Theophylline in Liver Disease

To the Editor: Piafsky et al. (N Engl J Med 296:1495–1497, 1977) have elegantly documented the need for reduction of maintenance theophylline in the setting of hepatic cirrhosis. However, the data presented may permit more definitive recommendations for maintenance doses than the investigators appear willing to state. Data derived from Case 9 reflected a much higher theophylline clearance (0.200 liter per kilogram per hour) than the remaining eight patients (clearances ≼0.035 liter per kilogram per hour). Justification for exclusion of this patient from final analysis could be argued either on the grounds that she had been given secobarbital, a known. . .