Use of theophylline in chronic obstructive pulmonary disease: examining the evidence.
OBJECTIVE
The role of theophylline in the management of chronic obstructive pulmonary disease remains controversial. This review was undertaken to determine the efficacy of theophylline in patients with stable disease.


RESULTS
Twenty-two good quality randomized controlled trials were included in this systematic review. The review showed that theophylline significantly improved forced expiratory volume in 1 s and forced vital capacity (weighted mean difference 0.10 L; 95% confidence interval 0.04-0.16 and weighted mean difference 0.21 L; 95% confidence interval 0.10-0.31, respectively). V also improved with theophylline (weighted mean difference 195.27 mL/min; 95% confidence interval 112.71-277.83), as did Pa and Pa (weighted mean difference 1.45 mmHg; 95% confidence interval 0.26-2.65 and weighted mean difference -1.09 mmHg; 95% confidence interval -1.83 to -0.35, respectively). Patients preferred theophylline over placebo (relative risk 2.27; 95% confidence interval 1.26-4.11). Theophylline increased the risk of nausea, however, compared with placebo (relative risk 7.67; 95% confidence interval 1.47-39.94).


CONCLUSIONS
This review has shown that oral theophylline plays an important role in the management of patients with stable chronic obstructive pulmonary disease by improving lung function, arterial blood gas tensions and ventilatory capacity. Patients also preferred treatment with theophylline when compared with placebo. The benefits of theophylline in stable chronic obstructive pulmonary disease, however, have to be weighed against the risk of adverse effects, particularly nausea.
Ram
Felix S F
FS
School of Health Sciences, Massey University, Auckland, New Zealand. fsfram@yahoo.co.uk
D001993:Bronchodilator Agents / Q000627:therapeutic use*; D004311:Double-Blind Method; D005541:Forced Expiratory Volume; D006801:Humans; D029424:Pulmonary Disease, Chronic Obstructive / Q000188:drug therapy* / Q000453:epidemiology* / Q000503:physiopathology; D016032:Randomized Controlled Trials as Topic; D013806:Theophylline / Q000627:therapeutic use*; D016896:Treatment Outcome; D014797:Vital Capacity
D001993:Bronchodilator Agents; D013806:Theophylline