PDE4 Inhibitors Improve Some COPD-Related Symptoms

Phosphodiesterase 4 inhibitors improve short-term lung function and reduce COPD exacerbations

TUESDAY, May 31 (HealthDay News) -- In chronic obstructive pulmonary disease (COPD), oral phosphodiesterase 4 (PDE4) inhibitors improve lung function and reduce the likelihood of exacerbations with little impact on quality of life or symptoms, according to a study published online May 11 in the Cochrane Database of Systematic Reviews.

Jimmy Chong, from the University of Auckland in New Zealand, and colleagues evaluated the efficacy and safety of PDE4 inhibitors in the management of individuals with stable COPD. The researchers identified 23 relevant trials from the Cochrane Airways Group Specialized Register of trials until 2010; nine trials of roflumilast included 9,211 patients; and 14 trials of cilomilast included 6,457 patients. Lung function, quality of life, symptom exacerbations, and adverse effects were the outcomes studied.

The investigators found that, regardless of COPD severity and concomitant COPD treatment, treatment with a PDE4 was correlated with a significant improvement in forced expiratory volume in one second compared with placebo (mean difference [MD], 45.59 mL). Treatment with PDE4 did not affect exercise tolerance, but quality of life (St. Georges Respiratory Questionnaire MD, − 1.04) and COPD-related symptoms showed small improvements. PDE4 inhibitor treatment was correlated with a significantly reduced likelihood of COPD exacerbation (odds ratio, 0.78). Compared to controls, PDE4 inhibitor treatment was associated with more nonserious adverse events, particularly gastrointestinal symptoms and headache, and roflumilast was associated with weight loss.

"Phosphodiesterase 4 inhibitors join an increasing list of treatments for COPD that improve short-term lung function and reduce exacerbations, but have not been shown to increase life expectancy," the authors write.

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