ATC Group: A10BH Dipeptidyl peptidase 4 (DPP-4) inhibitors

Alogliptin is a potent and highly selective inhibitor of DPP-4, >10,000-fold more selective for DPP-4 than other related enzymes including DPP-8 and DPP-9. Alogliptin improves glycaemic control via a glucose-dependent mechanism, whereby insulin release is enhanced and glucagon levels are suppressed when glucose levels are high.

The glucagon-like peptide-1 (GLP-1) is secreted from alimentary canal in response to meal that promotes insulin secretion from pancreas and regulates blood sugar post meal by controlling glucagon secretion. Evogliptin exhibits a hypoglycemic effect by controlling the decomposition of GLP-1 by inhibiting dipeptidyl peptidase-4 (DPP-4) activity and thereby increasing blood concentration of active form GLP-1.

Linagliptin is an inhibitor of the enzyme DPP-4 (dipeptidyl peptidase 4, EC 3.4.14.5) an enzyme which is involved in the inactivation of the incretin hormones GLP-1 and GIP (glucagon-like peptide1, glucose-dependent insulinotropic polypeptide). These hormones are rapidly degraded by the enzyme DPP-4. Both incretin hormones are involved in the physiological regulation of glucose homeostasis.

Saxagliptin is a highly potent (Ki: 1.3 nM), selective, reversible, competitive, DPP4 inhibitor. Saxagliptin improves glycaemic control by reducing fasting and postprandial glucose concentrations in patients with type 2 diabetes.

Sitagliptin is a member of a class of oral anti-hyperglycaemic agents called dipeptidyl peptidase 4 (DPP-4) inhibitors. The improvement in glycaemic control observed with this medicinal product may be mediated by enhancing the levels of active incretin hormones.

Teneligliptin is a potent, selective, and long-lasting DPP-4 inhibitor. It acts as a competitive reversible inhibitor of DPP-4 and decreases the degradation of incretins, especially GLP-1, thereby improving hyperglycemia by stimulating insulin secretion and suppressing glucagon secretion in a glucose-dependent manner (no or negligible risk of hypoglycemia).

Vildagliptin enhances the sensitivity of beta cells to glucose, resulting in improved glucose-dependent insulin secretion by increasing the endogenous levels of these incretin hormones. The administration of vildagliptin results in a rapid and complete inhibition of DPP-4 activity, resulting in increased fasting and postprandial endogenous levels of the incretin hormones GLP-1 (glucagon-like peptide 1) and GIP (glucose-dependent insulinotropic polypeptide).