Effect of theophylline plus beclometasone on lung function in smokers with asthma-a pilot study

¹ Respiratory Medicine, Faculty of Medicine, University of Glasgow, Glasgow
² Immunology, Faculty of Medicine, University of Glasgow, Glasgow
³ National Heart and Lung Institute, Imperial College, London, United Kingdom
⁴ General Practice, Faculty of Medicine, University of Glasgow, Glasgow

^* To whom correspondence should be addressed. E-mail: n.c.thomson{at}clinmed.gla.ac.uk.

	Abstract

Smoking is common in asthma and is associated with worse asthma control and a reduced therapeutic response to corticosteroids. We hypothesised that treating smokers with asthma with low dose theophylline added to inhaled corticosteroid would enhance steroid sensitivity and thereby improve lung function and symptoms.

In a double-blind, parallel group exploratory trial 68 asthmatic smokers were randomised to one of three treatments for 4 weeks: inhaled beclometasone (200 mcg per day), theophylline (400 mg per day), or both treatments combined. Outcome measures included change in lung function and asthma control questionnaire (ACQ) scores.

At four weeks, theophylline added to inhaled beclometasone produced an improvement in PEF (39.9 L·min^-1, 95% CI 10.9 to 68.8, p=0.008) and ACQ score (-0.47, -0.91 to -0.04, p=0.033) and a borderline improvement in pre-bronchodilator FEV₁ (mean difference 165 ml, -13 to 342, p=0.069) relative to inhaled corticosteroid alone. Theophylline alone improved ACQ score (-0.55, -0.99 to -0.11, p=0.016) but not lung function.

In this pilot study the combination of low dose theophylline and inhaled beclometasone produced improvements in both lung function and symptoms in a group of smokers with asthma. Larger trials are required to extend and confirm these findings.

(Clinicaltrials.gov number NCT00119496)

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