[Treatment of nocturnal bronchial asthma]

To date, the pathogenesis of nocturnal bronchiale asthma has not been completely clarified. For the treatment of nocturnal asthma that fails to respond to beta-2-sympathomimetics or inhalative glucocorticosteroids, theophylline in a delayed release form or delayed-release oral beta-2-sympathomimetics are available. In a double-blind crossover study, 10 patients with nocturnal or early-morning bronchial asthma were treated for one week with theophylline 390-900 mg daily (1/3 of the total dose being given in the morning, 2/3 in the evening) and one week with terbutaline 15 mg daily (7.5 mg in the morning and 7.5 mg in the evening). No significant differences were observed with respect to the measured peak flow values in the night and early morning. However, those receiving terbutaline more frequently required the additional application of inhalative beta-2-sympathomimetics for respiratory distress. Thus, the sustained-release form of theophylline is the more suitable drug for the treatment of nocturnal bronchial asthma. As a further study revealed, the sole administration of a sustained-release form of theophylline in the evening suffices. In the future, apart from theophylline in a delayed-release form, inhalative beta-2-sympathomimetics with a long-term effect will play an important role in the treatment of nocturnal breathing disorders.