Skip to main content
Top
Published in: Drugs 14/2015

01-09-2015 | Adis Drug Evaluation

Roflumilast: A Review in COPD

Author: Karly P. Garnock-Jones

Published in: Drugs | Issue 14/2015

Login to get access

Abstract

Roflumilast (Daliresp®, Daxas®) is a selective phosphodiesterase 4 (PDE4) inhibitor that decreases systemic and pulmonary inflammation and improves disease symptoms in patients with severe chronic obstructive pulmonary disease (COPD). This article reviews the pharmacological properties of roflumilast and its clinical efficacy and tolerability in patients with COPD. Roflumilast is an effective treatment in patients with moderate to severe COPD; it improves lung function and is generally associated with a lower risk of exacerbation, particularly in patients with more severe disease and/or chronic bronchitis, cough and sputum. It is generally well tolerated; the most common adverse event was diarrhoea. While associated with an increased risk of psychiatric adverse events and weight loss, roflumilast is not associated with an increased risk of respiratory disease and infection, and may decrease the risk of cardiovascular adverse events. Roflumilast is a useful addition to the treatment options for patients with COPD.
Literature
1.
go back to reference Global Initiative for Chronic Obstructive Lung Disease (GOLD). Global strategies for the diagnosis, management, and prevention of chronic obstructive pulmonary disease. 2015. http://www.goldcopd.org. Accessed 25 May 2015. Global Initiative for Chronic Obstructive Lung Disease (GOLD). Global strategies for the diagnosis, management, and prevention of chronic obstructive pulmonary disease. 2015. http://​www.​goldcopd.​org. Accessed 25 May 2015.
3.
go back to reference Rabe KF. Update on roflumilast, a phosphodiesterase 4 inhibitor for the treatment of chronic obstructive pulmonary disease. Br J Pharmacol. 2011;163(1):53–67.PubMedCentralCrossRefPubMed Rabe KF. Update on roflumilast, a phosphodiesterase 4 inhibitor for the treatment of chronic obstructive pulmonary disease. Br J Pharmacol. 2011;163(1):53–67.PubMedCentralCrossRefPubMed
4.
go back to reference Giembycz MA, Maurice DH. Cyclic nucleotide-based therapeutics for chronic obstructive pulmonary disease. Curr Opin Pharmacol. 2014;16(Suppl C):89–107.CrossRefPubMed Giembycz MA, Maurice DH. Cyclic nucleotide-based therapeutics for chronic obstructive pulmonary disease. Curr Opin Pharmacol. 2014;16(Suppl C):89–107.CrossRefPubMed
6.
go back to reference Hatzelmann A, Schudt C. Anti-inflammatory and immunomodulatory potential of the novel PDE4 inhibitor roflumilast in vitro. J Pharmacol Exp Ther. 2001;297(1):267–79.PubMed Hatzelmann A, Schudt C. Anti-inflammatory and immunomodulatory potential of the novel PDE4 inhibitor roflumilast in vitro. J Pharmacol Exp Ther. 2001;297(1):267–79.PubMed
7.
go back to reference Buenestado A, Grassin-Delyle S, Guitard F, et al. Roflumilast inhibits the release of chemokines and TNF-alpha from human lung macrophages stimulated with lipopolysaccharide. Br J Pharmacol. 2012;165(6):1877–90.PubMedCentralCrossRefPubMed Buenestado A, Grassin-Delyle S, Guitard F, et al. Roflumilast inhibits the release of chemokines and TNF-alpha from human lung macrophages stimulated with lipopolysaccharide. Br J Pharmacol. 2012;165(6):1877–90.PubMedCentralCrossRefPubMed
8.
go back to reference Buenestado A, Chaumais MC, Grassin-Delyle S, et al. Roflumilast inhibits lipopolysaccharide-induced tumor necrosis factor-alpha and chemokine production by human lung parenchyma. PLoS One. 2013;8(9):e74640.PubMedCentralCrossRefPubMed Buenestado A, Chaumais MC, Grassin-Delyle S, et al. Roflumilast inhibits lipopolysaccharide-induced tumor necrosis factor-alpha and chemokine production by human lung parenchyma. PLoS One. 2013;8(9):e74640.PubMedCentralCrossRefPubMed
9.
