Exploring pentoxifylline as an alternative treatment for dexamethasone in diabetic patients with COVID-19: a randomized controlled trial

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BACKGROUND: Recent infectious disease outbreaks, notably COVID-19, have significantly affected society. Despite initial preventive measures and vaccination efforts, COVID-19 persist, requiring effective treatments. Commonly used corticosteroids face debate over their efficacy, with studies questioning their impact on COVID-19 outcomes and their association with hyperglycemia, particularly in diabetic patients. This complex interaction between COVID-19, diabetes, and corticosteroid use underscores the need for alternative treatments like pentoxifylline (PTXF) to manage inflammation and mitigate corticosteroid-induced hyperglycemia in diabetic patients. METHOD: This study aimed to assess the effectiveness of PTXF in diabetic COVID-19 patients through a randomized, controlled trial. Patients with specific criteria were recruited from two academic hospitals in Yazd, Iran and randomized to receive PTXF or dexamethasone along with other medications. Outcome measures included inflammatory markers, clinical symptoms, adverse events, and hyperglycemic-related risks. RESULT: The clinical trial, involving 47 diabetic patients, revealed that on the seventh day, the PTXF group exhibited lower mean levels of WBC, neutrophil, lymphocyte, IL6, and CRP compared to the dexamethasone group (p-value < 0.05). In addition, the rise in blood sugar during the illness was significantly lower in the PTXF group due to great importance and interest. CONCLUSIONS: PTXF may present promising evidence in improving COVID-19 patients by reducing inflammatory parameters, especially in diabetic patients. TRIAL REGISTRATION: Trial registry date: 2024-10-12, Trial Registry number: IRCT20190810044500N29.

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