Potential for the use of a combination of alogliptin and pioglitazone in the treatment of type 2 diabetes mellitus: focus on the hepatotropic effect

Elsukova O.S., Nikitina E.A.

Kirov State Medical University, Kirov, Russia

Background: Treatment of non-alcoholic fatty liver disease (NAFLD) should be comprehensive and tailored to comorbidity. Type 2 diabetes mellitus (DM2) and NAFLD often coexist, each worsening the other’s course and prognosis. In this case, the optimal treatment is a hypoglycemic agent that not only provides good glycemic control but also modifies the factors that contribute to the onset and progression of NAFLD, thereby exerting a potential hepatotropic effect.
Objective: Evaluation of the potential of a fixed-dose combination (FC) of alogliptin and pioglitazone in correcting the factors that contribute to the onset and progression of NAFLD in DM2 patients.
Materials and methods: The study included 30 patients with DM2 with inadequate carbohydrate metabolism. This cohort of patients was assessed for anthropometric data, carbohydrate and lipid metabolism parameters, HOMA-IR insulin resistance index, and FIB-4 liver fibrosis index at baseline and over time 6 months after administration of alogliptin 25 mg and pioglitazone 30 mg while taking metformin at a dose of 2000 mg/day.
Results: When alogliptin and pioglitazone were added to metformin therapy, over a 6-month follow-up period, DM2 patients showed improved glycemic control and lipid profile, a decrease in insulin resistance, and a positive effect on the calculated FIB-4 liver fibrosis index.
Conclusion: Thus, the fixed-dose combination of alogliptin and pioglitazone not only provides a sustained hypoglycemic effect but also has a beneficial effect on most factors associated with the onset and progression of NAFLD in DM2 patients, thereby exerting a possible hepatotropic effect, which requires further study.

For citations: Elsukova O.S., Nikitina E.A. Potential for the use of a combination of alogliptin and pioglitazone in the treatment of type 2 diabetes mellitus: focus on the hepatotropic effect. Pharmateca. 2025;32(8):61-66. (In Russ.). DOI: https://dx.doi.org/10.18565/pharmateca.2025.8.61-66

Authors’ contribution: O.S. Elsukova – creation of the electronic database, scientific supervision of the study, data analysis, writing the article, and editing the manuscript. E.A. Nikitina – study design, data processing, statistical analysis, and writing the article. All authors made a significant contribution to the study and preparation of the article, read and approved the final version before publication.
Conflicts of interest: The authors confirm that they have no conflicts of interest to declare.
Funding: This work was completed without additional funding from third parties.
Patient Consent for Publication: All patients provided informed consent for the publication of their data.
Authors’ Data Sharing Statement: The data supporting the findings of this study are available upon request from the corresponding author after approval from the principal investigator.

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About the Authors

Olga S. Elsukova, Cand. Sci. (Med.), Associate Professor at the Department of Hospital Therapy, Kirov State Medical University, Kirov, Russia; oselsukova@mail.ru, ORCID: https://orcid.org/0000-0002-2341-9491
Elena A. Nikitina, Cand. Sci. (Med.), Associate Professor, Department of Internal Medicine, Kirov State Medical University, Kirov, Russia; nikitinae1991@mail.ru, ORCID: https://orcid.org/0000-0002-7316-3252 (corresponding author)

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