go back to reference Victoni T, Gleonnec F, Lanzetti M, et al. Roflumilast N-oxide prevents cytokine secretion induced by cigarette smoke combined with LPS through JAK/STAT and ERK1/2 inhibition in airway epithelial cells. PLoS One. 2014;9(1):e85243.PubMedCentralCrossRefPubMed Victoni T, Gleonnec F, Lanzetti M, et al. Roflumilast N-oxide prevents cytokine secretion induced by cigarette smoke combined with LPS through JAK/STAT and ERK1/2 inhibition in airway epithelial cells. PLoS One. 2014;9(1):e85243.PubMedCentralCrossRefPubMed
10.
go back to reference Vecchio D, Acquaviva A, Arezzini B, et al. Downregulation of NOX4 expression by roflumilast N-oxide reduces markers of fibrosis in lung fibroblasts. Mediators Inflamm. 2013;2013:745984.PubMedCentralCrossRefPubMed Vecchio D, Acquaviva A, Arezzini B, et al. Downregulation of NOX4 expression by roflumilast N-oxide reduces markers of fibrosis in lung fibroblasts. Mediators Inflamm. 2013;2013:745984.PubMedCentralCrossRefPubMed
11.
go back to reference Höhne K, Schließmann SJ, Kirschbaum A, et al. Roflumilast-N-oxide induces surfactant protein expression in human alveolar epithelial cells type II. PLoS One. 2012;7(7):e38369.PubMedCentralCrossRefPubMed Höhne K, Schließmann SJ, Kirschbaum A, et al. Roflumilast-N-oxide induces surfactant protein expression in human alveolar epithelial cells type II. PLoS One. 2012;7(7):e38369.PubMedCentralCrossRefPubMed
12.
go back to reference Milara J, Armengot M, Banuls P, et al. Roflumilast N-oxide, a PDE4 inhibitor, improves cilia motility and ciliated human bronchial epithelial cells compromised by cigarette smoke in vitro. Br J Pharmacol. 2012;166(8):2243–62.PubMedCentralCrossRefPubMed Milara J, Armengot M, Banuls P, et al. Roflumilast N-oxide, a PDE4 inhibitor, improves cilia motility and ciliated human bronchial epithelial cells compromised by cigarette smoke in vitro. Br J Pharmacol. 2012;166(8):2243–62.PubMedCentralCrossRefPubMed
13.
go back to reference Milara J, Peiro T, Serrano A, et al. Roflumilast N-oxide inhibits bronchial epithelial to mesenchymal transition induced by cigarette smoke in smokers with COPD. Pulm Pharmacol Ther. 2014;28(2):138–48.CrossRefPubMed Milara J, Peiro T, Serrano A, et al. Roflumilast N-oxide inhibits bronchial epithelial to mesenchymal transition induced by cigarette smoke in smokers with COPD. Pulm Pharmacol Ther. 2014;28(2):138–48.CrossRefPubMed
14.
go back to reference Milara J, Lluch J, Almudever P, et al. Roflumilast N-oxide reverses corticosteroid resistance in neutrophils from patients with chronic obstructive pulmonary disease. J Allergy Clin Immunol. 2014;134(2):314–22.CrossRefPubMed Milara J, Lluch J, Almudever P, et al. Roflumilast N-oxide reverses corticosteroid resistance in neutrophils from patients with chronic obstructive pulmonary disease. J Allergy Clin Immunol. 2014;134(2):314–22.CrossRefPubMed
15.
go back to reference Milara J, Morell A, Ballester B, et al. Roflumilast improves corticosteroid resistance COPD bronchial epithelial cells stimulated with toll like receptor 3 agonist. Respir Res. 2015;16:12.PubMedCentralCrossRefPubMed Milara J, Morell A, Ballester B, et al. Roflumilast improves corticosteroid resistance COPD bronchial epithelial cells stimulated with toll like receptor 3 agonist. Respir Res. 2015;16:12.PubMedCentralCrossRefPubMed
16.
go back to reference Hatzelmann A, Morcillo EJ, Lungarella G, et al. The preclinical pharmacology of roflumilast: a selective, oral phosphodiesterase 4 inhibitor in development for chronic obstructive pulmonary disease. Pulm Pharmacol Ther. 2010;23(4):235–56.CrossRefPubMed Hatzelmann A, Morcillo EJ, Lungarella G, et al. The preclinical pharmacology of roflumilast: a selective, oral phosphodiesterase 4 inhibitor in development for chronic obstructive pulmonary disease. Pulm Pharmacol Ther. 2010;23(4):235–56.CrossRefPubMed
17.
