Summary

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• This summary is based on the review of four systematic review(s)/meta-analysis(es). ^[1-4]
• Roflumilast improved quality of life and reduced inflammation in chronic obstructive pulmonary disease (COPD) patients, with modest improvements in lung function observed, including increases in forced expiratory volume in 1 second (FEV₁) (mean difference (MD) 49.33 mL) and peak expiratory flow (PEF) (MD 6.54 L/min).
• Dose-adjusted regimens, including dose-escalation and low-dose strategies, led to reduced discontinuation rates compared to standard dosing (relative risk (RR) 0.81 and 0.62, respectively) and showed improved adherence, although other pharmacotherapy changes showed minimal impact on adherence.
• The likelihood of COPD exacerbation was slightly reduced (odds ratio (OR) 0.78), with no significant impact on hospitalization or exacerbations from changes in pharmacotherapy.
• The low-dose roflumilast group showed a significantly reduced rate of diarrhea compared to the standard dose group (RR 0.58), and both dose-escalation and low-dose groups had lower discontinuation rates due to adverse reactions.
• The likelihood of experiencing adverse events was higher in roflumilast users compared to control (OR 1.30), with notable increases in gastrointestinal symptoms such as diarrhea (OR 3.20) and psychiatric adverse events with roflumilast 500 µg (OR 2.13). No significant effect on mortality was observed (OR 0.98).
• There is no population types or subgroups information available in the reviewed studies.