COMPARISON OF ADDITION OF THEOPHYLLINE TO INHALED STEROID WITH DOUBLING OF THE DOSE OF INHALED STEROID IN ASTHMA

The anti-asthmatic effects of theophylline may supplement those of inh aled steroids in asthma. The aim of the present trial was to study hol y the addition of theophylline compares to doubling the dose of inhale d steroid in asthmatics who remain symptomatic on beclomethasone dipro pionate (BDP) 400 mu g.day(-1). The trial was designed as a randomized , double-blind, parallel-group study in several European countries, Si xty nine patients were treated for 6 weeks with theophylline plus BDP 400 mu g.day(-1), compared to 64 patients treated with BDP 800 mu g.da y(-1). The mean+/-SD serum theophylline concentration was 10.1+/-4.2 m g.L-1. Lung function measurements were made throughout the study and p atients kept daily records of peak expiratory flow (PEF), symptoms and salbutamol usage, Forced expiratory volume in one second and PEF at m eek 6 mere significantly increased by both treatments (p<0.01). PEF va riability was reduced by about 30% in both groups, There were signific ant improvements in asthma symptoms and rescue medication use (p<0.001 ), There mere no significant differences between the treatment groups. The study demonstrated clinical equivalence of theophylline plus becl omethasone dipropionate 400 mu g.day(-1) and beclomethasone dipropiona te 800 mu g.day(-1) in patients whose asthma is not controlled on becl omethasone dipropionate 400 mu g.day(-1). The results support the use of theophylline as a steroid-sparing agent, The combination of low-dos e inhaled steroid plus theophylline is a suitable treatment for modera te asthma.