Comparison of inhaled corticosteroid combined with theophylline and double-dose inhaled corticosteroid in moderate to severe asthma.
OBJECTIVE
Recent studies have found that theophylline exerts anti-inflammatory and immunomodulatory effects. This study was performed to compare the efficacy of inhaled corticosteroids (ICS) combined with slow-release theophylline (SRT) with that of double-dose ICS in asthma control, anti-inflammatory activity and safety.


METHODS
In a randomized, open, parallel, control trial, 41 patients with asthma were randomly treated with either beclomethasone dipropionate 500 microg b.i.d. (BDP group) or a combination of BDP 250 microg b.i.d and SRT 0.2 g b.i.d. (SRT/BDP group) for 6 weeks. At the start and at the end of treatment, lung function testing and sputum induction were performed, and plasma cortisol levels were measured. Sputum was analyzed for cell differential counts and the interleukin (IL)-5 level. Patients kept a record of peak expiratory flow (PEF), symptom score, and beta2-agonist use.


RESULTS
Significant increases in the morning and the evening PEF and FEV1 were observed (P < 0.05), together with an obvious reduction in symptom score and beta2-agonist use (P < 0.01). Significant decreases in the percentage eosinophils and IL-5 level in induced sputum also occurred (P < 0.05). However, there was no difference between the two groups for all these parameters. There was no significant change in the plasma cortisol level for either group.


CONCLUSIONS
Both ICS combined with SRT and double-dose ICS had the same effect on asthma control, improving symptoms and ameliorating lung function. Both therapies had similar anti-airway inflammatory effects and therapeutic safety. Combining SRT with ICS may allow a reduction in ICS dose when treating asthma.
Wang
Yan
Y
Institute of Respiratory Diseases of PLA, Xinqiao Hospital, the Third Military Medical University, Chongqing, China.
Wang
Chang-Zheng
CZ
Lin
Ke-Xiong
KX
Qian
Gui-Sheng
GS
Zhuo
Wen-Lei
WL
Li
Shu-Ping
SP
Zhao
Zhi-Qiang
ZQ
Liao
Xiu-Qing
XQ
Song
Yun-Xi
YX
D000280:Administration, Inhalation; D000328:Adult; D001249:Asthma / Q000097:blood / Q000188:drug therapy*; D001507:Beclomethasone / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D001993:Bronchodilator Agents / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use; D004305:Dose-Response Relationship, Drug; D004359:Drug Therapy, Combination; D004804:Eosinophils / Q000187:drug effects / Q000378:metabolism; D005260:Female; D005938:Glucocorticoids / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D006261:Headache / Q000209:etiology; D006685:Hoarseness / Q000209:etiology; D006801:Humans; D006854:Hydrocortisone / Q000097:blood; D015848:Interleukin-5 / Q000097:blood; D008297:Male; D008875:Middle Aged; D010366:Peak Expiratory Flow Rate; D012129:Respiratory Function Tests; D012720:Severity of Illness Index; D013806:Theophylline / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D016896:Treatment Outcome
D001993:Bronchodilator Agents; D005938:Glucocorticoids; D015848:Interleukin-5; D013806:Theophylline; D001507:Beclomethasone; D006854:Hydrocortisone