RT Journal Article
SR Electronic
T1 Effect of low-dose theophylline plus beclometasone on lung function in smokers with asthma: a pilot study
JF European Respiratory Journal
JO Eur Respir J
FD European Respiratory Society
SP 1010
OP 1017
DO 10.1183/09031936.00158208
VO 33
IS 5
A1 M. Spears
A1 I. Donnelly
A1 L. Jolly
A1 M. Brannigan
A1 K. Ito
A1 C. McSharry
A1 J. Lafferty
A1 R. Chaudhuri
A1 G. Braganza
A1 I. M. Adcock
A1 P. J. Barnes
A1 S. Wood
A1 N. C. Thomson
YR 2009
UL http://erj.ersjournals.com/content/33/5/1010.abstract
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.