Evidence supporting the use of: Theophylline
For the health condition: Emphysema

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Synopsis

Source of validity: Scientific
Rating (out of 5): 2

Theophylline is a methylxanthine drug that has been used for decades in the management of chronic obstructive pulmonary diseases, including emphysema. Its primary mechanism of action is bronchodilation, achieved through non-selective inhibition of phosphodiesterase enzymes, which increases intracellular cyclic AMP, leading to relaxation of airway smooth muscle. Theophylline also has mild anti-inflammatory effects and may improve diaphragmatic contractility.

Historically, theophylline was a mainstay in the treatment of emphysema and other forms of COPD due to its oral availability and bronchodilator properties. However, over the last two decades, its use has declined significantly because of a narrow therapeutic window, frequent side effects, and the availability of more effective and safer inhaled bronchodilators (such as beta-agonists and anticholinergics) and corticosteroids.

Current guidelines (such as those from the Global Initiative for Chronic Obstructive Lung Disease, GOLD) recommend theophylline only as an adjunctive therapy in select patients when other treatments are inaccessible or insufficient. The evidence supporting theophylline's efficacy is modest: meta-analyses suggest a small improvement in lung function and symptoms, but these benefits are counterbalanced by a significant risk of adverse effects, including cardiac arrhythmias, gastrointestinal upset, and drug interactions. Therefore, while theophylline is scientifically validated as having some benefit in emphysema, the strength of evidence is limited, and its role is now largely secondary or adjunctive rather than primary.

More about Theophylline
More about Emphysema

Products containing Theophylline

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