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

TY - JOUR

T1 - Effect of low-dose theophylline plus beclometasone on lung function in smokers with asthma

T2 - A pilot study

AU - Spears, M.

AU - Donnelly, I.

AU - Jolly, L.

AU - Brannigan, M.

AU - Ito, K.

AU - McSharry, C.

AU - Lafferty, J.

AU - Chaudhuri, R.

AU - Braganza, G.

AU - Adcock, I. M.

AU - Barnes, P. J.

AU - Wood, S.

AU - Thomson, N. C.

PY - 2009/4/30

Y1 - 2009/4/30

N2 - 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.

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 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.

KW - Asthma

KW - Corticosteroid insensitivity

KW - Histone deacetylase

KW - Smoking

KW - Theophylline

UR - https://www.scopus.com/pages/publications/66749146095

U2 - 10.1183/09031936.00158208

DO - 10.1183/09031936.00158208

M3 - Article

C2 - 19196814

AN - SCOPUS:66749146095

SN - 0903-1936

VL - 33

SP - 1010

EP - 1017

JO - European Respiratory Journal

JF - European Respiratory Journal

IS - 5

ER -