Oral enoximone allows the reduction and discontinuation of inhaled steroids and beta2 agonists in asthmatic children.

Int J Pediatr Adolesc Med

Department of Pulmonary Medicine, Erasmus MC, 's-Gravendijkwal 230, 3015, CE, Rotterdam, the Netherlands.

Published: June 2022

AI Article Synopsis

  • - Over the past 20 years, asthma treatments for both adults and children have seen minimal advancements, with inhaled corticosteroids (ICS) and β-2-mimetics remaining the primary options, despite the introduction of some new therapies.
  • - Enoximone, a PDE3 inhibitor, previously used for severe asthma cases, was tested on over 70 patients (aged 0-77) and showed positive improvements in asthma symptoms, quality of life, and drug compliance, with minimal side effects.
  • - Enoximone not only alleviated asthma symptoms but also appeared to reduce the severity of related conditions such as allergies and eczema, suggesting it could serve as a valuable alternative or supplement to existing asthma treatments,

Article Abstract

In the last two decades, improvement on asthma treatment has been merely marginal for both adults and children; inhaled corticosteroids (ICS) combined with β-2-mimetics remain the main therapy [3,4]. "New" therapies are just variations on ICS or, for children, on various other drugs that were allowed for adult asthma patients (clinicaltrials.gov). Although currently monoclonal antibodies have been introduced to the field, there is still a large therapeutic burden, given the mortality rate and widespread prevalence of uncontrolled asthma [2]. A simple and adequate way to reduce distress and costs would have great merit. PDE3 inhibitor enoximone was used earlier in successful treatment of life-threatening bronchial asthma (status asthmaticus) as well as in preoperative settings to prevent patients with severe asthma from suffering major surgery-related exacerbations; also, translational mice models showed the anti-inflammatory effects when PDE3 was targeted. Both outcomes suggested a beneficial effect of enoximone in severe chronic asthma. We hypothesized that enoximone might also be helpful in patients with severe chronic asthma; hence, we treated (and followed) > 70 patients (age 0-77, all volunteers) with personalized low doses of enoximone (orally), among them 11 minors, who are described here. Both children and adults reported improvement and/or alleviation of their asthma symptoms. All patients reported a better quality of life and greater drug compliance. The drug was well tolerated and showed no/negligible side effects. Notable bonus: asthma-related comorbidities (allergies, eczema, and rhinitis) were reported also to be less severe or even to disappear. The evaluation shows that PDE3 inhibitor enoximone is an adequate alternative for or addition to current asthma therapeutics, as add-on as well as stand-alone, considerably reducing the use of β-2-mimetics/ICS, with no or negligible side effects. Additional studies are advisable.

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Source
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC9152565PMC
http://dx.doi.org/10.1016/j.ijpam.2021.02.002DOI Listing

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