PT  - JOURNAL ARTICLE
AU  - M. Spears
AU  - I. Donnelly
AU  - L. Jolly
AU  - M. Brannigan
AU  - K. Ito
AU  - C. McSharry
AU  - J. Lafferty
AU  - R. Chaudhuri
AU  - G. Braganza
AU  - I. M. Adcock
AU  - P. J. Barnes
AU  - S. Wood
AU  - N. C. Thomson
TI  - Effect of low-dose theophylline plus beclometasone on lung function in smokers with asthma: a pilot study
AID  - 10.1183/09031936.00158208
DP  - 2009 May 01
TA  - European Respiratory Journal
PG  - 1010--1017
VI  - 33
IP  - 5
4099  - http://erj.ersjournals.com/content/33/5/1010.short
4100  - http://erj.ersjournals.com/content/33/5/1010.full
SO  - Eur Respir J2009 May 01; 33
AB  - Smoking is common in asthma and is associated with worse asthma control and a reduced therapeutic response to corticosteroids. The present authors hypothesised that treating smokers with asthma with low-dose theophylline added to inhaled corticosteroids 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 μg·day−1), theophylline (400 mg·day−1) or both treatments combined. Outcome measures included change in lung function and Asthma Control Questionnaire (ACQ) scores. At 4 weeks, theophylline added to inhaled beclometasone produced an improvement in peak expiratory flow (39.9 L·min−1, 95% confidence intervals (CI) 10.9–68.8) and ACQ score (-0.47, 95% CI -0.91– -0.04) and a borderline improvement in pre-bronchodilator forced expiratory volume in one second (mean difference 165 mL, 95% CI -13–342) relative to inhaled corticosteroid alone. Theophylline alone improved the ACQ score (-0.55, 95% CI -0.99– -0.11), but not lung function. In the present 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.