go back to reference Martorana PA, Beume R, Lucattelli M, et al. Roflumilast fully prevents emphysema in mice chronically exposed to cigarette smoke. Am J Respir Crit Care Med. 2005;172(7):848–53.CrossRefPubMed Martorana PA, Beume R, Lucattelli M, et al. Roflumilast fully prevents emphysema in mice chronically exposed to cigarette smoke. Am J Respir Crit Care Med. 2005;172(7):848–53.CrossRefPubMed
18.
go back to reference Hohlfeld JM, Schoenfeld K, Lavae-Mokhtari M, et al. Roflumilast attenuates pulmonary inflammation upon segmental endotoxin challenge in healthy subjects: a randomized placebo-controlled trial. Pulm Pharmacol Ther. 2008;21(4):616–23.CrossRefPubMed Hohlfeld JM, Schoenfeld K, Lavae-Mokhtari M, et al. Roflumilast attenuates pulmonary inflammation upon segmental endotoxin challenge in healthy subjects: a randomized placebo-controlled trial. Pulm Pharmacol Ther. 2008;21(4):616–23.CrossRefPubMed
19.
go back to reference Grootendorst DC, Gauw SA, Verhoosel RM, et al. Reduction in sputum neutrophil and eosinophil numbers by the PDE4 inhibitor roflumilast in patients with COPD. Thorax. 2007;62(12):1081–7.PubMedCentralCrossRefPubMed Grootendorst DC, Gauw SA, Verhoosel RM, et al. Reduction in sputum neutrophil and eosinophil numbers by the PDE4 inhibitor roflumilast in patients with COPD. Thorax. 2007;62(12):1081–7.PubMedCentralCrossRefPubMed
20.
go back to reference Marquez-Martin E, Ortega F, Campano E, et al. Reduction in systemic inflammation by the PDE4 inhibitor roflumilast in patients with COPD [abstract no. 732A]. Chest. 2013;144(4 MeetingAbstracts). doi:10.1378/chest.1703911. Marquez-Martin E, Ortega F, Campano E, et al. Reduction in systemic inflammation by the PDE4 inhibitor roflumilast in patients with COPD [abstract no. 732A]. Chest. 2013;144(4 MeetingAbstracts). doi:10.​1378/​chest.​1703911.
21.
go back to reference Huennemeyer A, Nassr N, Bredenbröker D, et al. Supra-therapeutic doses of roflumilast have no effect on cardiac repolarization in healthy subjects. Expert Opin Drug Saf. 2011;10(4):509–19.CrossRefPubMed Huennemeyer A, Nassr N, Bredenbröker D, et al. Supra-therapeutic doses of roflumilast have no effect on cardiac repolarization in healthy subjects. Expert Opin Drug Saf. 2011;10(4):509–19.CrossRefPubMed
22.
go back to reference Bethke TD, Lahu G. High absolute bioavailability of the new oral phosphodiesterase-4 inhibitor roflumilast. Int J Clin Pharmacol Ther. 2011;49(1):51–7.CrossRefPubMed Bethke TD, Lahu G. High absolute bioavailability of the new oral phosphodiesterase-4 inhibitor roflumilast. Int J Clin Pharmacol Ther. 2011;49(1):51–7.CrossRefPubMed
23.
go back to reference Hauns B, Hermann R, Hunnemeyer A, et al. Investigation of a potential food effect on the pharmacokinetics of roflumilast, an oral, once-daily phosphodiesterase 4 inhibitor, in healthy subjects. J Clin Pharmacol. 2006;46(10):1146–53.CrossRefPubMed Hauns B, Hermann R, Hunnemeyer A, et al. Investigation of a potential food effect on the pharmacokinetics of roflumilast, an oral, once-daily phosphodiesterase 4 inhibitor, in healthy subjects. J Clin Pharmacol. 2006;46(10):1146–53.CrossRefPubMed
24.
go back to reference Bethke TD, Huennemeyer A, Lahu G, et al. Chronopharmacology of roflumilast: a comparative pharmacokinetic study of morning versus evening administration in healthy adults. Chronobiol Int. 2010;27(9–10):1843–53.CrossRefPubMed Bethke TD, Huennemeyer A, Lahu G, et al. Chronopharmacology of roflumilast: a comparative pharmacokinetic study of morning versus evening administration in healthy adults. Chronobiol Int. 2010;27(9–10):1843–53.CrossRefPubMed
25.
