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Therapeutic comparison between low-dose sustained-release theophylline dry syrup and capsule in children with mild persistent asthma

Korean Journal of Pediatrics 2007;50(3):284-291.
Published online March 15, 2007.
Therapeutic comparison between low-dose sustained-release theophylline dry syrup and capsule in children with mild persistent asthma
Hyun Seung Lee1, Hae Kyung Lee2, Hi Jeong Kwon2, Jeong Hee Kim3, Yeong Ho Rha4, Jin Tack Kim1, Young Ho Kim5, Hae Rhan Lee5, Bok Yang Pyun6
1Department of Pediatrics, College of Medicine The Catholic University of Korea, Seoul , Korea
2Department of Pediatrics, College of Medicine The Catholic University of Korea, Seoul, Korea
3Department of Pediatrics, College of Medicine, Inha University, Incheon, Korea
4Department of Pediatrics, College of Medicine, Kyunghee University, Seoul, Korea
5Department of Pediatrics, College of Medicine, Hallym University, Seoul, Korea
6Department of Pediatrics, College of Medicine, Soonchunhyang University∥, Seoul, Korea
유소아 경증 지속성 천식에서 저용량 서방형 테오필린 건조시럽과 캡슐 제형의 치료 효과 비교
이현승1, 이혜경2, 권희정2, 김정희3, 나영호4, 김진택1, 김영호5, 이혜란5, 편복양6
1가톨릭대학교 의과대학 소아과학교실
2가톨릭대학교 의과대학 임상병리학교실
3인하대학교 의과대학 소아과학교실
4경희대학교 의과대학 소아과학교실
5한림대학교 의과대학 소아과
6순천향대학교 의과대학 소아과학교실
Correspondence: 
Jin Tack Kim, Email: jintackk@catholic.ac.kr
Abstract
Purpose
: Theophylline has recently been reported to have concurrent anti-inflammatory effects at low therapeutic plasma concentrations which are below the doses at which significants, clinically useful bronchodilatation is evident. Sustained-release formulation in capsule and dry syrup forms were developed to reduce its adverse effects and improve its clinical effects. We compared the therapeutic effects of theophylline dry syrup and capsules in children with mild asthma.
Methods
: Ninety children with mild asthma were randomized to receive either theophylline dry syrup (n=44) or theophylline capsules (n=46); 4 mg per kilogram of body weight, twice a day, for 12 weeks. Baseline and serial measurements of daytime and nighttime asthma symptom score were performed. Compliance scores, drug swallowing scores, and drug usability scores were measured every 4 weeks. Each scoring was rated on a scale of 0-4. Serum theophylline concentration were measured at 4 and at 12 weeks. To examine the anti-inflammatory effect of theophylline on asthma, Serum eosinophilic cationic protein as a marker of airway inflammation caused by eosinophil was measured 12 weeks pre- and post-administration.
Results
: The daytime and nighttime asthma symptom scores of the two groups after 4 weeks significantly improved over the baseline score. Daytime and nighttime asthma symptom scores in the dry syrup group were statistically lower at all time points except for the nighttime symptom scores at 4 weeks. Compliance scores, drug swallowing scores, and drug usability scores in the dry syrup group were significantly higher at the end time point. Only in the dry syrup group was the serum ECP at the end time point statistically lower than baseline.
Conclusion
: Low-dose sustained-release theophylline may be safe and effective in bronchial asthma and this effect may be mediated by its anti-inflammatory action mechanisms. Especially, when used in children with asthma, dry syrup formulation is recommended because of its higher compliance than capsule formulation.
Key Words: Theophylline , Dry syrup , Asthma


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