Value of theophylline treatment in patients handicapped by chronic obstructive lung disease.

McKay, Shayna; Howie, Catherine A.; Thomson, Anne; Whiting, B.; Addis, G. J.

doi:10.1136/thx.48.3.227

Cited by 90 publications

(43 citation statements)

References 36 publications

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“…Combining these drugs produces the following additional benefits. In general, oral theophylline is a weakly effective bronchodilator and has more side-effects at pharmacological doses [34]. Inhaled corticosteroids produce a small improvement in post-bronchodilator FEV1 comparable with that due to longacting b-agonists (LABA) in some [35], but not all [36], clinical studies.…”

Section: Drugs and The Secondary Prevention Of Copdmentioning

confidence: 99%

Drugs (including oxygen) in severe COPD

Albert¹,

Calverley²

2008

Eur Respir J

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Access to comprehensive guidelines on the management of chronic obstructive pulmonary disease (COPD) is now available, and several treatment goals of therapy have been identified from these guidelines, which have since been studied in clinical trials.Drug therapy is a key component of an individual patient's management plan, particularly in more severe disease. During the past few years, a number of new drug treatments have become available, although these are not always appropriately prescribed; this is particularly the case for oxygen.For patients with a history of exacerbations, there is good evidence for the use of inhaled longacting anticholinergic agents or combined inhaled steroids and long-acting b-agonists. Evidence for prophylactic antibiotics and antioxidant agents is lacking. Nutritional and calorie supplementation have not been shown to improve exercise capacity. Statins may improve outcomes in COPD, but prospective trials are needed to confirm this.The evidence for the use of long-term oxygen therapy in hypoxaemic patients is robust. Ambulatory oxygen improves exercise capacity, but whether it is used appropriately is in doubt. Overall, short burst oxygen therapy does not offer a benefit and therefore cannot be recommended.

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Section: Drugs and The Secondary Prevention Of Copdmentioning

confidence: 99%

Drugs (including oxygen) in severe COPD

Albert¹,

Calverley²

2008

Eur Respir J

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“…Mode of administration, chemical structure, log , and 1/2 values of anticholinergics are given in Table 2. [33]. For example, changes in respiratory muscle function have been reported in patients treated with theophylline [34], but whether this reflects changes in dynamic lung volumes or a primary effect on the muscle remains unclear.…”

Section: Anticholinergicsmentioning

confidence: 99%

Pharmacotherapy of Chronic Obstructive Pulmonary Disease: A Clinical Review

Antus

2013

ISRN Pulmonology

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Chronic obstructive pulmonary disease (COPD) is one of the leading causes of mortality and morbidity worldwide. In addition to generating high healthcare costs, COPD imposes a significant burden in terms of disability and impaired quality of life. Unlike many leading causes of death and disability, COPD is projected to increase in many regions of the world as the frequency of smoking is rising and the population is aging. The pharmacological treatment of COPD includes bronchodilators to relax smooth muscle, such as 2 -agonists (salbutamol, terbutaline, and fenoterol, short-acting 2 -agonists as well as salmeterol, formoterol, and indacaterol, and long-acting 2 -agonists) and anticholinergics, such as ipratropium, oxitropium (short-acting anticholinergic), and tiotropium (long-acting anticholinergic). Although airway inflammation in COPD poorly responds to steroids, several inhaled corticosteroids (fluticasone, budesonide, and beclomethasone) are in use in combination with long-acting 2 -agonists. Other medications include theophylline (both a bronchodilator and a phosphodiesterase inhibitor) and the phosphodiesterase-4 antagonists, such as roflumilast. Finally, a number of novel long-acting anticholinergics and 2 -agonists with once-or twice-daily profiles are in development and clinical testing.

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“…Theophylline has been shown to non-selectively inhibit several PDE isoforms in the airways 60 . Randomized controlled studies have shown that theophylline alone or in addition to bronchodilators and corticosteroids improves respiratory function, dyspnoea and exercise tolerance in patients with severe COPD 61,62 .…”

Section: Theophyllinementioning

confidence: 99%

Management of Inflammation in Chronic Obstructive Pulmonary Disease-Update

Barman¹,

Alam²,

Islam

et al. 2013

Faridpur Med Coll J

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:Chronic obstructive pulmonary disease (COPD) is a systemic inflammatory condition, the earliest manifestation of which is airway obstruction which is only partially reversible and the treatment rationales are provided accordingly. Research has shown that COPD-inflammation involves multiple inflammatory cells and mediators and the underlying pathology differs from asthma inflammation.For these reasons, therapeutic agents that are effective in asthma patients may not be optimal in COPD patients. COPD exacerbations are intensified inflammatory events compared with stable COPD. The clinical and systemic consequences believed to result from the chronic inflammation observed in COPD, suggest that inflammation intensity is a key factor in COPD and exacerbation severity and frequency. Although inhaled corticosteroids are commonly used and are essential in asthma management, their efficacy in COPD is limited, with only a modest effect at reducing exacerbations. The importance of inflammation in COPD needs to be better understood by clinicians, and the differences in inflammation in COPD versus asthma should be considered carefully to optimize the use of anti-inflammatory agents. Current COPD management focuses predominantly on symptom relief by optimizing bronchodilatation. The role of phosphodiesterase type 4 inhibitors (PDE4), statins, angiotensin converting enzyme inhibitors, theophylline and tumor necrosis factor inhibitors in COPD management will be reviewed. Targeting COPD inflammation with the goal of reducing exacerbations is a major focus of current clinical practice & outcome research.

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Value of theophylline treatment in patients handicapped by chronic obstructive lung disease.

Abstract: Background It is still not certain whether it is worth using theophylline in

Cited by 90 publications

References 36 publications

Drugs (including oxygen) in severe COPD

Drugs (including oxygen) in severe COPD

Pharmacotherapy of Chronic Obstructive Pulmonary Disease: A Clinical Review

Management of Inflammation in Chronic Obstructive Pulmonary Disease-Update

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