Efficacy and safety of intravenous theophylline administration for treatment of mild acute exacerbation of bronchial asthma

Objective:  The present study was designed to evaluate the efficacy and safety of intravenously administered theophylline (IAT) for the treatment of an acute exacerbation of bronchial asthma. The theophylline was solubilized and not combined with ethylenediamine. Methodology:  The subjects were 22 asthmatic patients with mild acute exacerbation of bronchial asthma. All patients had been taking oral sustained-release theophylline and their serum concentrations of theophylline were measured. The 16 patients whose serum theophylline concentrations were <13 µg/mL were randomly selected and treated with IAT (200 mg theophylline in 200 mL saline) for 2 h. Six patients were randomly selected as controls and received 200 mL of saline. Pulmonary function and asthma severity (Borg scale) before and after treatment were measured. Results:  After IAT, both PEF (before IAT, 313 ± 79 L/min; after IAT, 335 ± 107; P < 0.05) and FEV1 (before IAT, 1.66 ± 0.47 L; after IAT, 1.83 ± 0.44; P < 0.05) increased significantly. Furthermore, their severity of asthma as assessed by the Borg scale (before IAT, 2.5 ± 1.2; after IAT, 1.3 ± 1.0; P < 0.05) improved significantly. In contrast, neither FEV1, PEF, severity of asthma or Borg scale changed significantly in the group who only received saline. None of the patients treated in this study had any adverse effects. Conclusion:  These results suggest that IAT is useful for patients with mild acute exacerbation of bronchial asthma and is safe if serum theophylline concentrations are measured.