AMINOPHYLLINE AT COPD EXACERBATIONS

More effective treatment of COPD exacerbations is an important goal of COPD therapy. A number of guidelines have suggested that intravenous aminophylline can be used to treat COPD exacerbations when the response to usual treatment is inadequate. However, the evidence for this option is weak and the few previous trials of aminophylline at exacerbation have been small and generally underpowered for relevant outcomes. In this month’s Thorax, Duffy and colleagues report the first adequately powered randomised trial of intravenous aminophylline in 80 patients admitted to hospital with COPD exacerbations, and the study is discussed in the accompanying editorial by Town. The study found that the addition of intravenous aminophylline to nebulised bronchodilators and oral corticosteroids in non-acidotic exacerbations produced small improvements in acid-base balance, but there was no effect on the subsequent clinical course. There …