Abstract
In chronic obstructive pulmonary disease (COPD) the inflammation occurring in the airways and in other lung tissues is complex and is orchestrated by various mediators including the isoenzyme 4 of the phosphodiesterases family (PDE4), which contributes to bronchoconstriction and inflammation. Various PDE4 inhibitors have been evaluated as potential therapies in asthma or COPD but among these only roflumilast have been authorized in Europe to be used in patients with severe COPD as an add-on to the bronchodilator therapy. This review discusses the existing preclinical and clinical data supporting the use of roflumilast for this therapeutic indication and tackles some of the pending issues related to PDE4 in general and to roflumilast in particular.
Keywords:
COPD; PDE4; efficacy; roflumilast; safety.
MeSH terms
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Aminopyridines / adverse effects
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Aminopyridines / therapeutic use*
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Animals
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Anti-Inflammatory Agents / adverse effects
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Anti-Inflammatory Agents / therapeutic use*
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Benzamides / adverse effects
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Benzamides / therapeutic use*
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Bronchodilator Agents / adverse effects
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Bronchodilator Agents / therapeutic use*
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Cyclopropanes / adverse effects
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Cyclopropanes / therapeutic use
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Drug Therapy, Combination
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Humans
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Lung / drug effects*
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Lung / physiopathology
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Phosphodiesterase 4 Inhibitors / adverse effects
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Phosphodiesterase 4 Inhibitors / therapeutic use*
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Pulmonary Disease, Chronic Obstructive / drug therapy*
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Pulmonary Disease, Chronic Obstructive / physiopathology
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Risk Assessment
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Treatment Outcome
Substances
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Aminopyridines
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Anti-Inflammatory Agents
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Benzamides
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Bronchodilator Agents
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Cyclopropanes
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Phosphodiesterase 4 Inhibitors
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Roflumilast