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Roflumilast with long-acting β2-agonists for COPD: influence of exacerbation history.
- Source :
-
The European respiratory journal [Eur Respir J] 2011 Sep; Vol. 38 (3), pp. 553-60. Date of Electronic Publication: 2011 Jul 07. - Publication Year :
- 2011
-
Abstract
- The oral, selective phosphodiesterase type-4 inhibitor roflumilast reduces exacerbations and improves lung function in patients with severe-to-very severe chronic obstructive pulmonary disease (COPD). We investigated the efficacy and safety of roflumilast used concomitantly with long-acting β(2)-agonists (LABAs) to reduce exacerbations, and the influence of exacerbation history. Pooled data were analysed from two 12-month, placebo-controlled roflumilast (500 μg once daily) studies involving 3,091 patients with severe-to-very severe COPD. Approximately half of patients used concomitant LABAs; 39% used concomitant short-acting muscarinic antagonists (SAMAs); 27% were frequent exacerbators (two or more exacerbations per year). Roflumilast reduced the rate of moderate or severe exacerbations, with LABA (rate ratio (RR) 0.79, 95% CI 0.69-0.91; p=0.001) or without LABA (RR 0.85, 95% CI 0.74-0.99; p=0.039) and prolonged time both to first (p=0.035 with LABA, p=0.300 without LABA) and second (p=0.018 with LABA, p=0.049 without LABA) exacerbations. Frequent exacerbators experienced a reduction in moderate or severe exacerbations (RR 0.78, 95% CI 0.66-0.91; p=0.002). Similarly, roflumilast remained effective with concomitant SAMA. No differences arose in adverse events between these subgroups. Roflumilast may be used to reduce exacerbations and improve dyspnoea and lung function, without increasing adverse events in COPD patients receiving concomitant LABAs.
- Subjects :
- Adrenal Cortex Hormones administration & dosage
Aged
Bronchodilator Agents administration & dosage
Cyclopropanes administration & dosage
Dyspnea metabolism
Female
Humans
Lung physiology
Male
Middle Aged
Placebos
Regression Analysis
Adrenergic beta-2 Receptor Agonists administration & dosage
Aminopyridines administration & dosage
Benzamides administration & dosage
Pulmonary Disease, Chronic Obstructive drug therapy
Pulmonary Disease, Chronic Obstructive physiopathology
Subjects
Details
- Language :
- English
- ISSN :
- 1399-3003
- Volume :
- 38
- Issue :
- 3
- Database :
- MEDLINE
- Journal :
- The European respiratory journal
- Publication Type :
- Academic Journal
- Accession number :
- 21737553
- Full Text :
- https://doi.org/10.1183/09031936.00178710