Theophylline and PDE4 inhibitors in asthma

Over the past three decades, beta(2)-adrenoceptor agonists and glucocorticosteroids have formed the mainstay of treatment for patients with asthma; during this time, only one new drug class, leukotriene receptor antagonists, have been introduced. Theophylline has also been used in the treatment of patients with asthma, although there is a perception that this drug does not offer the patient any advantages over conventional therapeutic strategies. However, a number of clinical studies have documented the efficacy of this orally active drug. The mechanism by which theophylline exerts its well recognized antiinflammatory activity remains to be established but, if explained, could lead to newer drug development with greater efficacy. The development of phosphodiesterase (PDE)4 inhibitors is one such approach, and recent studies have demonstrated the potential utility of this new drug class for the treatment of patients with asthma. (C) 2003 Lippincott Williams Wilkins, Inc.