[Clinical effectiveness of delayed-action theophylline preparations]

Area of Science:

• Pharmacology
• Pulmonology
• Clinical Medicine

Background:

• Chronic obstructive pulmonary disease (COPD) management requires effective long-acting bronchodilators.
• Theophylline derivatives offer a therapeutic option, but their clinical efficiency and optimal dosing require further elucidation.

Purpose of the Study:

• To assess the clinical efficiency of five long-acting theophylline drugs in patients with chronic obstructive pulmonary disease.
• To establish optimal dosing strategies and evaluate side effect profiles for theophylline-based therapy.

Main Methods:

• A clinical trial involving 139 patients with chronic obstructive pulmonary disease.
• Administration of five long-acting theophylline drugs: retaphylline, theo-dur, durophylline, theopek, and theobilong.
• Monitoring of serum theophylline levels, dose adjustments, and assessment of side effects (CNS, cardiovascular, gastrointestinal).

Main Results:

• All five theophylline drugs demonstrated similar efficacy when administered at adequate doses.
• A recommended initial therapeutic approach involves low doses (400 mg/day) for 3 days to determine individual sensitivity, followed by dose escalation.
• Serum theophylline levels should be monitored on day 7 for dose correction.
• A specific evening dosing regimen was effective for patients experiencing nocturnal asthma attacks.
• Side effect incidence and severity were correlated with dose, blood concentration, and individual patient sensitivity.

Conclusions:

• Long-acting theophylline drugs can be clinically effective for chronic obstructive pulmonary disease.
• Individualized dosing, starting low and monitoring serum levels, is crucial for optimizing efficacy and minimizing adverse events.
• Specific dosing regimens may be beneficial for managing nocturnal symptoms in COPD patients.