Pulmonary Function Assessment in Mild to Moderate Persistent Asthma Patients Receiving Montelukast, Doxofylline, and Tiotropium With Budesonide: A Randomized Controlled Study

Rajanandh, Muhasaparur Ganesan; Nageswari, A.D.; Ilango, K.

doi:10.1016/j.clinthera.2014.02.006

Cited by 36 publications

(26 citation statements)

References 26 publications

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“…Since the technical data sheets of the two drugs are identical, it is highly possible that the physicians indistinctly chose theophylline or doxophylline, because they have the same profile of activity [7,[10][11][12][13]18,[21][22][23][24].…”

Section: Discussionmentioning

confidence: 99%

Treatment plan comparison in acute and chronic respiratory tract diseases: an observational study of doxophylline vs. theophylline

Mennini

Sciattella

Marcellusi

et al. 2017

Expert Review of Pharmacoeconomics & Outcomes Research

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Background: The main objective of this article is to estimate the global cost related to the use of the two drugs (associated drugs, specialist visits, hospital admissions, plasma drug monitoring). Methods: The drug prescriptions were extracted from the Information System of the Pharmaceutical Prescriptions of the Marche Region for each ATC code in the years 2008-2012 and the number of patients per year and other outcomes measure were obtained. Results: 13,574 patients were treated with theophylline and 19,426 patients with doxophylline. The number of patients treated was approximately 5,000 per year. Co-prescription with other drugs, use of corticosteroids, mean number of visits and hospital admissions (per 100 patients) were lower for doxophylline vs theophylline (1.55vs5.50, 0.3vs0.7, 2.05vs3.73 and 1.57vs3.3 respectively). The annual mean cost per patient was €187.4 for those treated with doxophylline and €513.5 for theophylline. Conclusions: In our study, doxophylline resulted to be associated with a reduction of the overall cost.ARTICLE HISTORY

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Section: Discussionmentioning

confidence: 99%

Treatment plan comparison in acute and chronic respiratory tract diseases: an observational study of doxophylline vs. theophylline

Mennini

Sciattella

Marcellusi

et al. 2017

Expert Review of Pharmacoeconomics & Outcomes Research

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“…In order to calculate the sample size, we conducted a pilot study. 30 From the pilot study, we derived differences in mean changes and pooled standard deviation. The Type I error probability associated with this test of the null hypothesis was 0.05 and the power of the study is 90%.…”

Section: Sample Sizementioning

confidence: 99%

Assessment of various second‐line medications in addition to inhaled corticosteroid in asthma patients: a randomized controlled trial

Rajanandh

Nageswari

Ilango

2014

Clin Exp Pharma Physio

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Many patients with persistent asthma cannot achieve the treatment goal for asthma with a single controller medication. The aim of the present study was to assess lung function and rescue medication use in asthma patients receiving four different categories of drugs in combination with an inhaled corticosteroid. Patients recruited to the study were randomized into four groups to receive budesonide with either formoterol, doxofylline, montelukast or tiotropium for a period of 3 months. Lung function (i.e. forced expiratory volume in 1 s (FEV1 )) and rescue medication use were determined at baseline and on Day 15, 30, 45, 60 and 90 of treatment. A total of 297 patients completed the study. At baseline, no significant differences (P > 0.05) were observed in any of the outcome measures. Significant within-group improvement in FEV1 was observed in all groups. On Day 90, between-group differences showed that the improvement in FEV1 was significantly (P < 0.05) higher for patients receiving budesonide + formoterol, followed by budesonide + montelukast and budesonide + doxofylline, and least for those receiving budesonide + tiotropium. Similarly, within- and between-group comparisons showed significant (P < 0.05) reductions in rescue medication use in all groups. However, the magnitude of the decrease was greater in the budesonide + formoterol group, followed by the budesonide + montelukast, budesonide + doxofylline and budesonide + tiotropium groups. Based on our findings, among the second-line treatment regimens, budesonide with either montelukast or doxofylline was found to be better than budesonide + tiotropium in patients with mild-to-moderate persistent asthma. Further studies with a longer duration are likely to be useful.

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“…Nonetheless, we believe our observations are of considerable interest as they provide a good scientific rationale to further investigate doxofylline as a corticosteroid sparing agent in the clinic given it is a safe, orally active and effective drug for the treatment of asthma and COPD (6). Indeed a recent clinical study has suggested a corticosteroid sparing effect of doxofylline [29] which is supported by recent pharmacoeconomic data from Italy that in patients prescribed doxofylline for the treatment of their respiratory disease, there is less use of corticosteroids than in patients prescribed theophylline [30]. .001 vs sham group, *p<0.05 vs OVA group,, ***p<0.0001 vs OVA group.…”

Section: Accepted Manuscriptmentioning

confidence: 74%

Steroid sparing effects of doxofylline

Riffo‐Vasquez

Venkatasamy

Page

2018

Pulmonary Pharmacology & Therapeutics

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Glucocorticosteroids are widely used in the treatment of asthma and chronic obstructive pulmonary disease (COPD). However, there are growing concerns about the side effect profile of this class of drug, particularly an increased risk of pneumonia. Over the last two decades there have been many attempts to find drugs to allow a reduction of glucocorticosteroids, including xanthines such as theophylline. Use of xanthines has been shown to lead to a reduction in the requirement for glucocorticosteroids, although xanthines also have a narrow therapeutic window limiting their wider use. Doxofylline is another xanthine that has been shown to be of clinical benefit in patients with asthma or COPD, but to have a wider therapeutic window than theophylline. In the present study we have demonstrated that doxofylline produces a clear steroid sparing effect in both an allergic and a non-allergic model of lung inflammation. Thus, we have shown that concomitant treatment with a low dose of doxofylline and a low dose of the glucocorticosteroid dexamethasone (that alone had no effect) significantly reduced both allergen-induced eosinophil infiltration into the lungs of allergic mice, and lipopolysaccharide (LPS)-induced neutrophil infiltration into the lung, equivalent to a higher dose of each drug. Our results suggest that doxofylline demonstrates significant anti-inflammatory activity in the lung which can result in significant steroid sparing activity.

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Pulmonary Function Assessment in Mild to Moderate Persistent Asthma Patients Receiving Montelukast, Doxofylline, and Tiotropium With Budesonide: A Randomized Controlled Study

Cited by 36 publications

References 26 publications

Treatment plan comparison in acute and chronic respiratory tract diseases: an observational study of doxophylline vs. theophylline

Treatment plan comparison in acute and chronic respiratory tract diseases: an observational study of doxophylline vs. theophylline

Assessment of various second‐line medications in addition to inhaled corticosteroid in asthma patients: a randomized controlled trial

Steroid sparing effects of doxofylline

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