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多索茶碱治疗哮喘的疗效与安全性:一项荟萃分析。

Efficacy and safety profile of doxofylline in asthma: a meta-analysis.

作者信息

Gao Fa, Li Jian, Hou Yulong, Sun Shuxin, Chen Yiyuan, Cao Fang, Xu Hang, Li Jing

机构信息

College of Chinese Medicine, Changchun University of Chinese Medicine, Changchun, Jilin, China.

School of Basic Medicine, Changchun University of Chinese Medicine, Changchun, Jilin, China.

出版信息

J Asthma. 2025 Feb;62(2):205-215. doi: 10.1080/02770903.2024.2404192. Epub 2024 Sep 21.

Abstract

OBJECTIVE

This work aims to explore the effectiveness and safety of doxofylline in asthma treatment.

DATA SOURCES

Relevant studies published before March 2023 were retrieved from EMBASE, Cochrane Library, PubMed, and Web of Science databases.

STUDY SELECTIONS

Risk of Bias tool (RoB 2) was applied to determine the quality of randomized controlled trials (RCTs). Relative risks (RR, 95% confidence intervals [CI]) and weighted mean differences (WMD, 95% CI) were calculated for dichotomous and continuous outcomes, respectively, under fixed or random-effects models.

RESULTS

A total of eight clinical trials comprising 1627 patients were analyzed. The meta-analysis revealed no notable change in forced expiratory volume in 1 s (FEV1) (WMD = 0.48; 95% CI: -2.09 to 3.05), the use of albuterol as a rescue medication (WMD = -0.02; 95% CI: -0.57 to 0.52), forced vital capacity (FVC) (WMD = 0.19; 95% CI: -0.28 to 0.67) and FEV1 predicted value (WMD = 1.53; 95%CI: -0.88 to 3.94) between doxofylline and control groups. However, doxofylline treatment significantly reduced adverse reactions (RR = 0.71; 95% CI: 0.60 to 0.84) and decreased the incidence of asthma events (WMD = -0.18; 95% CI: -0.33 to 0.03). Subgroup analysis results indicated that the improvement in FEV1 with doxofylline combined with budesonide was superior to that of budesonide combined with montelukast or tiotropium but inferior to that of budesonide plus formoterol combination.

CONCLUSION

Doxofylline treatment significantly reduces the risk of asthma events and adverse events (AEs), demonstrating good safety and longer-term benefits.

摘要

目的

本研究旨在探讨多索茶碱治疗哮喘的有效性和安全性。

数据来源

从EMBASE、Cochrane图书馆、PubMed和Web of Science数据库中检索2023年3月之前发表的相关研究。

研究选择

应用偏倚风险工具(RoB 2)来确定随机对照试验(RCT)的质量。在固定效应或随机效应模型下,分别计算二分变量和连续变量结果的相对风险(RR,95%置信区间[CI])和加权平均差(WMD,95%CI)。

结果

共分析了8项临床试验,包括1627例患者。荟萃分析显示,多索茶碱组和对照组在第1秒用力呼气量(FEV1)(WMD = 0.48;95%CI:-2.09至3.05)、使用沙丁胺醇作为急救药物(WMD = -0.02;95%CI:-0.57至0.52)、用力肺活量(FVC)(WMD = 0.19;95%CI:-0.28至0.67)和FEV1预测值(WMD = 1.53;95%CI:-0.88至3.94)方面无显著变化。然而,多索茶碱治疗显著降低了不良反应(RR = 0.71;95%CI:0.60至0.84),并降低了哮喘事件的发生率(WMD = -0.18;95%CI:-0.33至0.03)。亚组分析结果表明,多索茶碱联合布地奈德在FEV1改善方面优于布地奈德联合孟鲁司特或噻托溴铵,但劣于布地奈德加福莫特罗联合治疗。

结论

多索茶碱治疗显著降低哮喘事件和不良事件(AE)的风险,显示出良好的安全性和长期效益。

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