Two recent randomized trials support the use of roflumilast, a phosphodiesterase-4 inhibitor, in moderate to severe COPD. The first randomized patients on salmeterol or tiotropium to roflumilast or placebo for 24 weeks, and found a mean increase in FEV1 of 49cc (in the salmeterol group) and 80cc (in the tiotropium group) (abstract). The second study randomized severe COPD to roflumilast or placebo for a year, with a mean increase in FEV1 of 48cc. The roflumilast patients also had a 17% reduction in number of moderate to severe exacerbations (abstract). Roflumilast may become a standard addition to regimens in moderate and severe COPD.
Dr. Scheurer is a clinical hospitalist and the Medical Director of Quality and Safety at the Medical University of South Carolina in Charleston, South Carolina, and is Assistant Professor of Medicine. She is a graduate of the University of Tennessee College of Medicine, completed her residency at Duke University, and completed her Masters in Clinical Research at the Medical University of South Carolina. She also serves as the Web Editor and Physician Advisor for the Society of Hospital Medicine.