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Enprofylline in chronic asthma.

B J Chapman1, C McDonald, S Capewell

  • 1Respiratory Diseases Unit, Northern General Hospital, Edinburgh.

British Journal of Diseases of the Chest
|October 1, 1988
PubMed
Summary
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High-dose intravenous enprofylline demonstrated superior bronchodilator effects compared to aminophylline in chronic asthma patients. However, enprofylline was associated with increased side effects like nausea.

Area of Science:

  • Pharmacology
  • Respiratory Medicine
  • Clinical Trials

Background:

  • Chronic asthma management often involves bronchodilators.
  • Intravenous theophylline derivatives are used for severe asthma exacerbations.
  • Enprofylline is a newer xanthine derivative with potential bronchodilator properties.

Purpose of the Study:

  • To compare the bronchodilator efficacy of two intravenous enprofylline dosage regimens against aminophylline and placebo in chronic asthma.
  • To evaluate the safety and tolerability of intravenous enprofylline.

Main Methods:

  • A double-blind, crossover study involving 14 patients with moderately severe chronic asthma.
  • Comparison of high-dose enprofylline (2 mg/kg bolus, 1 mg/kg/hr infusion), low-dose enprofylline (1 mg/kg bolus, 500 mcg/kg/hr infusion), aminophylline (5 mg/kg bolus, 500 mcg/kg/hr infusion), and placebo.

Related Experiment Videos

  • Measurements included peak expiratory flow (PEF) and forced expiratory volume in 1 second (FEV1).

    • Main Results:

    • High-dose enprofylline significantly improved PEF (P = 0.008) and FEV1 (P = 0.004) compared to aminophylline.
    • Low-dose enprofylline and aminophylline showed similar bronchodilator efficacy.
    • Adverse events, including nausea and headache, were more frequent with enprofylline, with three high-dose patients experiencing severe nausea.

    Conclusions:

    • High-dose intravenous enprofylline offers superior bronchodilation compared to aminophylline in patients with chronic asthma.
    • Further research is needed in acute severe asthma to establish the optimal dosage regimen and therapeutic role of intravenous enprofylline.
    • The higher-than-anticipated plasma enprofylline levels with the high-dose regimen warrant careful consideration regarding safety and dosing.