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

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.METHODSA 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.RESULTSPatients 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.CONCLUSIONSIn 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.

Manejo de la EPOC estable en relación con la GOLD: experiencia en un hospital universitario / Stable copd management in relation to the GOLD: experience at a university hospital

Introducción: Estudio prospectivo-descriptivo que analiza el plan de atención ambulatorio del usuario con EPOC estable de acuerdo con las recomendaciones de la GOLD en un hospital público en Bogota. Presenta los factores que influyen a nivel de educación, tratamiento farmacológico, rehabilitación pulmonar y oxigenoterapia. Se aplicó una encuesta para pacientes, evaluada y validada por grupo de expertos y una ficha para revisión de las historias clínicas. Materiales y métodos: Estudio de tres fases. En la fase I se seleccionaron los pacientes con diagnóstico primario de EPOC en etapa estable, atendidos por consulta externa que no hubieran presentado exacerbación por lo menos un mes antes de la encuesta. Se tomaron de las historias clinicas, los datos demograficos (género y edad), fechas de control previo, examenes solicitados, medicamentos formulados, remisión a programas de rehabilitación pulmonar, ejercicio y oxigenoterapia domiciliaria. En la fase II, se aplicó la encuesta a 61 pacientes adultos que cumplían con los criterios de inclusión y el registro de sus historias clínicas. En la fase III se hizo el anßlisis e interpretación de los resultados con un procesamiento estadístico de la información que comprendía anßlisis multivariado y univariado de datos utilizando el programa SPSS software, versión 11.5 para Windows.Resultados: Durante el período de estudio se atendieron por consulta externa en la institución 69 personas con diagnóstico primario de EPOC; de estos, 61 cumplían con los criterios de inclusión. La edad media del grupo fue 73 años y 70% eran mujeres; 50% tenía bajo nivel socioeconómico y ningún grado de escolaridad; 93% tenía dependencia económica de su familia. El mayor factor de riesgo, fue humo de leña (84%), con un promedio de exposición de 20 a±os; 30% recibió educación por parte del médico, 47% usaba broncodilatadores inhalados y 48% refería dificultades para conseguirlos.

Introduction: This paper presents a prospective and descriptive study discussing the outpatient care plan in a public hospital in Bogotß for patients with stable COPD according with the GOLD recommendations. The paper presents as well the influence of factors such as education, pharmacological treatment, pulmonary rehabilitation and oxygen-therapy. A survey was carried out among patients, and the results were evaluated and validated by a group of experts; a personal data card for the review of clinical records was considered.Materials and methods: This is a three-phase study. On the first phase, selected patients from outpatient care visits were included with a primary diagnosis of COPD on the stable condition stage; these patients had no evident exacerbation in at least one month before the survey. Clinical records, demographic data (gender, age), previous control dates, required examinations, prescribed medicines, referral to pulmonary rehabilitation programs, exercises and domiciliary oxygen-therapy were recorded. On the second phase, the survey was carried out among 61 adult patients who met the inclusion criteria and the clinical record register. On the third phase, the analysis and interpretation of the results were carried out with a statistic processing of the information, which considers multivariate and univariate data analysis using the software SPSS version 11.5 for Windows. Results: The number of patients with COPD diagnosis studied during the research period of time in our hospital outpatient service was 69, however only 61 of them fulfilled all the inclusion criteria. Sixty-one patients were interviewed, average age, 73. Seventy percent were female. Fifty percent of the participants were from low schooling, social and economic segments of the population; 50% had no formal education and 93% were family dependent. The major risk factor reported (84%) was wood fire smoke, with an average exposure of more than 20 years (72%).