{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,18]],"date-time":"2025-12-18T10:10:57Z","timestamp":1766052657739,"version":"3.48.0"},"reference-count":0,"publisher":"Jaypee Brothers Medical Publishing","issue":"11","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JAPI"],"published-print":{"date-parts":[[2025,11,10]]},"abstract":"<jats:p>Introduction: Chronic obstructive pulmonary disease (COPD) is a progressive respiratory condition \ncommonly managed with triple inhaler therapy comprising long-acting beta-agonist (LABA), \nlong-acting muscarinic antagonist (LAMA), and inhaled corticosteroid (ICS). Despite optimal \ninhalation therapy, many patients continue to experience persistent symptoms. Doxophylline, \na novel xanthine derivative, offers bronchodilator and anti-inflammatory benefits with a more \nfavorable safety profile than traditional methylxanthines.\nObjective: To assess the efficacy, safety, and tolerability of oral doxophylline in addition to triple \ninhaler therapy in patients with stable severe COPD.\nMaterials and methods: In this randomized controlled trial, 78 patients were allocated to group A \n(triple therapy + doxophylline 650 mg once daily) and group B (triple therapy alone). Assessment \nincluded the COPD assessment test (CAT score), C-reactive protein (CRP), spirometry parameters \n(FEV\u2081, FEV\u2081%, FEV\u2081\/FVC), adverse events, and evaluations were performed on days 0 and 90.\nResults: By day 90, group A showed greater improvement in CAT score (7.94 \u00b1 4.17 vs 10.06 \u00b1 3.99; \np = 0.033) and CRP (12.2 \u00b1 4.47 vs 15.33 \u00b1 5.37 mg\/L; p = 0.01). Spirometry gains were comparable: \nFEV\u2081 (0.97 \u00b1 0.23 vs 0.96 \u00b1 0.26 L\/minute; p = 0.872), FEV\u2081% predicted (49.10 \u00b1 8.73 vs 48.69 \u00b1 \n9.72%; p = 0.482), and FEV\u2081\/FVC% (54.09 \u00b1 6.57 vs 52.89 \u00b1 6.95%; p = 0.397). Mild adverse events \nincluding palpitations (14.29%), tremors (8.57%), and nausea (2.86%) were more frequent in  \ngroup A but were generally tolerated.\nConclusion: Adjunctive oral doxophylline significantly improved symptom burden and systemic \ninflammation in patients with stable severe COPD without conferring additional spirometric \nbenefits. Although mild adverse effects were observed, doxophylline was overall well tolerated \nand may represent a viable adjunctive option in selected COPD patients with persistent symptoms \ndespite optimized inhaler therapy.<\/jats:p>","DOI":"10.59556\/japi.73.1207","type":"journal-article","created":{"date-parts":[[2025,12,18]],"date-time":"2025-12-18T10:06:42Z","timestamp":1766052402000},"page":"38-42","source":"Crossref","is-referenced-by-count":0,"title":["Optimizing Management Beyond Triple Therapy in Stable  Severe Chronic Obstructive Pulmonary Disease: Efficacy of  Adjunctive Oral Doxophylline in a Randomized Controlled  Trial"],"prefix":"10.59556","volume":"73","author":[{"given":"Bhagiradhi","family":"Thimmapuram","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Subramanian","family":"Suriyan","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nagarjun","family":"Sakthivel","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nalini Jayanthi","family":"Nagesh","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"2914","published-online":{"date-parts":[[2025,11,10]]},"container-title":["Journal of the Association of Physicians of India"],"original-title":[],"deposited":{"date-parts":[[2025,12,18]],"date-time":"2025-12-18T10:06:43Z","timestamp":1766052403000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.japi.org\/article\/japi-73-11-38"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,11,10]]},"references-count":0,"journal-issue":{"issue":"11","published-online":{"date-parts":[[2025,11,10]]},"published-print":{"date-parts":[[2025,11,10]]}},"URL":"https:\/\/doi.org\/10.59556\/japi.73.1207","relation":{},"ISSN":["0004-5772"],"issn-type":[{"value":"0004-5772","type":"print"}],"subject":[],"published":{"date-parts":[[2025,11,10]]}}}