Meta AnalysisID 4527

口服黄嘌呤衍生物（茶碱与多索茶碱）治疗稳定期慢性阻塞性肺疾病患者 [Cochrane方案]

CRD42017082794

To compare the efficacy and safety of adding oral theophylline or doxofylline to usual treatment (long-acting beta2-agonists, antimuscarinics, inhaled corticosteroids) versus providing usual treatment alone fo

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Meta Analysis Id: 4527
Evidence Id: 13085
Core Evidence Id: 13085
Source Meta Analysis Id: 4496
Herb2 Meta Analysis Id: HBMA004496
Crd Id: CRD42017082794
Title: Oral xanthine derivatives (theophylline and doxofylline) for patients with stable chronic obstructive pulmonary disease (COPD) [Cochrane protocol]
Review Question: To compare the efficacy and safety of adding oral theophylline or doxofylline to usual treatment (long-acting beta2-agonists, antimuscarinics, inhaled corticosteroids) versus providing usual treatment alone for patients with stable COPD.
Study Type Included: We will include double-blind placebo-controlled trials and open trials including no placebo (usual treatment group) that were conducted in patients with stable COPD who received the trial treatment for at least 12 weeks. We will include studies reported in full text, as well as those published as abstract only and reported as unpublished data. In the light of increased risk of mortality described recently in the literature as an undesirable effect associated with long-term use of theophylline (<link ref=REF-Horita-2015 type=REFERENCE/>Horita 2015), we will include long-term follow-up observational studies such as analytical cohort studies comparing the addition of theophylline or doxofylline to usual treatment versus usual treatment alone.
Condition Being Studied: The Cochrane Airways Group
Participant: We will include adults with a diagnosis of stable COPD (mild, moderate, severe, very severe). We will include only studies that use an accepted set of criteria to screen participants for this condition (i.e. guidelines of the American Thoracic Society (ATS); the British Thoracic Society (BTS); Global Initiative for Obstructive Lung Disease (GOLD) 2016; and the Thoracic Society of Australia and New Zealand (TSANZ)).
Animal
Human Disease Modelled
Intervention: We will include studies comparing the following interventions in which the intervention group is receiving xanthine derivatives as complementary therapy to previously established therapies with any of the following active treatments for disease control: long-acting beta-agonists (LABAs), long-acting muscarinic antagonists (LAMAs), and/or inhaled corticosteroids (ICSs). In keeping with currently accepted COPD guidelines, we will include the following comparisons.<ol> LABA + ICS therapy vs LABA + ICS therapy + xanthine (theophylline or doxofylline). LAMA therapy vs LAMA + xanthine (theophylline or doxofylline). LAMA + LABA + ICS therapy vs LAMA + LABA + ICS + xanthine (theophylline or doxofylline). LABA + LAMA therapy vs LABA + LAMA + xanthine (theophylline or doxofylline).</ol> For technical reasons the intervention and comparators fields for Cochrane protocols are identical and each may include information on both interventions and comparators
Comparator Control: We will include studies comparing the following interventions in which the intervention group is receiving xanthine derivatives as complementary therapy to previously established therapies with any of the following active treatments for disease control: long-acting beta-agonists (LABAs), long-acting muscarinic antagonists (LAMAs), and/or inhaled corticosteroids (ICSs). In keeping with currently accepted COPD guidelines, we will include the following comparisons.<ol> LABA + ICS therapy vs LABA + ICS therapy + xanthine (theophylline or doxofylline). LAMA therapy vs LAMA + xanthine (theophylline or doxofylline). LAMA + LABA + ICS therapy vs LAMA + LABA + ICS + xanthine (theophylline or doxofylline). LABA + LAMA therapy vs LABA + LAMA + xanthine (theophylline or doxofylline).</ol> For technical reasons the intervention and comparators fields for Cochrane protocols are identical and each may include information on both interventions and comparators
Main Outcome: <ol> Acute exacerbations of COPD, defined as the need for treatment with oral steroids, antibiotics, or both (moderate exacerbations), or hospital admission for a COPD exacerbation (severe exacerbations) Health-related quality of life (measured by a generic or disease-specific tool) Mortality (all-cause)</ol>
Outcome Measure
Additional Outcome: <ol> Dyspnoea scores: defined by the modified Medical Research Council (mMRC), the Chronic Respiratory Questionnaire Self-Administered Standardized (CRQ-SAS) dyspnoea domain, or scores on the Baseline Dyspnoea Index (BDI)-Transition Dyspnoea Index (TDI) Lung function: change from baseline in trough FEV1 Exercise capacity: six-minute walking test Serious adverse events/non-fatal (gastrointestinal and cardiovascular) events</ol>
Study Method: Intervention, Systematic review
Keyword: Bronchodilator Agents; Humans; Pulmonary Disease, Chronic Obstructive; Theophylline; doxofylline
Contact: Olga M García Morales [email protected]
Organisational Affiliation: The Cochrane Collaboration http://www.cochrane.org/
Funding Source: María Ximena Rojas and Rodolfo Dennis
Other Selection Criteria
Final Publication
Same Topic Review
Published Protocol: http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD012748/abstract
Review Type
Language: English
Country: Colombia
Review Stage: Review Ongoing
First Submission Date
Registration Date: 2017-12-02
Anticipated Start Date: 2017-08-15
Anticipated Completion Date: 2018-01-30
Title Cn: 口服黄嘌呤衍生物（茶碱与多索茶碱）治疗稳定期慢性阻塞性肺疾病患者 [Cochrane方案]
Title En: Oral xanthine derivatives (theophylline and doxofylline) for patients with stable chronic obstructive pulmonary disease (COPD) [Cochrane protocol]
Bilingual Status: complete