El uso de roflumilast en el tratamiento de la enfermedad pulmonar obstructiva crónica: la perspectiva del neumólogo

Abstract

Objective

Roflumilast is a selective phosphodiesterase type 4 inhibitor that represents a novel pharmacological class approved for the treatment of chronic obstructive pulmonary disease (COPD). Data about its use in clinical practice is still very scarce. We sought to determine the profile of patients that are receiving roflumilast for the treatment of COPD and the specialists’ perceptions of the impact of roflumilast on patients’ health.

Material and methods

A cross-sectional web-based survey was conducted among Spanish pulmonary specialists assessing their perceptions and opinion in the use of roflumilast.

Results

Sixty-one out of the 106 invited specialists started the survey and 50 had enough experience with roflumilast to be finally selected. Most physicians use roflumilast for the treatment of severe COPD associated with chronic bronchitis in patients with a history of frequent exacerbations. This treatment is usually added to bronchodilator treatments but frequently replaces the use of theopylline. Most physicians perceived an improvement of symptoms, mainly in expectoration, coughing and dyspnea. After an average of two months of treatment, an improvement in patients’ quality of life in many ways was also reported. Diarrhoea and loss of weight were the side effects most frequently perceived. The ability to decrease exacerbations and the anti-inflammatory effect were considered the main strengths of roflumilast.

Conclusions

Roflumilast is included in the clinical practice of most pulmonary medicine specialists for the treatment of COPD. It is used in accordance with established recommendations. Most physicians perceive a positive impact of roflumilast on patients’ quality of life and symptoms.