[Clinical and functional benefits of adding theophylline to a standard treatment with short acting bronchodilators in patients with COPD].
BACKGROUND
Although theophylline is considered a third line bronchodilator drug for the treatment of chronic obstructive pulmonary disease (COPD), it is widely used in Chile, because it is administered orally and has a moderate cost.


OBJECTIVE
To evaluate if theophylline adds clinical and/or functional benefits when associated to standard recommended inhaled bronchodilator therapy.


METHODS
Thirty-eight stable COPD patients who accepted to participate in the study approved by the Ethics Committee of our institution were studied. Using a randomized double-blind placebo-controlled study, theophylline (250 mg) or placebo was administered twice a day for 15 days in addition to inhaled salbutamol and ipratropium bromide. Prior to and at the end of the study, patients underwent: a) a spirometry to evaluate changes in dynamic pulmonary hyperinflation using slow vital capacity (SVC) and inspiratory capacity (IC), b) the 6 min walking distance (6 MWD); and c) measurement of maximal inspiratory and expiratory pressures. Dyspnea and quality of life (QoL) were evaluated using appropriate questionnaires.


RESULTS
Compared to placebo, patients on theophylline showed significant increases in SVC (p=0.014), IC (p=0.002), and 6 MWD (p=0.005). They also experienced an improvement in dyspnea (p=0.042) and QoL (p=0.011). All patients improved at least one of these parameters with 53% of the patients showing an improvement in 3 or more.


CONCLUSIONS
Our results indicate that adding theophylline to standard treatment with inhaled bronchodilators provides additional benefits in stable COPD patients by reducing dynamic pulmonary hyperinflation, improving exercise tolerance, dyspnea and QoL.
Dreyse
Jorge
J
Departamento de Enfermedades Respiratorias, Pontificia Universidad Católica de Chile, Santiago, Chile.
Silva
Felipe
F
Díaz
Orlando
O
Borzone
Gisella
G
Lisboa
Carmen
C
D000280:Administration, Inhalation; D000284:Administration, Oral; D000368:Aged; D000420:Albuterol / Q000008:administration & dosage; D001993:Bronchodilator Agents / Q000008:administration & dosage* / Q000097:blood; D004311:Double-Blind Method; D004359:Drug Therapy, Combination; D004417:Dyspnea / Q000188:drug therapy; D005260:Female; D006801:Humans; D007320:Inspiratory Capacity; D009241:Ipratropium / Q000008:administration & dosage; D008297:Male; D011446:Prospective Studies; D029424:Pulmonary Disease, Chronic Obstructive / Q000097:blood / Q000188:drug therapy*; D011788:Quality of Life; D013806:Theophylline / Q000008:administration & dosage* / Q000097:blood
D001993:Bronchodilator Agents; D013806:Theophylline; D009241:Ipratropium; D000420:Albuterol