go back to reference de Mey C, Nassr N, Lahu G. No relevant cardiac, pharmacokinetic or safety interactions between roflumilast and inhaled formoterol in healthy subjects: an open-label, randomised, actively controlled study. BMC Clin Pharmacol. 2011;11:7.PubMedCentralCrossRefPubMed de Mey C, Nassr N, Lahu G. No relevant cardiac, pharmacokinetic or safety interactions between roflumilast and inhaled formoterol in healthy subjects: an open-label, randomised, actively controlled study. BMC Clin Pharmacol. 2011;11:7.PubMedCentralCrossRefPubMed
26.
go back to reference McCracken N, Lahu G, Bethke TD. Lack of pharmacokinetic and pharmacodynamic interactions of roflumilast with (R, S)-warfarin in healthy adult subjects. Int J Clin Pharmacol Ther. 2011;49(6):388–96.CrossRefPubMed McCracken N, Lahu G, Bethke TD. Lack of pharmacokinetic and pharmacodynamic interactions of roflumilast with (R, S)-warfarin in healthy adult subjects. Int J Clin Pharmacol Ther. 2011;49(6):388–96.CrossRefPubMed
27.
go back to reference Lee SD, Hui DS, Mahayiddin AA, et al. Roflumilast in Asian patients with COPD: a randomized placebo-controlled trial. Respirology. 2011;16(8):1249–57.CrossRefPubMed Lee SD, Hui DS, Mahayiddin AA, et al. Roflumilast in Asian patients with COPD: a randomized placebo-controlled trial. Respirology. 2011;16(8):1249–57.CrossRefPubMed
28.
go back to reference O’Donnell DE, Bredenbroker D, Brose M, et al. Physiological effects of roflumilast at rest and during exercise in COPD. Eur Respir J. 2012;39(5):1104–12.CrossRefPubMed O’Donnell DE, Bredenbroker D, Brose M, et al. Physiological effects of roflumilast at rest and during exercise in COPD. Eur Respir J. 2012;39(5):1104–12.CrossRefPubMed
29.
go back to reference Zheng J, Yang J, Zhou X, et al. Roflumilast for the treatment of COPD in an Asian population: a randomized, double-blind, parallel-group study. Chest. 2014;145(1):44–52.CrossRefPubMed Zheng J, Yang J, Zhou X, et al. Roflumilast for the treatment of COPD in an Asian population: a randomized, double-blind, parallel-group study. Chest. 2014;145(1):44–52.CrossRefPubMed
30.
go back to reference Rabe KF, Bateman ED, O’Donnell D, et al. Roflumilast - an oral anti-inflammatory treatment for chronic obstructive pulmonary disease: a randomised controlled trial. Lancet. 2005;366(9485):563–71.CrossRefPubMed Rabe KF, Bateman ED, O’Donnell D, et al. Roflumilast - an oral anti-inflammatory treatment for chronic obstructive pulmonary disease: a randomised controlled trial. Lancet. 2005;366(9485):563–71.CrossRefPubMed
31.
go back to reference Calverley PM, Rabe KF, Goehring UM, et al. Roflumilast in symptomatic chronic obstructive pulmonary disease: two randomised clinical trials. Lancet. 2009;374(9691):685–94.CrossRefPubMed Calverley PM, Rabe KF, Goehring UM, et al. Roflumilast in symptomatic chronic obstructive pulmonary disease: two randomised clinical trials. Lancet. 2009;374(9691):685–94.CrossRefPubMed
32.
go back to reference Calverley PM, Sanchez-Toril F, McIvor A, et al. Effect of 1-year treatment with roflumilast in severe chronic obstructive pulmonary disease. Am J Respir Crit Care Med. 2007;176(2):154–61.CrossRefPubMed Calverley PM, Sanchez-Toril F, McIvor A, et al. Effect of 1-year treatment with roflumilast in severe chronic obstructive pulmonary disease. Am J Respir Crit Care Med. 2007;176(2):154–61.CrossRefPubMed
33.
go back to reference National Institute for Health and Clinical Excellence. Premeeting briefing: roflumilast for the management of chronic obstructiv pulmonary disease. 2011. http://www.nice.org.uk. Accessed 29 Jul 2015. National Institute for Health and Clinical Excellence. Premeeting briefing: roflumilast for the management of chronic obstructiv pulmonary disease. 2011. http://​www.​nice.​org.​uk. Accessed 29 Jul 2015.
