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Oral theophylline for chronic obstructive pulmonary disease

Overview of attention for article published in Cochrane database of systematic reviews, October 2002
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Title
Oral theophylline for chronic obstructive pulmonary disease
Published in
Cochrane database of systematic reviews, October 2002
DOI 10.1002/14651858.cd003902
Pubmed ID
Authors

Felix SF Ram, Paul Jones, Jose Jardim, Aldemar A Castro, Álvaro N Atallah, Yves Lacasse, Roger Goldstein, Sonia Cendon

Abstract

Oral theophylline has, for many years, been used as a bronchodilator in patients with COPD. Despite the introduction of new drugs, and its narrow therapeutic index, theophylline is still recommended for COPD treatment. To determine the effectiveness of oral theophylline when compared to placebo in patients with stable COPD. The Cochrane Airways Review Group and Cochrane Controlled Clinical Registers were searched. All studies were randomised controlled trials (RCTs). Data were independently abstracted and the methodological quality assessed by two reviewers. Twenty RCTs met the inclusion criteria. Concomitant therapy varied from none to any other bronchodilator plus corticosteroid (oral and inhaled). The following outcomes were significantly different when compared to placebo. FEV1 improved with treatment: Weighted Mean Difference (WMD) 100 ml; 95% Confidence Interval (95%CI) 40, 160 ml. Similarly for FVC: WMD 210 ml 95%CI 100, 320. Two studies reported an improvement in VO2max; WMD 195 ml/min, 95%CI 113,27). At rest, PaO2 and PaCO2 both improved with treatment (WMD 3.2 mmHg; 95%CI = 1.2, 5., and WMD -2.4 mmHg; 95%CI = -3.5, -1.2, respectively). Walking distance tests did not improve (4 studies, Standardised Mean Difference 0.30, 95%CI -0.01, 0.62), neither did Visual Analogue Score for breathlessness isn two small studies (WMD 3.6, 95%CI -4.6, 11.8). The Relative Risk (RR) of nausea was greater with theophylline (RR 7.7; 95%CI 1.5, 39.9). However, patients' preference for theophylline was greater than that for placebo (RR 2.27; 95%CI = 1.26, 4.11). Very few patient withdrew from these studies for any reason. Theophylline has a modest effect on FEV1 and FVC and slightly improves arterial blood gas tensions in moderate to severe COPD. These benefits were seen in patients receiving a variety of different concomitant therapies. Improvement in exercise performance depended on the method of testing. There was a very low dropout rate in the studies that could be included in this review, which suggests that recruited patients may have been known by the investigators to be theophylline tolerant. This may limit the generalisability of these studies.

Mendeley readers

The data shown below were compiled from readership statistics for 105 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
United States 2 2%
United Kingdom 1 <1%
Canada 1 <1%
Unknown 101 96%

Demographic breakdown

Readers by professional status Count As %
Student > Master 19 18%
Unspecified 15 14%
Student > Postgraduate 10 10%
Student > Bachelor 10 10%
Student > Doctoral Student 10 10%
Other 41 39%
Readers by discipline Count As %
Medicine and Dentistry 62 59%
Unspecified 16 15%
Pharmacology, Toxicology and Pharmaceutical Science 9 9%
Nursing and Health Professions 5 5%
Social Sciences 4 4%
Other 9 9%