Effect of low-dose theophylline plus beclometasone on lung function in smokers with asthma: A pilot study

M. Spears, I. Donnelly, L. Jolly, M. Brannigan, K. Ito, C. McSharry, J. Lafferty, R. Chaudhuri, G. Braganza, I. M. Adcock, P. J. Barnes, S. Wood, N. C. Thomson (Lead / Corresponding author)

Research output: Contribution to journalArticlepeer-review

105 Citations (Scopus)


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 jig-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 Lmin -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.

Original languageEnglish
Pages (from-to)1010-1017
Number of pages8
JournalEuropean Respiratory Journal
Issue number5
Early online date5 Feb 2009
Publication statusPublished - 30 Apr 2009


  • Asthma
  • Corticosteroid insensitivity
  • Histone deacetylase
  • Smoking
  • Theophylline

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine


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