34.
go back to reference Takeda. OPUS study: effect of roflumilast on exacerbation rate in patients with chronic obstructive pulmonary disease (BY217/M2-111) [NCT00076089]. 2012. http://www.clinicaltrials.gov. Accessed 29 Jul 2015. Takeda. OPUS study: effect of roflumilast on exacerbation rate in patients with chronic obstructive pulmonary disease (BY217/M2-111) [NCT00076089]. 2012. http://​www.​clinicaltrials.​gov. Accessed 29 Jul 2015.
35.
go back to reference Creanga D, Bredenbroeker D, Brose M, et al. Effect of roflumilast treatment on dyspnea in patients with chronic obstructive pulmonary disease [abstract no. 97670]. J Hosp Med. 2012;7(Suppl 2):127. Creanga D, Bredenbroeker D, Brose M, et al. Effect of roflumilast treatment on dyspnea in patients with chronic obstructive pulmonary disease [abstract no. 97670]. J Hosp Med. 2012;7(Suppl 2):127.
36.
go back to reference Creanga D, Bredenbroeker D, Brose M, et al. Effect of roflumilast treatment on health-related quality of life in patients with chronic obstructive pulmonary disease [abstract no. 97664]. J Hosp Med. 2012;7(Suppl 2):121. Creanga D, Bredenbroeker D, Brose M, et al. Effect of roflumilast treatment on health-related quality of life in patients with chronic obstructive pulmonary disease [abstract no. 97664]. J Hosp Med. 2012;7(Suppl 2):121.
37.
go back to reference Rennard SI, Calverley PM, Goehring UM, et al. Reduction of exacerbations by the PDE4 inhibitor roflumilast: the importance of defining different subsets of patients with COPD. Respir Res. 2011;12:18.PubMedCentralCrossRefPubMed Rennard SI, Calverley PM, Goehring UM, et al. Reduction of exacerbations by the PDE4 inhibitor roflumilast: the importance of defining different subsets of patients with COPD. Respir Res. 2011;12:18.PubMedCentralCrossRefPubMed
38.
go back to reference Hanania NA, Calverley PM, Dransfield MT, et al. Pooled subpopulation analyses of the effects of roflumilast on exacerbations and lung function in COPD. Respir Med. 2014;108(2):366–75.CrossRefPubMed Hanania NA, Calverley PM, Dransfield MT, et al. Pooled subpopulation analyses of the effects of roflumilast on exacerbations and lung function in COPD. Respir Med. 2014;108(2):366–75.CrossRefPubMed
39.
go back to reference Bateman ED, Rabe KF, Calverley PM, et al. Roflumilast with long-acting beta2-agonists for COPD: influence of exacerbation history. Eur Respir J. 2011;38(3):553–60.CrossRefPubMed Bateman ED, Rabe KF, Calverley PM, et al. Roflumilast with long-acting beta2-agonists for COPD: influence of exacerbation history. Eur Respir J. 2011;38(3):553–60.CrossRefPubMed
40.
go back to reference Wedzicha JA, Rabe KF, Martinez FJ, et al. Efficacy of roflumilast in the COPD frequent exacerbator phenotype. Chest. 2013;143(5):1302–11.CrossRefPubMed Wedzicha JA, Rabe KF, Martinez FJ, et al. Efficacy of roflumilast in the COPD frequent exacerbator phenotype. Chest. 2013;143(5):1302–11.CrossRefPubMed
41.
go back to reference Rennard SI, Sun SX, Tourkodimitris S, et al. Roflumilast and dyspnea in patients with moderate to very severe chronic obstructive pulmonary disease: a pooled analysis of four clinical trials. Int J Chron Obstruct Pulmon Dis. 2014;9:657–73.PubMedCentralCrossRefPubMed Rennard SI, Sun SX, Tourkodimitris S, et al. Roflumilast and dyspnea in patients with moderate to very severe chronic obstructive pulmonary disease: a pooled analysis of four clinical trials. Int J Chron Obstruct Pulmon Dis. 2014;9:657–73.PubMedCentralCrossRefPubMed
42.
