Roflumilast: a selective phosphodiesterase 4 inhibitor

Roflumilast is a selective phosphodiesterase (PDE) 4 inhibitor with a range of anti-inflammatory properties and potential for treatment of inflammatory disease. The therapeutic effects of roflumilast are thought to be mediated via increased levels of cellular 3',5'-cyclic adenosine monophosphate (cAMP) and include inhibition of microvascular leakage, inhibition of trafficking, release of cytokines and chemokines from inflammatory cells, and bronchodilation. The anti-inflammatory and bronchodilator properties of roflumilast have resulted in clinical studies to investigate the effects of roflumilast in inflammatory airway diseases such as asthma and chronic obstructive pulmonary disease. In asthma, roflumilast taken as a once-daily oral dose of 500 ug has been shown to improve clinical symptoms and airway function, reduce exercise-induced asthma and decrease bronchial airway hyperresponsiveness. In chronic obstructive pulmonary disease, roflumilast taken as a once-daily oral dose of 500 ug has been shown to reduce the frequency of exacerbations with small effects on improving lung function. Side effects of roflumilast appear to be mild and short lasting. It is likely that this new class of selective PDE4 inhibitor may provide a therapeutic option for patients with inflammatory airway disease.