Pentoxifylline as a new adjunctive therapy in ankylosing spondylitis: A randomized clinical trial

Abstract

Treatment with tumor necrosis factor alpha inhibitors has been increasingly implicated in the management of autoimmune diseases. In spite of their promising effects, they are commonly associated with side effects. This issue indicates the need for newer drugs with the same efficacy and fewer serious adverse effects. Pentoxifylline is a phosphodiesterase which inhibits TNF secretion and exerts to some degree an anti-inflammatory effect. The purpose of this randomized clinical trial was to evaluate the effect of pentoxifylline as an adjunctive therapy in the management of ankylosing spondylitis. Twenty-five patients suffering from ankylosing spondylitis were randomly assigned to treatment or placebo groups having been matched for age and gender. The treatment group received pentoxifylline (1200 mg daily), and the placebo group received a placebo in addition to the standard treatment of sulfasalazine 2-3 gram daily and indomethacin 50-75 mg per day that were given to all the patients in both groups. Serum levels of TNF-α were measured before and after the study intervention. Serum levels of TNF-α were reduced significantly in both groups with a p-value of < 0.001. However, the reduction was more prominent in the group receiving pentoxifylline than in the placebo group, although this between-group difference was not statistically significant. The results demonstrate the need for further studies on the use of pentoxifylline as a safe adjunctive therapy in controlling disease activity and reducing tumor necrosis factor-alpha levels in patients with ankylosing spondylitis.

Pentoxifylline changes the balance of immune cell population in breast tumor-infiltrating lymphocytes

“…Pentoxifylline is a safe and well-tolerated drug widely used as an FDA-approved drug in cardiomyopathy, nephropathy, and vascular diseases [ 35 , 36 ]. Due to its low toxicity profile [ 37 , 38 ], the clinical use of this drug in antitumor therapies is much easier and more accessible than therapies that still have serious challenges and concerns about their safety [ 39 , 40 ].…”