AUTHOR=Fierro Vincenzo , Piscitelli Anna Lucia , Battaglia Edda , Fiocchi Alessandro 

TITLE=Doxofylline for Pediatric Asthma Steps 1–4. Pediatric Asthma: New Role for an Old Drug

JOURNAL=Frontiers in Pediatrics

VOLUME=Volume 10 - 2022

YEAR=2022

URL=https://www.frontiersin.org/journals/pediatrics/articles/10.3389/fped.2022.772704

DOI=10.3389/fped.2022.772704

ISSN=2296-2360

ABSTRACT=The panoply of anti-asthma drugs for children between 6 and 18 years is not limited to those 
reported in the guidelines. In this review, we will re-assess the role of doxofylline, a xanthine 
characterized by a much higher handling than that of theophylline, as add-on treatment in 
paediatric asthma grade 1 – 4. 
Ten studies evaluated doxofylline in the treatment of asthma of patients non-responsive to the 
first-line inhaled corticosteroids. Of these, two included children and one was exclusively 
paediatric. According to their results, doxofylline exerts a powerful bronchodilator and anti-
inflammatory activity, which can be exploited when the inhaled oral corticosteroids are not 
sufficient to get the desired effect of reducing symptoms. Unlike theophylline, doxofylline does 
not require blood testing. It can be administered together with or as an alternative to a series of 
other drugs considered in additional therapy. In particular, doxofylline could be preferable in the 
following conditions: risk of low compliance with inhalers; risk of neurologic side-effects with 
LTRA; risk of serious asthma-related events attributable to LABAs; risk of discontinuation due 
to perceived inefficacy with ICS/LABA; doubts on the efficacy of LAMA; need for concomitant 
use of drugs that interfere with cytochrome p450, as some antibiotics, anti-epileptics, and 
antiarrhythmics.