Theophylline for exacerbations of COPD

Methylxanthines may have some beneficial effects on lung function and clinical endpoints in exacerbations of COPD but these are offset by increased adverse effects.

A Cochrane review included 4 studies with a total of 169 subjects. Mean change in forced expiratory volume in one second (FEV₁) at 2 hours was similar in methylxanthine and placebo groups but transiently increased with methylxanthines at 3 days (WMD 101 ml, 95% CI 26 to 177). Data on clinical outcomes were sparse. Trends toward improvements in hospitalisation and length-of-stay were offset by a trend toward more relapses at one week. Changes in symptom scores were not significant. Methylxanthines caused more nausea and vomiting than placebo (OR 4.6, 95% CI 1.7 to 12.6) and trended toward more frequent tremor, palpitations, and arrhythmias.

Comment: The quality of evidence is downgraded by sparse data.

Ədəbiyyat

1. Barr RG, Rowe BH, Camargo CA. Methylxanthines for exacerbations of chronic obstructive pulmonary disease. Cochrane Database Syst Rev 2003;(2):CD002168 [Last assessed as up-to-date: 2 March 2005].