Long-acting beta2-agonists versus theophylline for maintenance treatment of asthma

Tee, Augustine; Koh, Mariko Siyue; Gibson, Peter G.; Lasserson, Toby J; Wilson, Amanda; Irving, Louis

doi:10.1002/14651858.cd001281.pub2

Cited by 50 publications

(21 citation statements)

References 35 publications

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“…Within the currently available add-on medications, LABA probably shows the strongest bronchodilator effects and is the fi rst-line therapy in persistent asthma in combination with ICS (NIH, 2002). In asthmatic adults on low doses of ICS, the addition of LABA is superior to LTRA or theophylline for asthma control (Ducharme et al, 2006;Tee et al, 2007). However, LABA is not primarily an antiinfl ammatory drug, and does not appear to have any clinically important anti-infl ammatory or proinfl ammatory effect (Sindi et al, 2009).…”

Section: Discussionmentioning

confidence: 99%

Comparison of Leukotriene Receptor Antagonist and Theophylline in Addition to Inhaled Corticosteroid in Adult Asthma: A Meta-Analysis

Fang¹,

Wang²,

Jin³

et al. 2011

Biomolecules and Therapeutics

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Section: Discussionmentioning

confidence: 99%

Comparison of Leukotriene Receptor Antagonist and Theophylline in Addition to Inhaled Corticosteroid in Adult Asthma: A Meta-Analysis

Fang¹,

Wang²,

Jin³

et al. 2011

Biomolecules and Therapeutics

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“…Fewer side effects were also experienced. 50 When compared with standard dose ICS, theophyllines were inferior with regard to frequency of exacerbations 49 although other studies have found standard dose ICS plus add-on theophylline to be superior to high dose ICS alone in patients uncontrolled at lower dose 51 thus promoting theophylline as a steroid sparing drug. Aminophylline still has a well-established role in the treatment of acute asthma.…”

Section: Methylxanthinesmentioning

confidence: 98%

Current and Emerging Pharmacotherapies in Children with Moderate to Severe Chronic Asthma

2011

Clinical Medicine Reviews in Therapeutics

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Moderate to severe chronic asthma in children provides challenges in both diagnosis and treatment for paediatricians. The clinician treating difficult to control asthma meets a number of challenges such as non-adherence and paucity of strong clinical evidence. Understanding different asthma phenotypes, pathophysiology and the inflammatory process that underpins asthma is essential in order to appreciate the action of the pharmacotherapies available for use beyond the British Thoracic Society Guidelines. Many of the newer drugs used today are inspired by other inflammatory diseases. Through this review we have summarised these issues for the reader and outlined the emerging therapies that may be available in the future.

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“…Consistent with this recommendation, addition of theophylline to low-dose ICS has been shown to be as effective as increasing the dose of ICS for improving control of asthma symptoms 35,36. However, comparison of step-up therapy with theophylline to LABAs has shown that LABAs (ie, salmeterol) are superior in improving morning and evening peak expiratory flow rates, as well as in reducing the use of rescue medication, while no differences were noted in improving FEV 1 36,37. Step-up therapy with the addition of theophylline, however, is associated with a higher incidence of central nervous system and gastrointestinal side effects.…”

Section: Controller Medications For Moderate Persistent Asthmamentioning

confidence: 99%

Achieving Symptom Control in Patients with Moderate Asthma

Weir

Levine

2011

Clin Med Insights Circ Respir Pulm Med

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Disease severity in asthma can be classified as mild, moderate or severe based upon the frequency of symptoms or the severity of airflow obstruction. This review will focus on the treatment of youths greater than 12 years of age and adults with moderate persistent asthma. Moderate asthmatics may have daily symptoms that cause some limitation with normal daily activities and require use of a rescue inhaled short-acting beta2-agonist inhaler or experience nocturnal awakenings secondary to asthma that occur more than once per week. Furthermore, spirometry may reveal airflow obstruction with a reduction in FEV1 to between 60% and 80% of predicted. Although inhaled corticosteroids (ICS) are the primary controller medication used to modify symptoms in moderate asthmatics, additional controller medications, such as inhaled long-acting beta2-agonists (LABA), leukotriene receptor antagonists (LTRA) or theophylline, are often needed to obtain optimal disease control. While the addition of an inhaled LABA to an ICS is very effective at improving disease control in moderate asthma, concerns have arisen over the safety of LABAs, in particular the risk of asthma-related death. Therefore, consideration may be given to initially adding a LTRA, rather than a LABA, to ICS when asthma symptoms are not adequately controlled by ICS alone. Furthermore, individualization of medication regimens, treatment of co-morbid conditions, and patient education are crucial to optimizing compliance with therapy, improving disease control, and reducing the risk of exacerbations. Lastly, the development of new asthma treatments, perhaps based upon personalized medicine, may revolutionize the future treatment of moderate asthma.

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Long-acting beta2-agonists versus theophylline for maintenance treatment of asthma

Cited by 50 publications

References 35 publications

Comparison of Leukotriene Receptor Antagonist and Theophylline in Addition to Inhaled Corticosteroid in Adult Asthma: A Meta-Analysis

Comparison of Leukotriene Receptor Antagonist and Theophylline in Addition to Inhaled Corticosteroid in Adult Asthma: A Meta-Analysis

Current and Emerging Pharmacotherapies in Children with Moderate to Severe Chronic Asthma

Achieving Symptom Control in Patients with Moderate Asthma

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