Theophylline vs. budesonide in the treatment of mild-to-moderate bronchial asthma.
Eight patients with mild extrinsic asthma participated in a double-blind randomized intraindividual cross-over study involving 6 weeks' treatment with twice daily oral theophylline (2 x 1 capsules = 800 mg/day Cronasma 400) and 6 weeks' treatment with twice daily inhaled budesonide (2 x 2 puffs = 0.8 mg/day Pulmicort) with nebuhaler administered in the morning and in the evening before eating. Lung function and carbachol provocation measured with the whole-body box method were performed at the beginning and after 6 weeks of treatment. Mucociliary clearance (MC) assessed with a scintillation camera and bronchoalveolar lavage (BAL) were both performed after 6 weeks of treatment. All patients documented daily peak flows in the morning and in the evening. [table: see text] Additional use of beta 2-agonists at night and during the day was not different for theophylline (0.10 +/- 0.39 and 1.16 +/- 2.87 puffs) and budesonide (0.11 +/- 0.45 and 1.97 +/- 3.02 puffs). MC (32 +/- 15% under theophylline and 33 +/- 14% after budesonide), carbachol provocation and lung function data at the end of both treatment periods were the same as well as BAL data. Two patients needed a reduction of the theophylline dose due to nausea. This study documents the equipotency of theophylline (mean blood level 11.9 +/- 4.6 mg/l) and budesonide (2 x 2 puffs = 0.8 mg/day) in patients with mild-to-moderate asthma.
Matthys
H
H
Department of Medicine, University Hospital Freiburg, Germany.
Müller
S
S
Herceg
R
R
D000280:Administration, Inhalation; D000284:Administration, Oral; D000328:Adult; D001249:Asthma / Q000188:drug therapy*; D001985:Bronchial Provocation Tests; D001992:Bronchoalveolar Lavage Fluid / Q000166:cytology; D001993:Bronchodilator Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D019819:Budesonide; D002217:Carbachol; D018592:Cross-Over Studies; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009079:Mucociliary Clearance / Q000187:drug effects; D010366:Peak Expiratory Flow Rate / Q000187:drug effects; D011282:Pregnenediones / Q000008:administration & dosage / Q000627:therapeutic use*; D013806:Theophylline / Q000008:administration & dosage / Q000627:therapeutic use*
D001993:Bronchodilator Agents; D011282:Pregnenediones; D019819:Budesonide; D002217:Carbachol; D013806:Theophylline