Comparative assessment of enprofylline and theophylline for chronic obstructive airways disease in the elderly.
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a randomized double-blind parallel design and commenced with a 1-week reference period when oral bronchodilators were withdrawn.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 From the enprofylline group 29% were withdrawn from the study due mainly to headache and nausea/vomiting and from the theophylline group 7% were withdrawn due mainly to nausea/vomiting.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.
Arnold
J D
JD
Department of Health Care for the Elderly, King's College School of Medicine and Dentistry, London, U.K.
Courtenay-Evans
R J
RJ
Whitfield
R
R
O'Reilly
J F
JF
Petrie
G R
GR
Higgins
A J
AJ
Swift
C G
CG
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*
D001993:Bronchodilator Agents; D014970:Xanthines; D013806:Theophylline; C034347:enprofylline