Comparison of Efficacy and Safety of Theophylline, Doxophylline and Acebrophylline as an Add-On in the Management of Chronic Obstructive Pulmonary Disease

BACKGROUND COPD is defined by GOLD as a disease characterized by airflow limitation that is not fully reversible. The chronic airflow limitation characteristic of COPD is caused by small airway disease (obstructive bronchiolitis) and parenchymal destruction (emphysema). We wanted to compare the efficacy and safety of theophylline, doxophylline and acebrophylline in the management of stable COPD patients. METHODS A prospective observational study was conducted in Burdwan Medical College and Hospital where 125 newly diagnosed adult stable COPD patients were divided into three groups each of which received theophylline, doxophylline or acebrophylline as add-on therapy over the standard for COPD. The study was conducted over a period of 13 months for spirometric parameters, severity of dyspnoea, quality of life. Assessment of adverse drug reactions was done by Naranjo's causality assessment scale. RESULTS Patients of all three groups showed statistically significant difference in improvement in spirometric parameters and modified medical research council score and quality of life within each group. Few adverse effects like nausea were found in 2 (5.88%) patients of theophylline group, 2 (6.06%) patients of doxophylline group, and 2 (6.06%) patients of acebrophylline group. Palpitation was found in 1 (2.94%) patient of theophylline group while headache was found in 2 (6.06%) patients of acebrophylline group. Thus, it is seen that cardiological complications are more in theophylline group. CONCLUSIONS In this study, all patients had shown some form of improvement in spirometry parameters after treatment which was maximum with doxophylline. Adverse effects were similar and non-serious in all the study patients.