Roflumilast in chronic obstructive pulmonary disease: evidence from large trials

Expert Opinion on Pharmacotherapy
Mario CazzolaMaria G Matera

Abstract

Chronic inflammation plays a central role in chronic obstructive pulmonary disease (COPD). Suppression of the inflammatory response is a logical approach to the treatment of COPD. Corticosteroids are highly effective as an anti-inflammatory treatment, but patients with COPD are poorly responsive to these drugs. The phosphodiesterase (PDE)-4 isoenzyme is a major therapeutic target in COPD because its inhibition increases intracellular cAMP concentrations, which ultimately results in reduction of cellular inflammatory activity. At present roflumilast is the most advanced PDE-4 inhibitor undergoing clinical trials for COPD. In this paper, we describe the importance of roflumilast as an anti-inflammatory drug and critically review the results of four large trials with roflumilast in COPD (NCT00297102, NCT00297115, NCT00313209, NCT00424268). An unbiased description of trials that have explored the therapeutic effects of roflumilast in COPD. At the moment, roflumilast should only be considered as a second-line treatment, and the exact indication remains to be determined. Apparently, it should be reserved for patients who have frequent exacerbations despite treatment with inhaled bronchodilators. However, considering the high risk of ...Continue Reading

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Citations

Oct 14, 2011·Inflammatory Bowel Diseases·Noah P ZimmermanMichael B Dwinell
Apr 13, 2013·Drugs & Aging·Timothy E AlbertsonAndrew L Chan
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May 14, 2016·Expert Opinion on Drug Discovery·Mario CazzolaMaria Gabriella Matera
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May 23, 2012·Pharmacological Reviews·Mario CazzolaM Gabriella Matera

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