Potential of doxofylline in the treatment of chronic obstructive airway diseases (Review)

Doxofylline, a xanthine derivative introduced in 1987, was developed as an alternative to theophylline for the treatment of chronic respiratory disease, including chronic obstructive pulmonary disease and bronchial asthma, but also a promising agent with therapeutic potential, unique pharmacological profile, improved safety and tolerability, potential to decrease corticosteroid dependence and applicability in diverse healthcare settings, including resource-limited environments. The present review examines the utility of doxofylline as an effective bronchodilator, highlighting its improved tolerability profile, minimal drug interactions and distinct pharmacological activities, including its roles as a phosphodiesterase inhibitor, adenosine receptor antagonist and β-adrenergic receptor agonist, alongside its bronchodilator, antitussive and anti-inflammatory properties. The present review performed a comprehensive analysis of literature and a comparative evaluation of relevant clinical trials. By contrast with theophylline, whose clinical use has diminished due to its narrow therapeutic window and notable side effects, doxofylline demonstrates a more favorable safety profile and wider therapeutic range. Doxofylline not only enhances spirometric values and reduces the need for salbutamol administration but also exhibits fewer adverse effects, contributing to improved patient tolerance and adherence to treatment. Clinical findings further suggest significant improvements in lung function, exercise capacity and quality of life among patients treated with doxofylline. These results underscore its potential as a viable long-term therapeutic option, particularly in resource-limited settings, where it may reduce corticosteroid dependency and provide an effective, affordable and safer alternative to theophylline.