title: Comparative assessment of enprofylline and theophylline for chronic obstructive airways disease in the elderly.
abstract: Enprofylline, a recently developed xanthine derivative, is a more potent bronchodilator than theophylline. This study compares the efficacy and safety of enprofylline with theophylline for chronic obstructive airways disease (COAD) in elderly subjects. The study was of a randomized double-blind parallel design and commenced with a 1-week reference period when oral bronchodilators were withdrawn. Patients were then treated with either enprofylline or theophylline 150 mg bd for 2 weeks (period 1) followed by 300 mg bd for a further 3 weeks (period 2). Patients recorded peak expiratory flow rate (PEFR) and adverse experiences, if any, in a diary, daily. Of 111 patients recruited for the study, 85 entered active treatment (theophylline, n = 44; enprofylline, n = 41). Mean age was 72 years and mean bronchodilator reversibility was 22%. Enprofylline increased mean morning PEFR by 11% (period 1) and 19% (period 2) whereas theophylline increased PEFR by 13% and 19%, respectively. From the enprofylline group 29% were withdrawn from the study due mainly to headache and nausea/vomiting and from the theophylline group 7% were withdrawn due mainly to nausea/vomiting. Mean plasma concentrations of enprofylline were 2.0 mg l-1 and 3.4 mg l-1, and with theophylline 5.4 mg l-1 and 10.0 mg l-1 at the end of periods 1 and 2, respectively. Enprofylline and theophylline produced similar improvements in lung functions and symptoms of chronic obstructive airways disease, but enprofylline was less well tolerated than theophylline.
authors.affiliation: Department of Health Care for the Elderly, King's College School of Medicine and Dentistry, London, U.K.
authors.forename: J D
authors.initials: JD
authors.lastname: Arnold
authors.forename: R J
authors.initials: RJ
authors.lastname: Courtenay-Evans
authors.forename: R
authors.initials: R
authors.lastname: Whitfield
authors.forename: J F
authors.initials: JF
authors.lastname: O'Reilly
authors.forename: G R
authors.initials: GR
authors.lastname: Petrie
authors.forename: A J
authors.initials: AJ
authors.lastname: Higgins
authors.forename: C G
authors.initials: CG
authors.lastname: Swift
mesh_terms: D000368:Aged; D001993:Bronchodilator Agents / Q000627:therapeutic use*; D004311:Double-Blind Method; D005260:Female; D006261:Headache / Q000139:chemically induced; D006801:Humans; D008173:Lung Diseases, Obstructive / Q000188:drug therapy* / Q000503:physiopathology; D008297:Male; D010366:Peak Expiratory Flow Rate / Q000187:drug effects; D013806:Theophylline / Q000009:adverse effects / Q000627:therapeutic use*; D014970:Xanthines / Q000009:adverse effects / Q000627:therapeutic use*
chemical_list: D001993:Bronchodilator Agents; D014970:Xanthines; D013806:Theophylline; C034347:enprofylline