to achieve the target HbA1c of less than 7% when treated with alogliptin. 24.2% of patients treated with 12.5 mg alogliptin achieved the target HbA1c. 26.9% of patients treated with 25 mg alogliptin achieved the target HbA1c. In contrast, only 10.7% of patients treated with glipizide achieved the target HbA1c.

Patients treated with 12.5 mg alogliptin experienced a reduction in body weight by 0.68 kg. Patients treated with 25 mg alogliptin experienced a reduction in body weight by 0.89 kg. Patients treated with glipizide experienced a 0.95 kg increase in body weight after 2 years.

Fewer patients experienced dangerously low blood glucose levels when treated with alogliptin (less than 2.5%) compared to glipizide (23.2%).

The authors concluded that T2D patients who fail metformin treatment are more likely to achieve better control of blood glucose levels with alogliptin compared to glipizide and do not experience dangerously low blood glucose levels or weight gain.

This study received funding from Takeda, the pharmaceutical company who developed alogliptin.

Consult your physician regarding the risks and benefits of alogliptin for the treatment of T2D.