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Efficacy of theophylline in people with stable chronic obstructive pulmonary disease: a systematic review and meta-analysis.

Respiratory medicine (2005-02-18)
F S F Ram, J R Jardin, A Atallah, A A Castro, R Mazzini, R Goldstein, Y Lacasse, S Cendon
ABSTRACT

To determine the efficacy of oral theophylline compared with placebo in people with stable chronic obstructive pulmonary disease (COPD). Systematic review of randomized-controlled trials comparing oral theophylline with placebo for a minimum of 7 days in people with stable COPD. Twenty randomized-controlled trials were included in this review. The following outcomes showed significant improvement with theophylline compared with placebo: FEV1 and FVC both improved with theophylline (weighted mean difference [WMD] 0.10 L; 95% confidence interval [95% CI] 0.04-0.16 and WMD 0.21 L; 95% CI 0.10-0.32, respectively). VO2 max also improved with theophylline (WMD 195.27mL/ min; 95% CI 112.71-277.83), as did PaO2 and PaCO2 (WMD 3.18 mmHg; 95% CI 1.23-5.13 and WMD -2.36mmHg; 95% CI -3.52 to -1.21, respectively). Patients preferred theophylline over placebo (relative risk 2.27; 95% CI 1.26-4.11). Theophylline increased the risk of nausea compared with placebo (RR 7.67; 95% CI 1.47-39.94). This review has shown that theophylline still has a role in the management of stable COPD, and is preferred by patients over placebo. However, the benefits of theophylline in stable COPD have to be weighed against the risk of adverse effects.

MATERIALS
Product Number
Brand
Product Description

Sigma-Aldrich
Theophylline, anhydrous, ≥99%, powder
Supelco
Theophylline, Pharmaceutical Secondary Standard; Certified Reference Material
Supelco
Theophylline melting point standard, Pharmaceutical Secondary Standard; Certified Reference Material
Theophylline, European Pharmacopoeia (EP) Reference Standard
USP
Theophylline, certified reference material, United States Pharmacopeia (USP) Reference Standard
Supelco
Theophylline solution, 1.0 mg/mL in methanol, ampule of 1 mL, certified reference material, Cerilliant®