Efficacy and safety profile of xanthines in COPD: a network meta-analysis

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Title: Efficacy and safety profile of xanthines in COPD: a network meta-analysis
Authors: Cazzola, M
Calzetta, L
Barnes, PJ
Criner, GJ
Martinez, FJ
Papi, A
Gabriella Matera, M
Item Type: Journal Article
Abstract: Theophylline can still have a role in the management of stable chronic obstructive pulmonary disease (COPD), but its use remains controversial, mainly due to its narrow therapeutic window. Doxofylline, another xanthine, is an effective bronchodilator and displays a better safety profile than theophylline. Therefore, we performed a quantitative synthesis to compare the efficacy and safety profile of different xanthines in COPD.The primary end-point of this meta-analysis was the impact of xanthines on lung function. In addition, we assessed the risk of adverse events by normalising data on safety as a function of person-weeks. Data obtained from 998 COPD patients were selected from 14 studies and meta-analysed using a network approach.The combined surface under the cumulative ranking curve (SUCRA) analysis of efficacy (change from baseline in forced expiratory volume in 1 s) and safety (risk of adverse events) showed that doxofylline was superior to aminophylline (comparable efficacy and significantly better safety), bamiphylline (significantly better efficacy and comparable safety), and theophylline (comparable efficacy and significantly better safety).Considering the overall efficacy/safety profile of the investigated agents, the results of this quantitative synthesis suggest that doxofylline seems to be the best xanthine for the treatment of COPD.
Issue Date: 30-Jun-2018
Date of Acceptance: 11-Mar-2018
ISSN: 0905-9180
Publisher: European Respiratory Society
Journal / Book Title: European Respiratory Review
Volume: 27
Issue: 148
Copyright Statement: ©ERS 2018. ERR articles are open access and distributed under the terms of the Creative Commons Attribution Non-Commercial Licence 4.0. (
Keywords: Respiratory System
Publication Status: Published
Conference Place: England
Online Publication Date: 2018-05-02
Appears in Collections:National Heart and Lung Institute
Airway Disease
Faculty of Medicine

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