EVects of theophylline and ipratropium bromide on exercise performance in patients with stable chronic obstructive pulmonary disease

Background—The eVects of theophylline or anticholinergic agents on exercise capacity in patients with chronic obstructive pulmonary disease (COPD) remain controversial. The aim of the present study was to compare the eVect of an oral theophylline with an inhaled anticholinergic agent and to examine the eVects of combined therapy on exercise performance using progressive cycle ergometry. Methods—Twenty one men with stable COPD and a mean (SD) forced expiratory volume in one second (FEV1) of 1.00 (0.40) l were studied. Theophylline (600 or 800 mg daily), ipratropium bromide (160 μg), a combination of both drugs, and placebo were given in a randomised, double blind, four period crossover design study. Spirometric data, pulse rate, and blood pressure were assessed before and at 90 and 120 minutes after inhalation. Symptom limited progressive cycle ergometer exercise tests (20 watts/min) were performed 90 minutes after each inhalation, and dyspnoea was measured during exercise using the Borg