Asthma: aminophylline decreased hospital admissions.

Clinical bottom line (level 1b)

  1. Patients presenting to the emergency department with asthma exacerbation or wheezing who were given aminophylline, were less likely to be admitted to hospital, than those given placebo (NNT = 7 at unknown) .
  2. Patients given aminophylline had no clear difference in forced expiratory volume in one second or peak flow rate, than those given placebo.
  3. This study found no clear difference in side effects.
Wrenn et al: Annals of Internal Medicine 1991; 115 (4): 241-247
Expires June 2003

The study

Double-blinded concealed randomised trial ?with intention-to-treat
Setting: general hospital, UK

133 patients (aged ?, 58% female) presenting with asthma exacerbation or wheezing

Excluded if
  • aged <16 years
  • use of theophylline-containing product within preceding 24 hours
  • history of adverse reaction to theophylline
  • contraindication to corticosteroids or beta-agonists
  • insulin dependent diabetes
  • possible myocardial ischaemia
  • pulmonary oedema


    • Note:
  • Some patients had chronic obstructive pulmonary disease.


    • Control Group: (n = 68, 68 analysed): placebo
    Experimental Group: (n = 65, 65 analysed): aminophylline , loading dose 5.6 mg/kg body weight over 20 minutes, followed by a constant infusion of 0,9 mg/kg/hour
    All patients received metaproterenol sulphate by hand-held nebuliser at intervals of 15 to 20 minutes for three back-to-back treatments. They also received methylprednisolone sodium succinate, 80 mg iv.
    100% followed for ?
    Outcome notes:
    • side effects : nausea, anxiety, tremor, seizure, palpitations or arrythmia

    The evidence

    Outcome Time to outcome CEREERRRR
    (95% CI)    		ARR
    (95% CI)    		NNT
    (95% CI)
    admitted to hospital unknown 14
    (20.6%)    		 4
    (6.15%)    		 70%
    (14% to 90%)    		 14.4%
    (3.19% to 25.7%)    		 7
    (4 to 31)
    side effects unknown 23
    (33.8%)    		 31
    (47.7%)    		 -41%
    (-114% to 7%)    		 -13.9%
    (-30.4% to 2.68%)    		 -7
    (NNT = 37 to infinity;
    NNH = 3 to infinity)

  • There was no clear difference between the two treatments in forced expiratory volume in one second and peak flow rate at 60 or 120 minutes (numbers were only given in a graph).

    • Citation

    1. Wrenn CM, Slovis CM, Murphy F, et al: Aminophylline therapy for acute bronchospastic disease in the emergency room. Annals of Internal Medicine 1991; 115 (4): 241-247
    Contributor: Clare Wotton and Musab Hayatli, June 2000
    Reviewer: Mitsuhiro Kamei

    Clinical Question.
    Patient asthma exacerbation or wheezing
    Intervention or Exposure aminophylline
    Comparison placebo
    Outcome peak flow, forced expiratory volume and hospital admission