What are xanthines, and what is their efficacy and side-effect profile as a maintenance treatment for asthma in children?
Label:chem
Topic
Xanthines, such as theophylline and aminophylline, have been used as bronchodilators and may also have anti-inflammatory effects in treating asthma.
Answer
Oral xanthines, including theophylline and aminophylline, are effective as a first-line preventative treatment for mild to moderate asthma in children, alleviating symptoms and reducing the need for rescue medication. They show similar efficacy to regular short-acting beta-agonists (SABA) and sodium cromoglycate (SCG) as a single preventative agent. However, compared to inhaled corticosteroids (ICS), xanthines are less effective in preventing exacerbations and are associated with more frequent side effects like headache and nausea. While there is evidence for increased overall adverse effects compared to placebo, no specific adverse effect (including behavioral or attention issues) has been proven to occur more frequently. Xanthines may have a role as add-on therapy for more severe asthma not controlled by ICS, but further studies are needed to define their risk-benefit ratio against other agents in this role
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