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Controlled trial of slow-release aminophylline in childhood asthma: are short-term trials valid?
Insights
Slow-release aminophylline improved mild asthma symptoms in children but did not affect severe symptoms or lung function. This asthma medication is suitable for mild cases, not severe attacks.
Area of Science:
- Pediatric Pulmonology
- Clinical Pharmacology
Background:
- Slow-release aminophylline is commonly used for childhood asthma prophylaxis.
- Formal assessments of its efficacy and safety are limited.
Purpose of the Study:
- To formally assess the efficacy and safety of slow-release aminophylline in children with perennial asthma.
- To evaluate its impact on mild and severe asthma symptoms, lung function, and bronchodilator use.
Main Methods:
- A four-month double-blind, cross-over trial involving 24 children with perennial asthma.
- Dosage administered was 14 mg/kg twice daily.
- Serum theophylline concentrations and side effects were monitored.
Main Results:
- Satisfactory serum theophylline levels were achieved in 17 children with minimal side effects.
- Significant improvement was observed in mild daytime and night-time asthma symptoms.
- Severe asthma symptoms, peak expiratory flow, and bronchodilator use remained unaffected.
Conclusions:
- Slow-release aminophylline can be beneficial for prophylaxis in mild perennial childhood asthma.
- It is not suitable for children experiencing severe asthma attacks.
- The cross-over trial design presented significant limitations for this study.
Abstract:
Slow-release aminophylline, although widely used for the prophylaxis of childhood asthma, has had only limited formal assessment. A four-month double-blind cross-over trial of slow-release aminophylline (14 mg/kg twice daily) was carried out in 24 children with perennial asthma. Satisfactory serum theophylline concentrations were obtained in 17 children, with few side effects. There was a significant improvement in mild daytime and night-time symptoms. The incidence of more severe symptoms was unaffected. Treatment did not improve the mean peak expiratory flow or reduce the incidence of use of bronchodilators. It is concluded that slow-release aminophylline has a place in the prophylaxis of perennial childhood asthma but is unsuitable for children who suffer from severe attacks. The cross-over trial design has severe limitations.