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

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 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.