Effect of theophylline on the rate of moderate to severe exacerbations among patients with chronic obstructive pulmonary disease
Effect of theophylline on the rate of moderate to severe exacerbations among patients with chronic obstructive pulmonary disease
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DOI：
10.1111/j.1365-2125.2007.02977.x
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发表时间：
2008-01-01
影响因子：
3.4
通讯作者：
Blais, Lucie
中科院分区：
文献类型：
--
作者：
Cyr, Marie-Christyne;Beauchesne, Marie-France;Blais, Lucie
目的探讨茶碱治疗中重度慢性阻塞性肺疾病(COPD)的疗效。结果发现茶碱使用者比长效β(2)激动剂(LABA)使用者中重度COPD加重的几率低[每100病人年粗率84比91，调整比率(RR)0.89，95%可信区间(CI)0.84，茶碱加ICS的患者比服用LABA加ICS的患者中重度COPD加重的可能性更小(粗率为114比112每100人年，调整后RR为0.89，95%CI为0.87，0.92)。研究发现，使用茶碱的患者比使用ICS的患者更有可能发生COPD恶化(粗率为84比77/100人年，调整后RR为1.07，95%CI为1.04，1.10)，这种相关性在进入队列前一年至少有3次恶化的患者中更强(粗率为273比213，调整后RR为1.28，95%CI为1.19，1.38)。结论在所有COPD患者中，茶碱的使用与COPD恶化的发生率降低有关，但在频繁恶化的患者中不如ICS有效。
AIM To determine the effectiveness of theophyllines in real clinical practice on moderate to severe exacerbations.METHODS A cohort of 36 492 chronic obstructive pulmonary disease (COPD) patients aged >= 50 years was reconstructed from the health administrative databases of the province of Quebec, Canada, between 1 January 1995 and 31 December 2002 to compare users of theophyllines with users of inhaled corticosteroids (ICS) and users of long-acting beta(2)-agonists (LABA) on their rate of moderate to severe COPD exacerbations.RESULTS Users of theophyllines were found to be less likely than users of LABA [crude rates 84 vs. 91 per 100 patient-years, adjusted rate ratio (RR) 0.89, 95% confidence interval (CI) 0.84, 0.95] and users of theophyllines plus ICS were found to be less likely than users of LABA plus ICS ( crude rates 114 vs. 112 per 100 patient-years, adjusted RR 0.89, 95% CI 0.87, 0.92) to have moderate to severe COPD exacerbations. Users of theophyllines were found to be more likely than users of ICS to have a COPD exacerbation (crude rates 84 vs. 77 per 100 patient-years, adjusted RR 1.07, 95% CI 1.04, 1.10), and this association was even stronger among patients who had at least three exacerbations in the year prior to cohort entry ( crude rates 273 vs. 213 per 100 patient-years, adjusted RR 1.28, 95% CI 1.19, 1.38).CONCLUSION The use of theophyllines was found to be associated with a reduction in the rate of COPD exacerbations among all COPD patients, but to be less effective than ICS among patients with frequent exacerbations.