SynthesisBMJ (Clinical research ed.)2003
Methylxanthines for exacerbations of chronic obstructive pulmonary disease: meta-analysis of randomised trials.
Synthesis in BMJ (Clinical research ed.), 2003. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 32 papers, 2 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
32 citing papers in PubMed, 2 syntheses or guidelines pooled it, 146 citations in OpenAlex.
- Pooled it
- Low-dose theophylline in addition to ICS therapy in COPD patients: A systematic review and meta-analysis.PloS one · 2021Pooled it
- Trial
- Trial
- Pharmacogenetic Factors Shaping Treatment Outcomes in Chronic Obstructive Pulmonary Disease.Genes · 2025Review
- Management of Asthma and COPD Exacerbations in Adults in the ICU.CHEST critical care · 2025Article
- Gold 2023: Highlights for primary care.NPJ primary care respiratory medicine · 2023Article
- Global Initiative for Chronic Obstructive Lung Disease 2023 Report: GOLD Executive Summary.The European respiratory journal · 2023Article
- Global Initiative for Chronic Obstructive Lung Disease 2023 Report: GOLD Executive Summary.American journal of respiratory and critical care medicine · 2023Article
- Factors affecting the choice of budesonide in the therapy of croup, asthma and chronic obstructive pulmonary disease.Postepy dermatologii i alergologii · 2022Article
- Methylxanthine Treatment in Patients Hospitalized for Acute Exacerbation of Chronic Obstructive Pulmonary Disease in China: A Real-World Study Using Propensity Score Matching Analysis.Frontiers in pharmacology · 2022Article
- Therapeutic preferences and factors determining the use of inhaled corticosteroids with long-acting βPostepy dermatologii i alergologii · 2021Article
- Chronic obstructive pulmonary disease exacerbations: latest evidence and clinical implications.Therapeutic advances in chronic disease · 2014Review
- Treatment of chronic obstructive pulmonary disease in hospitalized geriatric patients.Zeitschrift fur Gerontologie und Geriatrie · 2014Article
- The effects of theophylline on hospital admissions and exacerbations in COPD patients: audit data from the Bavarian disease management program.Deutsches Arzteblatt international · 2014Article
- The Saudi Guidelines for the Diagnosis and Management of COPD.Annals of thoracic medicine · 2014Article
- Doxofylline and theophylline: a comparative clinical study.Journal of clinical and diagnostic research : JCDR · 2012Article
- Chronic obstructive pulmonary disease.Lancet (London, England) · 2012Review
- [Diagnosis and therapy of COPD exacerbation].Medizinische Klinik, Intensivmedizin und Notfallmedizin · 2012Review
- Acute lung failure.Seminars in respiratory and critical care medicine · 2011Review
Corrections and comments
- Commented on by
- Erratum issued
Authors and funding
3 authors at 3 institutions in 2 countries.
Funding
Abstract
objectiveTo evaluate the addition of methylxanthines to standard treatments in patients presenting with acute exacerbations of chronic obstructive pulmonary disease (COPD).
designMeta-analysis of randomised controlled trials. DATA SOURCE: The Cochrane airways review group's COPD register. Two reviewers independently selected articles for inclusion, assessed methodological quality, and extracted data. SELECTION OF STUDIES: Four trials met the inclusion criteria, with 169 patients.
main outcome measuresMean change in spirometry, clinical end points, symptom scores, and adverse events.
resultsMean change in forced expiratory volume at one second at two hours was similar in methylxanthine and placebo groups but transiently increased with methylxanthines at three days. Non-significant reductions in admissions to hospital and length of stay were offset by a non-significant increase in relapses at one week. Changes in symptom scores did not reach significance. Methylxanthines caused more nausea and vomiting than placebo (odds ratio 4.6, 95% confidence interval 1.7 to 12.6), and non-significant increases in tremor, palpitations, and arrhythmias were also observed.
conclusionsThe available data do not support the use of methylxanthines for the treatment of exacerbations of chronic obstructive pulmonary disease. Potential benefits of methylxanthines for lung function and symptoms were generally not confirmed at standard levels of significance, whereas the potentially important adverse events of nausea and vomiting were significantly increased in patients receiving methylxanthines.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.