Relative efficacy of maintenance therapy with theophylline, inhaled albuterol, and the combination for chronic asthma

• Published in: Journal of allergy and clinical immunology Vol. 79; no. 1; pp. 78 - 85
• Main Authors: Joad, Jesse P., Ahrens, Richard C., Lindgren, Scott D., Weinberger, Miles M.
• Format: Journal Article
• Language: English
• Published: New York, NY Mosby, Inc 1987; Elsevier
• Subjects: Adolescent; Adult; Aged; Albuterol - administration & dosage; Albuterol - adverse effects; Albuterol - therapeutic use; Asthma - drug therapy; Asthma - physiopathology; Biological and medical sciences; Chronic Disease; Drug Administration Schedule; Drug Therapy, Combination; Humans; Lung - drug effects; Lung - physiopathology; Medical sciences; Middle Aged; Nebulizers and Vaporizers; Peak Expiratory Flow Rate; Pharmacology. Drug treatments; Respiratory system; Theophylline - administration & dosage; Theophylline - adverse effects; Theophylline - therapeutic use; Time Factors; Human; Drug combination; Respiratory disease; Bronchodilator; β-Adrenergic receptor agonist; Asthma; β2-»Adrenergic receptor; Chemotherapy; Chronic; Adolescent; Aerosols; Theophyllin; Adult; Xanthine derivatives
• ISSN: 0091-6749; 1097-6825
• DOI: 10.1016/S0091-6749(87)80020-9

The relative benefit of maintenance therapy with theophylline, inhaled albuterol, and the combination was examined in 18 adolescents and adults with chronic asthma during a 3-month, randomized, double-blind, crossover trial. Theophylline and combination regimens were associated wtih significantly fewer days with symptoms (52% and 55%) than albuterol (72%). The greater frequency of symptoms during the albuterol regimen was increasingly apparent more than 4 hours after albuterol doses and was greatest between 4 and 8 a.m. Albuterol transiently inhibited histamine-induced bronchospasm to a much greater degree than did theophylline, and combining the drugs produced at least an additive effect. The effect of albuterol was completely absent by 4 hours, however, whereas that of theophylline persisted. Thus, in spite of greater acute effects on the airways, the transient duration of effect from inhaled albuterol appears to limit its usefulness as maintenance therapy, especially for patients with nocturnal symptoms.