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Author: Admin | 2025-04-28
The regular ICS treatment prevents the progression of asthma airway remodeling related to frequent exacerbations. However, the effect of ICS on airway remodeling is closely related to the timing of ICS treatment (O’Byrne et al., 2009). ICS preventing airway injuries from repeated exacerbations is the key mechanism (Bai et al., 2007). Despite the fact that bronchodilators are a mainstay for COPD treatment, the ICS-containing regimens for COPD are limited for frequent exacerbated COPD and the presence of blood eosinophilia (Agusti et al., 2018). Hence, roflumilast may fill the treatment gap as nonsteroid anti-inflammatory therapy for high-risk COPD patients (Singh et al., 2016b). To date, the ICS’s sparing effect of roflumilast or PDE4 inhibitors on COPD has never been shown in well-designed clinical studies. Despite the benefit in terms of future risk reduction, roflumilast has shown the clinical benefit of reducing fat-free mass and reducing the level of glycosylated hemoglobin in patients with COPD. According to the mechanisms of action, roflumilast may be beneficial in COPD comorbidities and extrapulmonary features including chronic rhinosinusitis, COPD overlap with obstructive sleep apnea, COPD with skeletal muscle dysfunction, and COPD with metabolic syndrome including diabetes.Roles of Roflumilast in COPD Patients With Specific Phenotypes and ComorbiditiesRoflumilast has been investigated for clinical effects on COPD patients with specific phenotypes such as COPD with frequent exacerbations and chronic bronchitis despite maximized treatment and specific comorbidities, for instance, effect on obesity, metabolic diseases, and cardiovascular diseases. This drug also has a potential mechanism in other conditions associated with COPD,
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