The use of roflumilast in COPD: a review

Abstract

Chronic obstructive pulmonary disease (COPD) is a major cause of morbidity and mortality worldwide. Chronic inflammation and exacerbations play a central role in the progression of the disease. Currently, treatment options for COPD have been shown to improve the progressive decline in lung-function and/or decrease mortality rates. Roflumilast, a phosphodiesterase- 4 inhibitor, is an anti-inflammatory drug which has been licensed as an add-on therapy for COPD patients with forced expiratory volume in the first second <50% and frequent exacerbations. Clinical trials have demonstrated that roflumilast improves lung function and reduces exacerbation frequency. Roflumilast has a mechanism of action which allows it to obtain a significant additive effect to current therapeutic options for COPD patients. It is generally well tolerated, although the most common adverse effects include diarrhea, nausea, weight loss, and headache. This review article provides an overview of the positive effects of roflumilast on lung function, exacerbation frequency and glucose metabolism, and its interaction with concomitant inhaled treatments.

Roflumilast: the fourth Mousquetaire in COPD pharmacological treatment

“…This issue of Monaldi Archives is dedicated to real life reports of the use of roflumilast in clinical practice. After a comprehensive review on the drug and its clinical data [15], six reports from different Hospitals and groups across Italy describe similar stories [16][17][18][19][20][21]. The reports deal with patients with recurrent AECOPD episodes causing multiple hospitalization (so called "revolving door patients"), patients not responding to conventional treatments, with accelerated decline of lung function, multiple comorbidities, developing disability.…”