BMJ  2003;327 (20 September), doi:10.1136/bmj.327.7416.0-d

Adding methylxanthines to standard COPD treatment is not beneficial

Methylxanthines do not confer any benefit on lung function and symptoms in patients with exacerbations of chronic obstructive pulmonary disease (COPD) at standard levels of significance. In a meta-analysis of four randomised trials comprising 169 patients, Barr and colleagues (p 643) found that changes in lung function, clinical outcomes, and self rated symptom scores were not significantly different between methylxanthine and placebo groups, but significantly more adverse events of nausea and vomiting occurred in patients receiving methylxanthines. These findings contradict current recommendations for using this class of drugs as the second line treatment for exacerbations, say the authors.

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Methylxanthines for exacerbations of chronic obstructive pulmonary disease: meta-analysis of randomised trials

R Graham Barr, Brian H Rowe, and Carlos A Camargo, Jr
BMJ 2003 327: 643. [Abstract] [Full Text] [PDF]