Doxofylline as a steroid-sparing treatment in Mexican children with asthma

J Asthma. 2024 Jun;61(6):574-583. doi: 10.1080/02770903.2023.2294909. Epub 2023 Dec 28.

Abstract

Objective: The aim of this pilot study was to assess the efficacy of doxofylline as an ICS-sparing agent in the treatment of Mexican children with asthma.

Methods: 10-week, open-label, crossover, pilot study, we examined the steroid-sparing effect of doxofylline in Mexican children with asthma. Patients aged 6-16 years treated with inhaled corticosteroids (ICS) for at least 8 wk before enrollment were divided randomly into two groups at the baseline visit. Group A (n = 31) received doxofylline (18 mg/kg/day) plus standard-dose budesonide (D + SDB) for the first 4-week period followed by doxofylline plus reduced-dose budesonide (D + RDB) for the second 4-week period. Group B (n = 30) received D + RDB followed by D + SDB. Clinical outcomes assessed included lung function (forced expiratory volume; in 1 s, FEV1), fractional exhaled nitric oxide (FeNO), asthma control, number of exacerbations and use of rescue medication (salbutamol).

Results: It was shown that combined use of doxofylline and ICS may allow children with asthma to reduce their daily dose of ICS while maintaining lung function and improving asthma control (p = 0.008). There were few asthma exacerbations and only one patient required treatment with systemic corticosteroids. Rescue medication use decreased significantly in patients receiving D + SDB during the first 4-week period.

Conclusions: Our results suggest that doxofylline may be a steroid-sparing treatment in asthma, but longer-term, controlled studies are needed to confirm these observations.

Keywords: allergy; asthma; budesonide; corticosteroids; exacerbations; lung function; xanthine.

Publication types

  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Administration, Inhalation
  • Adolescent
  • Adrenal Cortex Hormones / administration & dosage
  • Adrenal Cortex Hormones / therapeutic use
  • Anti-Asthmatic Agents / administration & dosage
  • Anti-Asthmatic Agents / therapeutic use
  • Asthma* / drug therapy
  • Bronchodilator Agents / administration & dosage
  • Bronchodilator Agents / therapeutic use
  • Budesonide* / administration & dosage
  • Budesonide* / therapeutic use
  • Child
  • Cross-Over Studies*
  • Drug Therapy, Combination*
  • Female
  • Forced Expiratory Volume / drug effects
  • Humans
  • Male
  • Mexico
  • Pilot Projects
  • Theophylline* / administration & dosage
  • Theophylline* / analogs & derivatives*
  • Theophylline* / therapeutic use
  • Treatment Outcome

Substances

  • doxofylline
  • Theophylline
  • Budesonide
  • Adrenal Cortex Hormones
  • Bronchodilator Agents
  • Anti-Asthmatic Agents