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Evidence summaries

Theophylline for Exacerbations of COPD

Methylxanthines may have some beneficial effects on lung function and clinical endpoints in exacerbations of COPD but these are offset by increased adverse effects. Level of evidence: "C"

A Cochrane review [Abstract] 1 included 4 studies with a total of 169 subjects. Mean change in forced expiratory volume in one second (FEV1) at 2 hours was similar in methylxanthine and placebo groups but transiently increased with methylxanthines at 3 days (WMD 101 ml, 95% CI 26 to 177). Data on clinical outcomes were sparse. Trends toward improvements in hospitalisation and length-of-stay were offset by a trend toward more relapses at one week. Changes in symptom scores were not significant. Methylxanthines caused more nausea and vomiting than placebo (OR 4.6, 95% CI 1.7 to 12.6) and trended toward more frequent tremor, palpitations, and arrhythmias.

Comment: The quality of evidence is downgraded by sparse data.

References

Primary/Secondary Keywords