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Evidence summaries

Oral Theophylline for Chronic Obstructive Pulmonary Disease

Theophylline has a modest effect on FEV1 and FVC and slightly improves arterial blood gas tensions in moderate to severe COPD. Level of evidence: "A"

A Cochrane review [Abstract] 1 included 20 studies. FEV1 improved with treatment: WMD 100 ml; 95% CI 40 to 160 ml. Similarly for FVC: WMD 210 ml, 95% CI 100 to 320 ml. Two studies reported an improvement in VO2max; WMD 195 ml/min, 95% CI 113 to 278 ml/min. At rest, PaO2 and PaCO2 both improved with treatment (WMD 3.2 mmHg; 95% CI 1.2 to 5.1 mmHg, and WMD -2.4 mmHg; 95% CI -3.5 to -1.2 mmHg, respectively). Walking distance tests did not improve (4 studies, SMD 0.30, 95% CI -0.01 to 0.62), neither did Visual Analogue Score for breathlessness in two small studies (WMD 3.6, 95% CI -4.6 to 11.8). The relative risk (RR) of nausea was greater with theophylline (RR 7.7; 95% CI 1.5 to 39.9). However, patients' preference for theophylline was greater than that for placebo (RR 2.27; 95% CI 1.26 to 4.11). Very few participants withdrew from these studies for any reason.

    References

    • Ram FS, Jones PW, Castro AA, De Brito JA, Atallah AN, Lacasse Y, Mazzini R, Goldstein R, Cendon S. Oral theophylline for chronic obstructive pulmonary disease. Cochrane Database Syst Rev 2002;(4):CD003902. [PubMed]

Primary/Secondary Keywords