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Roflumilast improves lung function in patients with COPD

Patients who used roflumilast to treat chronic obstructive pulmonary disease showed improved lung function as well as alleviation of dyspnea and a decrease in acute exacerbations, according to a study results published in Respiratory Research.

However, there was also a higher risk for adverse events for patients using the treatment, according to the researchers.

“Roflumilast can be considered as an alternative therapy in selective patients with moderate-to-severe COPD due to the effect of lung function improvement, dyspnea alleviation and acute exacerbation decrease but increase of risk of adverse events,” Jian Luo, of the department of respiratory and critical care medicine at Sichuan University in Chengdu, China, and colleagues wrote. “More large studies are needed, particularly with different follow-up and treatment duration, to further determine the role of roflumilast, including cost-effectiveness and time-to-survive, in patients with moderate-to-severe COPD.”

Luo and colleagues performed a search of the PubMed, Cochrane Central Register of Controlled Trials, Web of Science and American College of Physicians databases and identified 13 trials with 14,563 patients related to roflumilast and COPD, according to the abstract. The researchers looked for studies with outcomes involving forced expiratory volume in 1 second, forced vital capacity (FVC), St. George’s Respiratory Questionnaire, transition dyspnea index, COPD exacerbation incidence and adverse events.

They found that pre-bronchodilator FEV1 mean difference was 54.6 (95% CI, 46.02-63.18) and the post-bronchodilator mean difference was 57.86 (95% CI, 49.8-65.91). In patients with roflumilast, the mean difference in pre-bronchodilator FEV1 (z = 12.47) and post-bronchodilator (z = 14.07) rates were significant (P < .001 for both). Mean differences in FVC for pre-bronchodilator patients and post-bronchodilator patients were also significant (mean deviation, 90.37; 95 % CI, 73.95-106.78).

Roflumilast also resulted in a significant alleviation of transition dyspnea index (mean difference, 0.30; 95% CI, 0.14-0.46) and a significant decrease of acute exacerbations (RR = 0.86; 95% CI, 0.81-0.91) with no significant difference in St. George’s Respiratory Questionnaire (mean difference, −1.30; 95% CI, −3.16 to 0.56), according to the abstract.

However, Luo and colleagues noted that roflumilast significantly increased the number of adverse events (RR = 1.31; 95% CI, 1.16-1.47). – by Jeff Craven

Disclosure: The researchers report no relevant financial disclosures.