The pharmacologic management of type 2 diabetes has changed dramatically in the 
past two decades. We have moved from a situation of only having two choices, 
insulin and sulfonylureas, to a position of myriad choices from 11 categories of 
medications (insulin, sulfonylureas, biguanides, α-glucosidase inhibitors, 
gliptins (dipeptidyl peptidase 4 [DPP IV] inhibitors), bromocriptine, 
glucagon-like peptide analogues, thiazolidinediones, glinides, amylin analogues 
and bile acid sequestrants. One of the most recent additions to this list are 
the DPP IV inhibitors commonly known as gliptins. Currently, there are four DPP 
IV inhibitors available in various countries-alogliptin, sitagliptin, 
vildagliptin and saxagliptin (1). Of these, two have been approved for clinical 
use in the United States: sitagliptin and saxagliptin. Additionally, 
linagliptin, vildagliptin and alogliptin are currently in phase III development 
in the United States while studies with another DPP IV inhibitor, dutogliptin, 
have been terminated (2). Alogliptin was approved for use in Japan under the 
trade name Nesina® in April 2010 (3). This manuscript will review alogliptin, 
its chemistry, pharmacokinetics/pharmacodynamics, drug interactions, clinical 
trials and its current state of FDA review. Preclinical animal data have been 
reviewed elsewhere and will not be outlined in this manuscript. The interested 
reader is referred to those recent reviews (4, 5).