EDITORIAL

Theophylline for COPD

Theophylline for COPD

P J Barnes

Correspondence to:
Correspondence to:
Professor Peter J Barnes
National Heart & Lung Institute, Imperial College London, Dovehouse Street, London SW3 6LY, UK; p.j.barnes@imperial.ac.uk

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Reinstatement in the light of new evidence?

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Keywords: chronic obstructive pulmonary disease; theophylline; inhaled corticosteroid; histone deacetylase; peroxynitrite

The first 150 words of the full text of this article appear below.

Theophylline has been used as a bronchodilator in the treatment of COPD for over 70 years, but has lost popularity as better tolerated and more effective bronchodilators have been introduced. However, new insights into the molecular action of theophylline have raised the possibility that this old drug may come back into favour as an anti-inflammatory treatment and may even reverse steroid resistance in COPD.¹ A paper by Hirano et al in this issue of Thorax provides further support for the anti-inflammatory effects of theophylline in patients with COPD.²

In the major guidelines for the treatment of COPD, theophylline is relegated to a third line bronchodilator after inhaled anticholinergics and β₂ agonists. Nevertheless, it is recognised that theophylline is a useful treatment in patients with severe COPD as its withdrawal leads to significant clinical worsening of the disease.³ Many older clinicians have been convinced by its clinical value . . . [Full text of this article]

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This article has been cited by other articles:

• Cosio, B G, Iglesias, A, Rios, A, Noguera, A, Sala, E, Ito, K, Barnes, P J, Agusti, A (2009). Low-dose theophylline enhances the anti-inflammatory effects of steroids during exacerbations of COPD. Thorax 64: 424-429 [Abstract] [Full Text]  
• Barnes, P. J. (2008). Future Treatments for Chronic Obstructive Pulmonary Disease and Its Comorbidities. Proc Am Thorac Soc 5: 857-864 [Abstract] [Full Text]  
• Barnes, P. J. (2008). Emerging Pharmacotherapies for COPD. Chest 134: 1278-1286 [Abstract] [Full Text]  
• Hanania, N. A., Donohue, J. F. (2007). Pharmacologic Interventions in Chronic Obstructive Pulmonary Disease: Bronchodilators. Proc Am Thorac Soc 4: 526-534 [Abstract] [Full Text]