Oral theophylline for chronic obstructive pulmonary disease

Abstract

Theophylline has a modest effect on FEV1 and FVC and slightly improves arterial blood gas tensions in moderate to severe COPD. These benefits were seen in patients receiving a variety of different concomitant therapies. Improvement in exercise performance depended on the method of testing. There was a very low dropout rate in the studies that could be included in this review, which suggests that recruited patients may have been known by the investigators to be theophylline tolerant. This may limit the generalisability of these studies.

Efficacy and safety of roflumilast in patients with chronic obstructive pulmonary disease: a systematic review and meta-analysis

“…Although theophylline can be toxic and close monitoring of drug levels is necessary, it has been shown to improve respiratory symptoms, gas exchange, lung function and respiratory muscle function in patients with COPD [Murciano et al 1989]. In a meta-analysis of 20 randomized, controlled trials, the mean improvement in FEV 1 with theophylline was 100 ml compared with placebo [Ram et al 2002], which is much greater than that of roflumilast (52 ml) noted in this meta-analysis. Although comparing the efficacy of medications across studies is hampered by biases as studies commonly use different selections criteria, the above comparison may still be valid given comparable baseline characteristics between the two meta-analyses.…”

Role of Transcription Factors in the Pathogenesis of Asthma and COPD

“…Despite most current COPD guidelines stating that theophylline is of limited value in the routine management of COPD, many short-term controlled clinical trials support the utility of theophylline in the management of stable COPD patients (Ram et al, 2002) and further larger controlled clinical trials are ongoing for investigating the long-term anti-infl ammatory and clinical effi cacy of low dose theophylline. Bronchial biopsy studies are required to evaluate whether low dose theophylline has, as demonstrated in bronchial asthma, a signifi cant in vivo anti-infl ammatory activity .…”

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“…[34] Many dietary plant, fruits, vegetables, medicinal plants, and herbs contain various phytochemical constituents, such as alkaloids, nitrogencompounds, and vitamins. [35] Phytomedicine is known as the branch of plant-based traditional medical practice that uses various plant materials considered both preventive and therapeutic. Herbs usually naturally contain many important chemicals and thus medicines derived from such sources can have multiple health benefits when administered to patients.…”

“…In addition, Boskabady and colleagues have demonstrated that extracts and oils from N.sativa have inhibitory effects on histamine (H 1 ) receptors, stimulatory effects on β-adrenergic receptors and antitussive effects. [35] To translate these promising in vitro findings Boskabady and colleagues set out to investigate the effect of boiled N. sativa extract on lung function in asthmatic patients. [36] In this study, they compared the bronchodilatory effects of N. sativa with those of theophylline in 16 asthmatics.…”