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Abstract
Roflumilast 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.