Giving patients with chronic obstructive pulmonary disease newly available oral phosphodiesterase 4 (PDE4) inhibitors, roflumilast or cilomilast, improves lung function and reduces the likelihood of a flare-up, but does not increase general quality of life. 

Roflumilast and cilomilast are members of a new class of medicines, and trials have now evaluated their safety and performance. A team of researchers looked at data from nine trials of roflumilast and 14 trials of cilomilast involving over 1000 patients. 

Treatment with a PDE4 inhibitor was associated with a reduced likelihood of COPD exacerbation, but more participants in the treatment groups experienced non-serious adverse events compared with controls, particularly gastrointestinal symptoms and head­ache. Roflumilast was associated with weight loss during the trial period. 

So far trials have run for only 1 year or less, indicating a need to look at longer-lasting effects. 

For more information, go to  www.thecochranelibrary.com [9].