Effect of theophylline as an adjunct to inhaled corticosteroids on COPD exacerbations

The results of a new study do not support the use of low-dose theophylline as adjunctive therapy to inhaled corticosteroids for the prevention of exacerbations among adults with chronic obstructive pulmonary disease (COPD), U.K. researchers report.

The results of a new study do not support the use of low-dose theophylline as adjunctive therapy to inhaled corticosteroids for the prevention of exacerbations among adults with chronic obstructive pulmonary disease (COPD), U.K. researchers report. The drug has been used as a bronchodilator to treat COPD for years; however, the higher doses that are required to achieve an effect are associated with adverse effects. In this study, more than 1,500 participants in the United Kingdom were randomized to receive low-dose theophylline (200 mg once or twice per day) to provide plasma concentrations of 1 to 5 mg/L (based on ideal body weight and smoking status) or placebo. The participants had a ratio of forced expiratory volume in the first second to forced vital capacity of less than 0.7 with at least two exacerbations in the previous year and were using an inhaled corticosteroid. There were 3,430 exacerbations in a 1-year period, with a mean number of 2.24 in the theophylline group and 2.23 in the placebo group. The researchers note that low-dose theophylline was not associated with a greater number of adverse reactions or serious adverse events, nor were there significant differences in the symptom profiles of serious adverse events between the theophylline and placebo groups.