Objective: This review discusses available clinical data regarding PDE4-inhibitors in the
treatment of Chronic Obstructive Pulmonary Disease (COPD).
Background: COPD is an inflammatory disease characterized by progressive decline of lung function
with periods of acute exacerbations. Cigarette smoking is strongly associated with the development of
COPD. Current therapies are not optimal and few COPD-specific medications exist. Furthermore,
clinical trials specifically designed to assess candidate drugs are difficult and expensive to perform
given the chronic and slowly progressive nature of the disease. These issues, among others, are
significant barriers towards the development of effective management strategies. Phosphodiesterase 4
(PDE4), a member of a class of important inflammatory mediators, is an important modulator of lung
inflammation. Inhibition of PDE4 with small, orally available molecules is a novel treatment strategy
that has shown promise in the treatment of COPD.
Conclusion: PDE-4 inhibitors are a novel class of orally bioavailable medications that have shown
clinical promise in patients with COPD. Roflumilast is the first drug of this class approved for the use
in a specific subset of COPD patients.