Effect of low dose of inhaled corticosteroid combined with small dose of oral theophylline on treatment of bronchial asthma

Objective To investigate the effect of small dose of oral theophyllin combined with low dose of inhaled beclomethasone dipropionate (BDP) on clinical symptoms, bronchial responsiveness and hypothalamic pituitary adrenal axis (HPAA) Methods 43 patients with mild moderate bronchial asthma were randomly divided into A and B groups 21 subjects in group A were treated with oral substained release theophyllin (Protheo) (200 mg/night) and inhaled BDP (300 μg/day); 22 cases in group B received inhaled BDP (600 μg/day) and oral placebo Result Before and 13 weeks after the treatment, symptom scores, peak flow(PEF), and peak flow rate (PEFR) for group A were (1 8±0 9) and (0 10±0 30), (295±98) L/min and (444±150) L/min, (22±8)% and (9±3)% respectively, and those for group B were (1 90±0 70) and (0 10±0 30), (328±129) L/min and (441±146)L/min, (24±7)% and (9±3)% respectively, which were remarkably improved in both groups ( P 0 01), and bronchial provocation responsiveness to histamine tests (BHR) in both groups were also improved significantly ( P 0 01) There were no differences between two groups ( P 0 05) Frequency of using inhaled β 2 agonist to relieve nocturnal asthmatic attacks in group B (3 9±1 7) was significantly greater than that in group A (1 3±1 0, P 0 05) Plasma ACTH concentrations, basic cortisol levels and cortisol responses to ACTH before and 13 weeks after the treatment in group B were (31±13) ng/L and (20±8) ng/L, (95±50) μg/L and (86±48) μg/L, (156±98)% and (74±46)% respectively, which were decreased significantly after the treatment ( P 0 05) There were no such changes in group A Conclusions It was suggested that small dose of oral theophylline combined with low dose of inhaled BDP might have the same effect on relief of clinical symptoms and bronchial responsiveness, without suppression on HPAA function, comparing with relatively higher dose of inhaled BDP