Roflumilast does not ease arterial stiffness in COPD patients

Treatment with the phosphodiesterase 4 inhibitor roflumilast does not appear to provide any benefits on arterial stiffness in patients with chronic obstructive pulmonary disease (COPD), suggest the results of a study.

“Cardiovascular risk is substantially increased in patients with COPD and can be quantified via arterial stiffness,” the authors said, noting that roflumilast provides a potential reduction in COPD-related cardiovascular risk.

To examine the effects of the study drug on arterial stiffness, 80 COPD patients were enrolled in this randomized controlled trial and were assigned to receive either roflumilast or placebo for 24 weeks. Change in carotid to femoral pulse wave velocity (PWV) was the primary outcome. Secondary ones comprised markers of vascular function, systemic inflammation, and clinical characteristics of COPD.

Thirty-three patients in the roflumilast group (median age, 64.5 years; median forced expiratory volume in the first second [FEV1], 34.5 percent predicted; median 6-minute walk test [6MWT], 428 m) and 34 in the placebo arm (median age, 64.5 percent; FEV1, 35.3 percent predicted; median 6MWT, 456 m) completed the trial.

No significant between-group difference was observed in change from baseline PWV (roflumilast: 5.0 percent, 95 percent confidence interval [CI], –2.0 to 13.0; placebo: 0.0 percent, 95 percent CI, –7.0 to 7.0; p=0.268). Moreover, roflumilast failed to improve the markers of vascular function or systemic inflammation.

On the other hand, a significant improvement was seen in change from baseline 6MWT with roflumilast (53.0 m, 95 percent CI, 19.1–86.9) relative to placebo (–0.92 m, 95 percent CI, –35.1 to 33.3; p=0.026).

“Further studies are needed to test a potential improvement of exercise capacity with roflumilast in COPD,” the authors said.