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Doxofylline as a steroid-sparing treatment in Mexican children with asthma
Sandra Nora González-Díaz1, Ignacio J Ansotegui2, Carlos Macouzet-Sánchez1
1Regional Center of Allergy and Clinical Immunology, University Hospital "Dr Jose Eleuterio Gonzalez", Autonomous University of Nuevo León, Monterrey, Mexico.
Insights
Doxofylline may help children with asthma reduce inhaled corticosteroid (ICS) doses while maintaining lung function and improving asthma control. This pilot study suggests doxofylline as a potential steroid-sparing agent for pediatric asthma management.
Area of Science:
- Pediatric Pulmonology
- Pharmacology
- Asthma Management
Background:
- Asthma is a chronic respiratory disease affecting children worldwide.
- Inhaled corticosteroids (ICS) are the cornerstone of asthma treatment.
- Reducing ICS dosage is desirable to minimize side effects.
Purpose of the Study:
- To assess the efficacy of doxofylline as an ICS-sparing agent in Mexican children with asthma.
- To evaluate if doxofylline can enable a reduction in ICS dosage while maintaining asthma control.
Main Methods:
- A 10-week, open-label, crossover pilot study in 61 Mexican children (aged 6-16 years) with asthma.
- Patients received doxofylline combined with standard-dose or reduced-dose budesonide in a crossover design.
- Outcomes included lung function (FEV1), fractional exhaled nitric oxide (FeNO), asthma control, exacerbations, and rescue medication use.
Main Results:
- Combined use of doxofylline and ICS allowed for ICS dose reduction while maintaining lung function and improving asthma control (p=0.008).
- Few asthma exacerbations were observed, with only one patient requiring systemic corticosteroids.
- Rescue medication use significantly decreased during the initial 4-week period with standard-dose budesonide and doxofylline.
Conclusions:
- Doxofylline shows potential as a steroid-sparing treatment in pediatric asthma.
- Further longer-term, controlled studies are necessary to confirm these findings.
- Doxofylline may offer a valuable therapeutic option for managing childhood asthma.
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.
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