Cilomilast, a selective phosphodiesterase-4 inhibitor for treatment of patients with chronic obstructive pulmonary disease: a randomised, dose-ranging study

Roles of roflumilast, a selective phosphodiesterase 4 inhibitor, in airway diseases

“…COPD exacerbation reduction was noted in clinical studies of long-acting bronchodilators [LABA and/or long-acting muscarinic (49). Effects on PEFR were also observed in short-term studies on COPD treated with roflumilast (250 and 500 µg) compared with a placebo (50).…”

Enhanced recovery from respiratory infection following treatment with a PDE-5 inhibitor: a single case study

“…Related agents, PDE-4 inhibitors, have been used in COPD for their antiinflammatory effect. 6,7 Tadalafil 5mg (a PDE-5 inhibitor) was available, since samples had been provided for use in patients with erectile dysfunction; though it is not licensed for use in pulmonary hypertension it had the advantage not only of availability but a once-daily dosing schedule.…”

PDE4-inhibitors: A novel, targeted therapy for obstructive airways disease

“…The PDE4-inhibitor cilomilast was evaluated in a dose finding study in patients with moderate to severe COPD over a relatively short treatment period of 6 weeks, significantly increasing baseline FEV1 by 11% at the end of the study [17] ( Table 2). The improvement in baseline lung function developed gradually, suggesting that, unlike current bronchodilators used in COPD, PDE4-inhibitors may modulate lung function by mechanisms unrelated to airway smooth muscle relaxation per se.…”

“…The presence of the PDE4-isoenzyme in many of the cell types implicated in COPD would make it a promising target for disease modifying therapy, given the strong relationship between chronic airway inflammation and mucus hypersecretion with increased decline in lung function [16]. Most of the (long-term) studies in COPD so far have been performed with the second generation of oral PDE4-inhibitors, cilomilast (Glaxo Smith Kline) and roflumilast (Nycomed), of which roflumilast possesses the best pharmacological profile (once daily dosing) combined with good clinical efficacy with overall mild and self limiting side effects [17]. In this review we will focus on the most recent clinical trials with the PDE4-inhibitor, roflumilast, showing clinical efficacy in patients with COPD.…”