go back to reference Fabbri LM, Calverley PM, Izquierdo-Alonso JL, et al. Roflumilast in moderate-to-severe chronic obstructive pulmonary disease treated with longacting bronchodilators: two randomised clinical trials. Lancet. 2009;374(9691):695–703.CrossRefPubMed Fabbri LM, Calverley PM, Izquierdo-Alonso JL, et al. Roflumilast in moderate-to-severe chronic obstructive pulmonary disease treated with longacting bronchodilators: two randomised clinical trials. Lancet. 2009;374(9691):695–703.CrossRefPubMed
43.
go back to reference Martinez FJ, Calverley PMA, Goehring U-M, et al. Effect of roflumilast on exacerbations in patients with severe chronic obstructive pulmonary disease uncontrolled by combination therapy (REACT): a multicentre randomised controlled trial. Lancet. 2015;385(9971):857–66.CrossRefPubMed Martinez FJ, Calverley PMA, Goehring U-M, et al. Effect of roflumilast on exacerbations in patients with severe chronic obstructive pulmonary disease uncontrolled by combination therapy (REACT): a multicentre randomised controlled trial. Lancet. 2015;385(9971):857–66.CrossRefPubMed
44.
go back to reference Chong J, Leung B, Poole P. Phosphodiesterase 4 inhibitors for chronic obstructive pulmonary disease. Cochrane Database Syst Rev. 2013;11:Cd002309.PubMed Chong J, Leung B, Poole P. Phosphodiesterase 4 inhibitors for chronic obstructive pulmonary disease. Cochrane Database Syst Rev. 2013;11:Cd002309.PubMed
45.
go back to reference Oba Y, Lone NA. Efficacy and safety of roflumilast in patients with chronic obstructive pulmonary disease: a systematic review and meta-analysis. Ther Adv Respir Dis. 2013;7(1):13–24.CrossRefPubMed Oba Y, Lone NA. Efficacy and safety of roflumilast in patients with chronic obstructive pulmonary disease: a systematic review and meta-analysis. Ther Adv Respir Dis. 2013;7(1):13–24.CrossRefPubMed
46.
go back to reference Yan JH, Gu WJ, Pan L. Efficacy and safety of roflumilast in patients with stable chronic obstructive pulmonary disease: a meta-analysis. Pulm Pharmacol Ther. 2014;27(1):83–9.CrossRefPubMed Yan JH, Gu WJ, Pan L. Efficacy and safety of roflumilast in patients with stable chronic obstructive pulmonary disease: a meta-analysis. Pulm Pharmacol Ther. 2014;27(1):83–9.CrossRefPubMed
47.
go back to reference Pan L, Guo YZ, Zhang B, et al. Does roflumilast improve dyspnea in patients with chronic obstructive pulmonary disease? A meta-analysis. J Thorac Dis. 2013;5(4):422–9.PubMedCentralPubMed Pan L, Guo YZ, Zhang B, et al. Does roflumilast improve dyspnea in patients with chronic obstructive pulmonary disease? A meta-analysis. J Thorac Dis. 2013;5(4):422–9.PubMedCentralPubMed
48.
go back to reference Wouters EFM, Teichmann P, Brose M, et al. Effects of roflumilast, a phosphodiesterase 4 inhibitor, on body composition in chronic obstructive pulmonary disease [abstract]. Am J Respir Crit Care Med. 2010;181:A4473. Wouters EFM, Teichmann P, Brose M, et al. Effects of roflumilast, a phosphodiesterase 4 inhibitor, on body composition in chronic obstructive pulmonary disease [abstract]. Am J Respir Crit Care Med. 2010;181:A4473.
49.
go back to reference Calverley PMA, Fabbri LM, Rabe KF, et al. Roflumilast in the treatment of COPD: a pooled safety analysis [abstract no. P4001]. In: The European Respiratory Society Annual Congress; 2010. Calverley PMA, Fabbri LM, Rabe KF, et al. Roflumilast in the treatment of COPD: a pooled safety analysis [abstract no. P4001]. In: The European Respiratory Society Annual Congress; 2010.
