Alogliptin, sold under the brand names Nesina and Vipidia, is an oral

anti-diabetic drug Drugs used in diabetes treat types of diabetes mellitus by decreasing blood sugar level, glucose levels in the blood. With the exception of Insulin (medication), insulin, most GLP-1 receptor agonists (liraglutide, exenatide, and others), and pra ...

in the

DPP-4 inhibitor Inhibitors of dipeptidyl peptidase 4 (DPP-4 inhibitors or gliptins) are a class of oral hypoglycemics that block the enzyme dipeptidyl peptidase-4 (DPP-4). They can be used to treat diabetes mellitus type 2. The first agent of the class – sit ...

(gliptin) class. Like other members of the gliptin class, it causes little or no weight gain, exhibits relatively little risk of hypoglycemia, and has relatively modest glucose-lowering activity. Alogliptin and other gliptins are commonly used in combination with metformin in people whose diabetes cannot adequately be controlled with metformin alone. In April 2016, the U.S.

Food and Drug Administration The United States Food and Drug Administration (FDA or US FDA) is a List of United States federal agencies, federal agency of the United States Department of Health and Human Services, Department of Health and Human Services. The FDA is respo ...

(FDA) added a warning about increased risk of

heart failure Heart failure (HF), also known as congestive heart failure (CHF), is a syndrome caused by an impairment in the heart's ability to Cardiac cycle, fill with and pump blood. Although symptoms vary based on which side of the heart is affected, HF ...

. It was developed by Syrrx, a company which was acquired by

Takeda Pharmaceutical Company The is a Japanese multinational pharmaceutical company. It is the third largest pharmaceutical company in Asia, behind Sinopharm and Shanghai Pharmaceuticals, and one of the top 20 largest pharmaceutical companies in the world by revenue (t ...

in 2005. In 2020, it was the 295th most commonly prescribed medication in the United States, with more than 1million prescriptions.

Medical uses

Alogliptin is a

dipeptidyl peptidase-4 inhibitor Inhibitors of dipeptidyl peptidase 4 (DPP-4 inhibitors or gliptins) are a class of oral hypoglycemics that block the enzyme dipeptidyl peptidase-4 (DPP-4). They can be used to treat diabetes mellitus type 2. The first agent of the class – si ...

(DDP-4) that decreases blood sugar levels similar to other DPP-4 inhibitors.

Side effects

Adverse events include

hypoglycemia Hypoglycemia (American English), also spelled hypoglycaemia or hypoglycæmia (British English), sometimes called low blood sugar, is a fall in blood sugar to levels below normal, typically below 70 mg/dL (3.9 mmol/L). Whipple's tria ...

pruritis An itch (also known as pruritus) is a sensation that causes a strong desire or reflex to scratch. Itches have resisted many attempts to be classified as any one type of sensory experience. Itches have many similarities to pain, and while both ...

(itching),

nasopharyngitis The common cold, or the cold, is a viral infectious disease of the upper respiratory tract that primarily affects the respiratory mucosa of the nose, throat, sinuses, and larynx. Signs and symptoms may appear in as little as two days after ...

, headache, and

upper respiratory tract infection An upper respiratory tract infection (URTI) is an illness caused by an acute infection, which involves the upper respiratory tract, including the nose, sinuses, pharynx, larynx or trachea. This commonly includes nasal obstruction, sore throat ...

. It may also cause joint pain that can be severe and disabling. Like other DDP-4 inhibitors, alogliptin is weight-neutral. A 2014 letter to the editor claimed alogliptin is not associated with increased risk of cardiovascular events. In April 2016, the U.S. Food and Drug Administration (FDA) added a warning about increased risk of

Market access

In December 2007, Takeda submitted a

New Drug Application The Food and Drug Administration's (FDA) New Drug Application (NDA) is the vehicle in the United States through which drug sponsors formally propose that the FDA approve a new pharmaceutical for sale and marketing. Some 30% or less of initial ...

(NDA) for alogliptin to the

United States Food and Drug Administration The United States Food and Drug Administration (FDA or US FDA) is a List of United States federal agencies, federal agency of the United States Department of Health and Human Services, Department of Health and Human Services. The FDA is respo ...

(FDA), after positive results from

Phase III clinical trials The phases of clinical research are the stages in which scientists conduct experiments with a health intervention to obtain sufficient evidence for a process considered effective as a medical treatment. For drug development, the clinical phases ...

. In September 2008, the company also filed for approval in Japan, winning approval in April 2010. The company also filed a Marketing Authorization Application elsewhere outside the United States, which was withdrawn in June 2009 needing more data. The first NDA failed to gain approval and was followed by a pair of NDAs (one for alogliptin and a second for a combination of alogliptin and

pioglitazone Pioglitazone, sold under the brand name Actos among others, is an anti-diabetic medication used to treat type 2 diabetes. It may be used with metformin, a sulfonylurea, or insulin. Use is recommended together with exercise and diet. It is not ...

) in July 2011. In 2012, Takeda received a negative response from the FDA on both of these NDAs, citing a need for additional data. In 2013, the FDA approved the drug in three formulations: as a stand-alone with the brand-name Nesina, combined with

metformin Metformin, sold under the brand name Glucophage, among others, is the main first-line medication for the treatment of type2 diabetes, particularly in people who are overweight. It is also used in the treatment of polycystic ovary syndrome, ...

using the name Kazano, and when combined with

as Oseni.

References

External links

* * {{Portal bar , Medicine Dipeptidyl peptidase-4 inhibitors Nitriles Piperidines Ureas Imides Pyrimidinediones Enantiopure drugs Drugs developed by Takeda Pharmaceutical Company Sanofi