Page 122 - Ebook-Book JCMS 2025

Effect of Add-on Doxofylline on Symptom Improvement in
Severe COPD Exacerbation: A Double-blind, Randomized,
Placebo-controlled Trial
Nathaorn Phuangsombut, Pitchayapa Ruchiwit*
Department of Medicine, Faculty of Medicine, Thammasat University
*Corresponding Author E-mail: toon.pitchayapa@gmail.com
Background: Abstract
Acute exacerbations of chronic obstructive pulmonary disease (COPD AE) are a significant
global health burden. Doxofylline has bronchodilatory and anti-inflammatory properties,
along with a steroid-sparing effect, but limited data exists on its use in severe COPD
exacerbations.
Objective: To assess the effect of doxofylline on dyspnea symptoms, lung function and the incidence
of recurrent exacerbations at 30 days, along with inflammatory marker levels.
Methods: This double-blind, randomized, placebo-controlled trial enrolled patients presenting with
COPD AE at a tertiary hospital. Patients received either 400 mg of doxofylline or placebo, in
addition to standard treatment.
Results: Twenty-four patients (mean age 73.7 ± 9.1 years, 95.8% male) were enrolled. No significant
differences were observed between treatment and placebo groups in dyspnea symptoms
(measured by CATS, mMRC, and VAS), lung function, or recurrent exacerbations at 30 days.
However, the doxofylline group showed a trend towards lower C-reactive protein (CRP)
levels compared to the placebo group (1.47 vs. 2.50 mg/dL, p = 0.08).
Conclusions: Doxofylline did not significantly improve clinical symptoms in severe COPD AE but showed
a potential reduction in inflammatory biomarkers. These results suggest doxofylline’s
anti-inflammatory effects merit further study, with larger trials needed to confirm its role in
COPD AE management.
120 Joint Conference in Medical Sciences 2025