EFFECT OF THEOPHYLLINE ON ERYTHROCYTOSIS IN CHRONIC OBSTRUCTIVE PULMONARY-DISEASE

Background: Patients with chronic obstructive pulmonary disease (COPD) tend to develop secondary erythrocytosis to compensate for their chro nic hypoxia. Theophylline has recently been shown to reduce hematocrit and erythropoietin blood levels in normal subjects and in patients wi th erythrocytosis after renal transplantation. Objective: To determine whether theophylline may be used to lower the hematocrit in patients with COPD, Methods: Two hundred four patients with COPD were studied r etrospectively and 10 patients prospectively (8 starting treatment wit h the drug [group 1] and 2 who suspended its long-term use [group 2]) for the correlation between theophylline therapy and hematocrit and er ythropoietin level. Results: In the patients studied retrospectively, lon er hematocrits were found in the theophylline-treated than in the untreated patients (0.43 +/- 0.006 vs 0.46 +/- 0.007, respectively; P< .002), Twelve untreated patients and 2 of those treated with theophyll ine had hematocrits above 52%, Oxygen saturation levels were similar i n both groups, and exclusion of patients with oxygen saturation lower than 88% did not change the pattern, suggesting that the effect of the ophylline could not be entirely explained by improved oxygen availabil ity. Seven of the 8 patients studied prospectively in group 1 (P<.02) and the 2 patients in group Z showed inverse correlations between hema tocrits and theophylline administration. A similar pattern was observe d with serum erythropoietin levels in 5 of 7 patients studied. The eff ects were reproducible on rechallenge in 3 of the 4 patients in group 1 and the 2 patients in group 2. Conclusions: Theophylline may have a beneficial effect in treatment and prevention of erythrocytosis in pat ients with COPD.