Efficacy and safety profile of xanthines in COPD: a network meta-analysis

Cazzola, Mario; Calzetta, Luigino; Barnes, Peter J.; Criner, Gerard J.; Martínez, Fernando J.; Papi, Alberto; Matera, Maria Gabriella

doi:10.1183/13993003.congress-2018.pa615

Cited by 8 publications

(13 citation statements)

References 11 publications

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“…The small differences in results between the pairwise and network meta-analyses may be due to the presence of the placebo node in the Bayesian analysis that reinforced the comparison across the investigated arms. Taken together the findings of this meta-analysis support the rationale for using doxofyilline to treat chronic obstructive respiratory disorders, and its superiority with respect to theophylline [6,8,17]. Considering also the beneficial cost-effectiveness profile of the pharmacological treatment with doxofyilline [7], and the advantage of not needing the monitoring of theophyllinemia, there is no reason not to choose doxofylline as first line treatment when a methylxanthine is indicated in asthmatic patients.…”

Section: Discussionmentioning

confidence: 55%

“…Citations of previously published analyses and relevant reviews were examined to identify further pertinent studies, if any [6,8,[17][18][19].…”

Section: Search Strategymentioning

confidence: 99%

“…The novel methylxanthine doxofylline, that is characterized by bronchodilator and antiinflammatory activities, seems to be not affected by the major drawback of theophylline [1][2][3][4][5]. Doxofylline has a favourable efficacy profile accompanied by a high level of tolerability, at least in COPD patients [6]. Moreover, an observational study aimed to assess the treatment plan in acute and chronic respiratory tract diseases, has demonstrated a significant difference in the unit cost per patient in favour of doxophylline compared to theophyllne.…”

Section: Introductionmentioning

confidence: 99%

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

et al. 2019

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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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Section: Discussionmentioning

confidence: 55%

“…Citations of previously published analyses and relevant reviews were examined to identify further pertinent studies, if any [6,8,[17][18][19].…”

Section: Search Strategymentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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

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“…The change in lung function was not correlated with the change in HbA 1c during the observation period. The extent of FEV 1 increase overcame the minimal clinically important difference (MCID) of 100 ml [29].…”

Section: Discussionmentioning

confidence: 99%

Long-term observational study on the impact of GLP-1R agonists on lung function in diabetic patients

Rogliani

Matera

Calzetta

et al. 2019

Respiratory Medicine

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Introduction: Preclinical research suggests a role of Glucagon Like Peptide-1 Receptors (GLP-1R) on the regulation of human bronchial tone. We investigated the effect of GLP-1R agonists on lung function of Type 2 Diabetes Mellitus (T2DM) population without co-existing chronic obstructive respiratory disorders. Methods: This was a prospective cohort study that examined change in lung function measurements over two years of T2DM patients (n = 32) treated with metformin monotherapy (control cohort), metformin plus GLP-1R agonists (GLP-1R agonists cohort), or metformin plus insulin (insulin cohort). Results: After 24 months of treatment, the forced expiratory volume in 1 s (FEV 1 ) significantly (p < 0.05) increased from baseline in the GLP-1R agonists cohort (218 ml [95%CI 88-246]), but not in the control and insulin cohorts (94 ml [95%CI -28 -216] and 26 ml [95%CI -174 -226], respectively; p > 0.05 vs. baseline). The average increase in FEV 1 in the GLP-1R agonists cohort was significantly greater than that in the control and insulin cohorts (delta: 110 ml [95%CI 18-202] and 177 ml [95%CI 85-270], respectively, p < 0.05). The forced vital capacity (FVC) also increased significantly more in the GLP-1R agonists cohort than in the control and insulin cohorts (overall delta FVC: 183 ml [95%CI 72-295], p < 0.05). The maximal expiratory flow at 50-75% significantly (p < 0.05) improved from baseline in the GLP-1R agonists cohort, but not in the control and insulin cohorts (p > 0.05). Conclusion:Our preliminary results suggest a potential new therapeutic perspective to treat airway disorders with GLP-1R agonists.

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“…The risk of bias in the network meta-analysis was checked via the normalized consistency/inconsistency analysis that permitted to assess whether the outcomes resulting from the consistency and inconsistency models fit adequately with the line of equality, as previously described (Cazzola et al, 2017). The inconsistency of evidence was also assessed by quantifying the inconsistency factor, indicating whether one of the treatment had a different effect when it was compared with the others (Cazzola et al, 2018). The quality of the evidence was scored in agreement with the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) system (Guyatt et al, 2011).…”

Section: Quality Of Studies Risk Bias and Evidence Profilementioning

confidence: 99%

Anthelminthic medicinal plants in veterinary ethnopharmacology: A network meta-analysis following the PRISMA-P and PROSPERO recommendations

Calzetta

Pistocchini²,

Leo

et al. 2020

Heliyon

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Medicinal plants may be effective against helminthic infestation in animals, but to date few studies have investigated the real impact of anthelminthic medicinal plants in veterinary ethnopharmacology.The aim of this study was to assess the geographical use of anthelminthic medicinal plants in livestock in European Union (EU), and to quantify the anthelminthic efficacy of medicinal plants in comparison with anthelminthic drugs. Surveys on the use of anthelminthic traditional medicinal plants in livestock in the EU were included in the qualitative synthesis. Studies that investigated the efficacy of anthelminthic traditional medicinal plants in animals, compared with negative control and/or anthelminthic drugs, were included in the quantitative synthesis (network meta-analysis).Twelve surveys (9 in Italy, 2 in Spain, 1 in Austria) reported the use of anthelminthic medicinal plants in livestock living in EU Countries. Data obtained from 256 animals and extracted from 6 studies were included in the network meta-analysis. Medicinal plants and drugs were more effective than negative control (standardized mean difference [SMD]: -0.60 95%CrI -0.88 to -0.31, -0.73 95%CrI -1.08 to -0.38, respectively, P < 0.001). Overall, no difference was detected between anthelminthic medicinal plants and anthelminthic drugs, namely albendazole, ivermectin, fenbendazole, and doramectin (SMD: 0.26 95%CrI -0.02 to 0.55, P > 0.05). The most effective anthelminthic medicinal plants were Artemisia absintihium, Allium sativum, and Duranta erecta.There is the strong medical need of performing adequately powered randomized controlled trials in different livestock species aimed to improve the quality of the current evidence concerning the anthelminthic efficacy of medicinal plants compared to that of the currently available antiparasitic drugs.

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Efficacy and safety profile of xanthines in COPD: a network meta-analysis

Cited by 8 publications

References 11 publications

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

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

Long-term observational study on the impact of GLP-1R agonists on lung function in diabetic patients

Anthelminthic medicinal plants in veterinary ethnopharmacology: A network meta-analysis following the PRISMA-P and PROSPERO recommendations

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