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

Abstract

Abstract In the last two decades, improvement with regard to 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 the still 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.cWe hypothesized that enoximone might also be helpful in patients with (severe) chronic asthma; hence, we treated (and followed)\u202f>\u202f70 patients (age 0–77, all volunteers) with personalized low doses of enoximone (orally), among which were 11 minors, which we describe here. 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 disappear.The evaluation shows that PDE3 inhibitor enoximone is an adequate alternative for or addition to current asthma therapeutics, both 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.