Synopsis

Source of validity: Scientific
Rating (out of 5): 4

Theophylline is a methylxanthine drug that has long-standing use in respiratory medicine, particularly for supporting the bronchial system. Its primary mechanism is as a bronchodilator: it relaxes bronchial smooth muscle by inhibiting phosphodiesterase, thereby increasing intracellular cyclic AMP and promoting bronchodilation. Theophylline also has mild anti-inflammatory effects and can improve diaphragmatic contractility.

Historically, theophylline was a mainstay in the management of asthma and chronic obstructive pulmonary disease (COPD), especially before the widespread availability of inhaled corticosteroids and selective beta-2 agonists. Scientific evidence from numerous randomized controlled trials and meta-analyses in the late 20th century confirmed that theophylline improves airflow obstruction and reduces symptoms in asthma and COPD patients. However, its use has declined due to a narrow therapeutic window, potential for significant side effects (such as arrhythmia and seizures), and the availability of drugs with better safety profiles.

Current guidelines (e.g., Global Initiative for Asthma, GOLD for COPD) acknowledge theophylline as an alternative or adjunctive therapy, especially where inhaled medications are inaccessible or unaffordable. Nonetheless, its inclusion in treatment regimens is based on substantial scientific evidence demonstrating efficacy in bronchodilation, particularly in select patient populations. Therefore, theophylline’s use to support the bronchial system is scientifically validated, though with some caveats regarding safety and preferred alternatives.

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