Efficacy and safety profile of doxofylline compared to theophylline in asthma: a meta-analysis

  • Paola Rogliani Unit of Respiratory Medicine, Department of Experimental Medicine, University of Rome “Tor Vergata”, Rome, Italy.
  • Luigino Calzetta | luigino.calzetta@uniroma2.it Unit of Respiratory Medicine, Department of Experimental Medicine, University of Rome “Tor Vergata”, Rome, Italy.
  • Josuel Ora Division of Respiratory Medicine, University Hospital “Tor Vergata”, Rome, Italy.
  • Mario Cazzola Unit of Respiratory Medicine, Department of Experimental Medicine, University of Rome “Tor Vergata”, Rome, Italy.
  • Maria Gabriella Matera Unit of Pharmacology, Department of Experimental Medicine, University of Campania “Luigi Vanvitelli”, Naples, Italy.

Abstract

Background: Oral methylxanthines are effective drugs for the treatment of chronic obstructive respiratory disorders. The novel methylxanthine doxofylline, that has bronchodilator and anti-inflammatory activities, is not affected by the major drawback of theophylline. Nowadays large-scale quantitative synthesis comparing the efficacy and safety profile of doxofylline vs. theophylline in the treatment of asthma is still lacking. Therefore, we performed a quantitative synthesis to compare the efficacy/safety profile of doxofylline and theophylline in asthma. Methods: A pairwise and network meta-analyses were performed to assess the impact of doxofylline vs. theophylline and placebo on the change in asthma events, risk of adverse events (AEs), forced expiratory volume in 1 s (FEV1), and salbutamol use. Results: Data obtained from 696 asthmatic patients were extracted from 4 randomized controlled trials published between 2015 and 2018. Doxofylline was significantly (P < 0.05) more effective than theophylline in reducing the daily asthma events (mean difference − 0.14, 95%CI -0.27 – 0.00) and risk of AEs (relative risk 0.76, 95%CI 0.59–0.99). Doxofylline was as effective as theophylline in improving FEV1, and a trend of superiority (P = 0.058) was detected for doxofylline over theophylline with respect to the reduction in the use of salbutamol as rescue medication. The rank of effectiveness was doxofylline>theophylline> > placebo, and the rank of safety was placebo>doxofylline> > theophylline. Conclusions: Doxofylline is an effective and safe methylxanthine for the treatment of asthma, with an efficacy/ safety profile greater than that of theophylline. Trial registration: Meta-analysis registration: CRD42019119849.

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Published
2019-08-03
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Original Research Articles
Keywords:
Asthma, Doxofylline, Theophylline, Meta-analysis
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How to Cite
Rogliani, P., Calzetta, L., Ora, J., Cazzola, M., & Matera, M. G. (2019). Efficacy and safety profile of doxofylline compared to theophylline in asthma: a meta-analysis. Multidisciplinary Respiratory Medicine, 14(1). https://doi.org/10.4081/mrm.2019.26

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