# Prospective Evaluation of Low-Dose Theophylline as an Add-On Therapy in Patients With Chronic Obstructive Pulmonary Disease (COPD)

## TL;DR

This study found that adding low-dose theophylline to standard treatment for COPD improved lung function and reduced symptoms with few side effects.

## Contribution

The study provides new evidence that low-dose theophylline is a safe and effective add-on therapy for COPD patients.

## Key findings

- Low-dose theophylline significantly improved FEV₁ and FVC over 12 months.
- COPD symptoms, as measured by CAT and mMRC scores, decreased significantly.
- Most patients adhered to the treatment and experienced no adverse effects.

## Abstract

Background: Chronic obstructive pulmonary disease (COPD) is still a big health concern across the globe, and better pharmacological techniques are needed to better control the condition.

Objective: This study aimed to find out whether low-dose theophylline may help COPD patients get better when used with other treatments.

Methodology: This prospective observational research was place at the Department of Pulmonology of Abbas Institute of Medical Sciences (AIMS) in Muzaffarabad, Pakistan, from April 2023 to March 2024. A total of 132 individuals with stable moderate to severe COPD who were at least 40 years old were recruited and given low-dose theophylline (300 mg once a day) along with their normal inhaled treatment. We checked up on the patients every three months for a year. The main results were spirometric measures (FEV₁, FVC, FEV₁/FVC), COPD Assessment Test (CAT) scores, Modified Medical Research Council (mMRC) dyspnea grades, how often exacerbations happened, how well people followed their treatment, and any side effects. We used IBM SPSS Statistics for Windows, Version 26.0 (Released 2019; IBM Corp., Armonk, New York, United States), to look at the data and ran repeated measures ANOVA and chi-squared testing.

Results: The mean FEV₁ increased from 1.12±0.25 L at baseline to 1.33±0.28 L at 12 months (p<0.001) and FVC increased from 2.01±0.42 L to 2.20±0.44 L (p<0.01). CAT scores dropped from 22.8 to 15.6 and mMRC grades from 2.92 to 2.02 (both p<0.001). A total of 59 patients (44.7%) experienced no exacerbations during follow-up. Therapy adherence >80% was achieved in 117 patients (88.6%), and 94 patients (71.2%) reported no adverse effects.

Conclusion: Low-dose theophylline may offer a well-tolerated, cost-effective adjunct to conventional COPD treatment in resource-limited settings.