A meta-analysis on the efficacy of oral theophylline in patients with stable COPD

BACKGROUND Theophylline is a nonspecific inhibitor of phosphodiesterases that, despite exerting bronchodilator and anti-inflammatory effects, is a third-line therapy rarely used to treat chronic airflow limitation. We wished to evaluate the efficacy of oral theophylline as measured by improvements in trough (pre-dose) or peak (post-dose) FEV1 and FVC in patients with clinically stable COPD. DESIGN Meta-analysis of randomized, placebo-controlled trials reported as of June 2005 in which theophylline was orally administered to stable COPD patients and the functional evaluations included pre- and post-theophylline values for FEV1 and FVC. RESULTS Atotal of 18 trials were included in the meta-analysis. The weighted mean differences (WMD) with 95% confidence intervals (95% CI) for improvement over placebo in trough FEV1 and FVC were 0.108L (0.053-0.163) and 0.186L (0.036-0.336), respectively, while peak FEV1 and FVC improved by 0.096L (0.044-0.147) and 0.242L (0.11-0.374), respectively. CONCLUSIONS Treatment with oral theophylline improves both trough and peak FEV1 and FVC in clinically stable COPD patients. These results support previously reported benefits of theophylline in COPD.