Effect of theophylline on the rate of moderate to severe exacerbations among patients with chronic obstructive pulmonary disease
Notice bibliographique
Résumé
WHAT IS ALREADY KNOWN ABOUT THIS SUBJECT • Despite active research, none of the existing medications used to treat chronic obstructive pulmonary disease (COPD) has been shown to modify the long‐term decline in lung function. • Theophyllines have been recognized for their bronchodilating effects and anti‐inflammatory properties, but at the same time they are associated with the risk of adverse events due to their narrow therapeutic range and potential for drug interactions. • To our knowledge, no study has investigated the effects of theophylline on outcomes that can reflect the overall morbidity of COPD patients. WHAT THIS STUDY ADDS • The use of theophyllines is associated with a reduction in the rate of COPD exacerbations compared with long‐acting β 2 ‐agonists among COPD patients. • Theophyllines could be seen as an interesting alternative in the treatment of COPD, because they are much less expensive than long‐acting β 2 ‐agonists, and, from the patient's perspective, an oral formulation might be easier to take than an inhaled formulation. 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 β 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.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction distillée sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Apprise à partir de 10 348 étiquettes directes de Codex et de 10 348 étiquettes directes de Gemma. Le mode candidate est l'union des têtes enseignantes seuillées; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont ni des étiquettes humaines ni des étiquettes directes de modèles de pointe.
Scores Codex et Gemma par catégorie
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,003 | 0,002 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,001 | 0,000 |
| Bibliométrie | 0,000 | 0,000 |
| Études des sciences et des technologies | 0,000 | 0,001 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,001 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,001 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule tête enseignante, pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».