title: Effect of low-dose theophylline plus beclometasone on lung function in smokers with asthma: a pilot study.
abstract: Smoking is common in asthma and is associated with worse asthma control and a reduced therapeutic response to corticosteroids. The present authors hypothesised that treating smokers with asthma with low-dose theophylline added to inhaled corticosteroids would enhance steroid sensitivity and thereby improve lung function and symptoms. In a double-blind, parallel group exploratory trial, 68 asthmatic smokers were randomised to one of three treatments for 4 weeks: inhaled beclometasone (200 microg day(-1)), theophylline (400 mg day(-1)) or both treatments combined. Outcome measures included change in lung function and Asthma Control Questionnaire (ACQ) scores. At 4 weeks, theophylline added to inhaled beclometasone produced an improvement in peak expiratory flow (39.9 L min(-1), 95% confidence intervals (CI) 10.9-68.8) and ACQ score (-0.47, 95% CI -0.91- -0.04) and a borderline improvement in pre-bronchodilator forced expiratory volume in one second (mean difference 165 mL, 95% CI -13-342) relative to inhaled corticosteroid alone. Theophylline alone improved the ACQ score (-0.55, 95% CI -0.99- -0.11), but not lung function. In the present pilot study, the combination of low-dose theophylline and inhaled beclometasone produced improvements in both lung function and symptoms in a group of smokers with asthma. Larger trials are required to extend and confirm these findings.
authors.affiliation: Faculty of Medicine, University of Glasgow, Glasgow, UK.
authors.forename: M
authors.initials: M
authors.lastname: Spears
authors.forename: I
authors.initials: I
authors.lastname: Donnelly
authors.forename: L
authors.initials: L
authors.lastname: Jolly
authors.forename: M
authors.initials: M
authors.lastname: Brannigan
authors.forename: K
authors.initials: K
authors.lastname: Ito
authors.forename: C
authors.initials: C
authors.lastname: McSharry
authors.forename: J
authors.initials: J
authors.lastname: Lafferty
authors.forename: R
authors.initials: R
authors.lastname: Chaudhuri
authors.forename: G
authors.initials: G
authors.lastname: Braganza
authors.forename: I M
authors.initials: IM
authors.lastname: Adcock
authors.forename: P J
authors.initials: PJ
authors.lastname: Barnes
authors.forename: S
authors.initials: S
authors.lastname: Wood
authors.forename: N C
authors.initials: NC
authors.lastname: Thomson
mesh_terms: D000280:Administration, Inhalation; D000284:Administration, Oral; D000293:Adolescent; D000328:Adult; D000704:Analysis of Variance; D018927:Anti-Asthmatic Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D001249:Asthma / Q000188:drug therapy* / Q000503:physiopathology*; D001507:Beclomethasone / Q000627:therapeutic use*; D001993:Bronchodilator Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D004311:Double-Blind Method; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects; D011446:Prospective Studies; D012129:Respiratory Function Tests; D012907:Smoking / Q000503:physiopathology*; D018709:Statistics, Nonparametric; D013806:Theophylline / Q000627:therapeutic use*; D016896:Treatment Outcome
chemical_list: D018927:Anti-Asthmatic Agents; D001993:Bronchodilator Agents; D013806:Theophylline; D001507:Beclomethasone