Stroke: theophylline has no effect on death.

Clinical bottom line (level 1a-)

  1. Patients with acute ischaemic stroke who are given theophylline or an analogue of it had no clear difference in early death, than those given placebo or nothing.
Mohiuddin et al: The Cochrane Library, Issue 2, Oxford: Update Software 1999; 2: -
Expires December 2003

The study

Systematic review of truly randomised, unconfounded controlled parallel trials of
  • Patients: within one week of acute stroke and not known to have had primary intracerebral haemorrhage
  • Intervention: intravenous or oral theophylline or analogue compared with placebo or nothing
  • Outcome: death at 4 weeks


    • Articles found in ? language using Cochrane Stroke Group trials register, MEDLINE, EMBASE, ISI, from 1965 (search terms: stroke or cerebr* and theophylline or aminophylline or caffeine or methylxanthine or afonilum or aminophyllin or cardophylline or clonofilin or duraphyllin or escophylline or etophyllin or eufilina or euphylline or inophylline or palason or pecram or peterphylline or phylocortin or phylotemp or planphylline or terfamin or zepholin ) and contacted drug companies.

    Selection criteria: as above
    Appraisal criteria: detailed
    Articles excluded if: Theophylline plus active drug versus placebo alone

    Two trials involving 119 patients were included.

    The evidence

    • Theophylline or its analogues gave an increased odds of death at four weeks of 12.0% (95% CI -156% to 51.0%)

    Citation

    1. Mohiuddin AA, Bath FJ, Bath PMW: Theophylline, aminophylline, caffeine and analogues for acute ischaemic stroke. The Cochrane Library, Issue 2, Oxford: Update Software 1999; 2: -
    Contributor: Clare Wotton and Bob Phillips, December 1999
    Reviewer:

    Clinical Question.
    Patient acute stroke
    Intervention or Exposure theophylline or analogue
    Comparison placebo or nothing
    Outcome early death