The Value of Maintenance Theophylline in Steroid-Dependent Asthma

Abstract

We examined the value of maintenance theophylline at serum concentrations of 10 to 20 μg per milliliter in a placebo-controlled, randomized, double-blind trial of 33 children with steroid-dependent chronic asthma. Patients were free of all symptoms 63±6 per cent of the days (mean ±S.E.M.) when taking theophylline as compared with 42±6 per cent when taking placebo (P≤0.01). Inhaled metaproterenol was required twice as often with placebo (P≤0.01), and additional daily corticosteroids were needed more than three times as often with placebo (P ≡ 0.02). Daily peak flow measurements improved with theophylline (P≤0.01) as did monthly spirometric measurements and residual volume measured by plethysmography. Theophylline was associated with a 50 per cent increase in the number of patients able to complete an exercise test (P≡0.01) and with a smaller decrease in forced expiratory volume in one second among patients completing the exercise (P≤0.02). We conclude that maintenance bronchodilator therapy with theophylline can provide clinically important benefit for patients with chronic steroid-dependent asthma. (N Engl J Med. 1981; 304:71–5.)