Alogliptin (Vipidia®) has been launched for the treatment of type 2 diabetes. Alogliptin is a DPP-4 inhibitor in the same class of medicines as sitagliptin.
It is licensed for use in type 2 diabetes to improve glycaemic control with other glucose-lowering treatments, including insulin. It does not currently have a monotherapy license and the safety of triple therapy with metformin and a sulphonylurea has not been established. It will be available in three strengths to allow appropriate dosing in patients with renal impairment. It will also be available in a fixed dose combination with metformin at 12.5mg/1000mg strength (Vipdomet®). Summaries of Product Characteristics containing detailed prescribing information are available for Vipidia and Vipdomet.
A New Medicines Evidence Summary has already been published by NICE. This summary notes that alogliptin reduces HbA1c by around 5.5 mmol/mol compared to placebo and that no serious safety concerns have been identified to date. It is also noted that alogliptin has similar tolerability to other oral hypoglycaemic drugs. Both products have been launched at an NHS cost of £26.60 for 28 days treatment. This represents a 16% to 20% saving compared to current treatments.
As required by some regulatory agencies, a cardiovascular safety study has been conducted in more than 5,000 patients with type 2 diabetes who had recently has an acute coronary syndrome. The study found no difference between treatment with alogliptin or placebo in the rates of major adverse cardiovascular events (death from cardiovascular causes, nonfatal myocardial infarction or nonfatal stroke).
Action: Clinicians should be aware of this new drug launch. Other DPP-4 inhibitors in the class have a wider range of licensed indications for use and are also due to come off patent sooner. These factors need to be considered when choosing an appropriate drug within this class.