Theophylline

Theophylline is not recommended to treat COPD in Australia. Previous recommendations to use theophylline were based on a study that showed a reduced number of exacerbations in patients treated with theophylline compared to placebo1. However, patients in this study were not treated with current standard therapy for COPD (eg long-acting bronchodilators, inhaled corticosteroids [ICS]). In a 2018 study of patients with a recent history of COPD exacerbations, theophylline did not reduce the number of exacerbations in 1 year2.

1 Zhou Y, Wang X, Zeng X, Qiu R, Xie J, Liu S, et al. Positive benefits of theophylline in a randomized, double-blind, parallel-group, placebo-controlle study of low-dose, slow-release theophylline in the treatment of COPD for 1 year. Respirology 2006;11(5):603-10. [URL]Return
2 Devereux G, Cotton S, Fielding S, McMeekin N, Barnes PJ, Briggs A, et al. Effect of Theophylline as Adjunct to Inhaled Corticosteroids on Exacerbations in Patients With COPD: A Randomized Clinical Trial. JAMA 2018;320(15):1548-59. [URL]Return