Review: Methylxanthines are not effective for acute exacerbations of chronic obstructive pulmonary disease: COMMENTARY

Niewoehner, Dennis E.
May 2004
ACP Journal Club;May/Jun2004, Vol. 140 Issue 3, p60
Academic Journal
It was not so long ago that most experts recommended theophylline as a first-line agent for treating both stable and exacerbated chronic obstructive pulmonary disease (COPD). Theophylline use increased dramatically during the 1970s, but then waned just as quickly during the 1990s. These rapid shifts in prescribing patterns were not strongly evidence-based because large multicenter trials to evaluate clinical outcomes were never done. New findings suggest that theophylline may possess anti-inflammatory effects at levels below those clinically used in the past Moreover, secondary results from 2 large trials of stable COPD show that theophylline may prevent severe COPD exacerbations when given long term. If these findings can be confirmed, theophylline might yet play an important role in the treatment of COPD, if not for treating exacerbations, then for their prevention.


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