Efficacy of theophylline in people with stable chronic obstructive pulmonary disease: a systematic review and meta-analysis

被引:46
作者
Ram, FSF [1 ]
Jardin, JR
Atallah, A
Castro, AA
Mazzini, R
Goldstein, R
Lacasse, Y
Cendon, S
机构
[1] Natl Collaborating Ctr Womens & Childrens Hlth, London, England
[2] Univ Fed Sao Paulo, Div Resp, Sao Paulo, Brazil
[3] Emergency Med Div, Sao Paulo, Brazil
[4] Univ Fed Alagoas, Vasc Dis Div, Sao Paulo, Brazil
[5] Univ Fed Sao Paulo, Div Resp, Pulm Rehabil Ctr, Sao Paulo, Brazil
[6] Univ Toronto, W Pk Healthcare Ctr, Toronto, ON, Canada
[7] Univ Laval, Hop Laval, Ctr Pneumol, Inst Cardiol & Pneumol, Laval, PQ, Canada
[8] Univ Fed Sao Paulo, Div Internal Med, Sao Paulo, Brazil
关键词
COPD; oral; theophylline; systematic review; meta-analysis; cochrane;
D O I
10.1016/j.rmed.2004.10.009
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Objectives: To determine the efficacy of oral theophylline compared with placebo in people with stable chronic obstructive pulmonary disease (COPD). Methods: Systematic review of randomized-controlled trials comparing oral Theophylline; with placebo for a minimum of 7 days in people with stable COPD. Results: Twenty randomized-controlled trials were included in this review. The Meta-analysis; following outcomes showed significant improvement with theophylline compared with placebo: FEV, and FVC both improved with theophylline (weighted mean difference [WMD] 0.10 L; 95% confidence interval [95% CI] 0.04-0.16 and WMD 0.21 L; 95% CI 0.10-0.32, respectively). VO2 max also improved with theophylline (WMD 195.27mL/ min; 95% Cl 112.71-277.83), as did PaO2 and PaCO2 (WMD 3.18mmHg;,95% Cl 1.23-5.13 and WMD -2.36mmHg; 95% Cl -3.52 to -1.21, respectively). Patients preferred theophylline over placebo (relative risk 2.27; 95% Cl 1.26-4.11). Theophylline increased the risk of nausea compared with placebo (RR 7.67; 95% Cl 1.47-39.94). Conclusion: This review has shown that theophylline still has a role in the management of stable COPD, and is preferred by patients over placebo. However, the benefits of theophylline in stable COPD have to be weighed against the risk of adverse effects. (C) 2004 Elsevier Ltd. All rights reserved.
引用
收藏
页码:135 / 144
页数:10
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