Phosphodiesterase 4 inhibitors for chronic obstructive pulmonary disease

Drug safety evaluation of roflumilast for the treatment of COPD: a meta-analysis

“…In fact, although we can generally confirm previous results from meta-analysis published in 2011 25 , 2013 24 and 2014 23 , our meta-analytic approach has identified a different overall risk of AEs, provided specific data on the risk of SAEs, and reported a more selective characterization of AEs induced by roflumilast. The differences between our results and those of previous meta-analyses may be related with the current availability of results from recently published RCTs [40][41][42] , that together enrolled more that 2,500 COPD patients, and with the fact that our meta-analysis has been specifically designed for assessing the safety profile of roflumilast in COPD.…”

“…Published randomized clinical trials (RCTs) were searched in PubMed and Google Scholar through March 2016 21 , and citations of previous published systematic review and meta-analyses were examined to identify further pertinent studies, if any [22][23][24][25] . The terms "roflumilast" AND "COPD" AND/OR "safety" AND/OR "adverse events" AND/OR "side effects" were searched.…”

“…In effect it appears that the weight loss may be attributed to preferential loss of fat mass 61 . However, it is not possible to rule out that the weight loss may be a result of diarrhoea 25 . In any case, the amount of weight was greater in the first 6 months of treatment, and it was reversible after three months discontinuation 51,61 .…”

Practical management problems of stable chronic obstructive pulmonary disease in the elderly

“…Theoretically, by promoting the ventilatory drive, theophylline could benefit patients with nocturnal bradypnea [38]. Finally, a more recently introduced drug, roflumilast, a phosphodiesterase 4 inhibitor, was shown to improve lung function and to reduce exacerbations in COPD populations whose mean age was about 65 years [39][40][41][42]. Nevertheless, the place of roflumilast in the management of older patients with COPD is still to be established.…”

How I would manage a man with COPD who is symptomatic and at high risk of an exacerbation: a primary care perspective from Norway

“…8 One might consider adding roflumilast (a PDE4 inhibitor) if he has a lot of symptoms of cough and mucus. 9 Roflumilast is a new oral treatment indicated as maintenance therapy for patients with severe COPD associated with symptoms of chronic bronchitis and with a history of frequent exacerbations, 10 though more research is needed to clarify its place in the management of COPD.…”