50.
go back to reference White WB, Cooke GE, Kowey PR, et al. Cardiovascular safety in patients receiving roflumilast for the treatment of COPD. Chest. 2013;144(3):758–65.CrossRefPubMed White WB, Cooke GE, Kowey PR, et al. Cardiovascular safety in patients receiving roflumilast for the treatment of COPD. Chest. 2013;144(3):758–65.CrossRefPubMed
51.
go back to reference Ferguson G, Hanania N, Goehring UM, et al. Respiratory-associated adverse events in the roflumilast COPD safety pool [abstract]. Chest. 2012;142(4 Suppl 1):665A.CrossRef Ferguson G, Hanania N, Goehring UM, et al. Respiratory-associated adverse events in the roflumilast COPD safety pool [abstract]. Chest. 2012;142(4 Suppl 1):665A.CrossRef
52.
go back to reference Solem CT, Sun SX, Sudharshan L, et al. Exacerbation-related impairment of quality of life and work productivity in severe and very severe chronic obstructive pulmonary disease. Int J Chron Obstruct Pulmon Dis. 2013;8:641–52.PubMedCentralCrossRefPubMed Solem CT, Sun SX, Sudharshan L, et al. Exacerbation-related impairment of quality of life and work productivity in severe and very severe chronic obstructive pulmonary disease. Int J Chron Obstruct Pulmon Dis. 2013;8:641–52.PubMedCentralCrossRefPubMed
53.
go back to reference White WB, Kowey PR, Zhu H. Evaluation of major adverse cardiac events (MACE) in a one-year, placebo-controlled study of roflumilast in patients with chronic obstructive pulmonary disease (COPD): rationale and design [abstract no. F68]. Am J Respir Crit Care Med. 2013;187:A1484.CrossRef White WB, Kowey PR, Zhu H. Evaluation of major adverse cardiac events (MACE) in a one-year, placebo-controlled study of roflumilast in patients with chronic obstructive pulmonary disease (COPD): rationale and design [abstract no. F68]. Am J Respir Crit Care Med. 2013;187:A1484.CrossRef
55.
go back to reference Samyshkin Y, Kotchie RW, Mork AC, et al. Cost-effectiveness of roflumilast as an add-on treatment to long-acting bronchodilators in the treatment of COPD associated with chronic bronchitis in the United Kingdom. Eur J Health Econ. 2014;15(1):69–82.PubMedCentralCrossRefPubMed Samyshkin Y, Kotchie RW, Mork AC, et al. Cost-effectiveness of roflumilast as an add-on treatment to long-acting bronchodilators in the treatment of COPD associated with chronic bronchitis in the United Kingdom. Eur J Health Econ. 2014;15(1):69–82.PubMedCentralCrossRefPubMed
56.
go back to reference Hertel N, Kotchie RW, Samyshkin Y, et al. Cost-effectiveness of available treatment options for patients suffering from severe COPD in the UK: a fully incremental analysis. Int J Chron Obstruct Pulmon Dis. 2012;7:183–99.PubMedCentralCrossRefPubMed Hertel N, Kotchie RW, Samyshkin Y, et al. Cost-effectiveness of available treatment options for patients suffering from severe COPD in the UK: a fully incremental analysis. Int J Chron Obstruct Pulmon Dis. 2012;7:183–99.PubMedCentralCrossRefPubMed
57.
go back to reference Nowak D, Ehlken B, Kotchie R, et al. Roflumilast in combination with long-acting bronchodilators in the management of patients with severe and very severe COPD. A cost-effectiveness analysis for Germany. Dtsch Med Wochenschr. 2013;138(4):119–25.CrossRefPubMed Nowak D, Ehlken B, Kotchie R, et al. Roflumilast in combination with long-acting bronchodilators in the management of patients with severe and very severe COPD. A cost-effectiveness analysis for Germany. Dtsch Med Wochenschr. 2013;138(4):119–25.CrossRefPubMed
58.
go back to reference Samyshkin Y, Schlunegger M, Haefliger S, et al. Cost-effectiveness of roflumilast in combination with bronchodilator therapies in patients with severe and very severe COPD in Switzerland. Int J Chron Obstruct Pulmon Dis. 2013;8:79–87.PubMedCentralCrossRefPubMed Samyshkin Y, Schlunegger M, Haefliger S, et al. Cost-effectiveness of roflumilast in combination with bronchodilator therapies in patients with severe and very severe COPD in Switzerland. Int J Chron Obstruct Pulmon Dis. 2013;8:79–87.PubMedCentralCrossRefPubMed
Metadata
Title
Roflumilast: A Review in COPD
Author
Karly P. Garnock-Jones
Publication date
01-09-2015
Publisher
Springer International Publishing
Published in
Drugs / Issue 14/2015
Print ISSN: 0012-6667
Electronic ISSN: 1179-1950
DOI
https://doi.org/10.1007/s40265-015-0463-1

Other articles of this Issue 14/2015

Drugs 14/2015 Go to the issue