Related Experiment Video
Updated: Dec 13, 2025
Measuring the Carotid to Femoral Pulse Wave Velocity Cf-PWV to Evaluate Arterial Stiffness
Published on: May 3, 2018
Effects of roflumilast on arterial stiffness in COPD (ELASTIC): A randomized trial
Matthias H Urban1, Nicole Kreibich2, Andreas Gleiss3
1Department of Internal and Respiratory Medicine, Krankenhaus Nord - Klinik Floridsdorf and Ludwig Boltzmann Institute for COPD and Respiratory Epidemiology, Vienna, Austria.
Insights
Roflumilast did not improve arterial stiffness in COPD patients. However, it significantly enhanced exercise capacity (6MWT), suggesting potential benefits beyond vascular function.
Area of Science:
- Cardiology
- Pulmonology
- Pharmacology
Background:
- Cardiovascular disease is a major concern in COPD patients.
- Arterial stiffness is a key indicator of cardiovascular risk.
- Roflumilast, a PDE-IV inhibitor, has shown potential in reducing COPD-related cardiovascular risk.
Purpose of the Study:
- To investigate the effects of roflumilast on arterial stiffness in stable COPD patients.
- To quantify changes in pulse wave velocity (PWV) as a measure of arterial stiffness.
- To assess roflumilast's impact on vascular function, inflammation, and exercise capacity.
Main Methods:
- A 24-week randomized, placebo-controlled trial involving 80 stable COPD patients.
- Primary outcome: change in carotid-femoral pulse wave velocity (cf-PWV).
- Secondary outcomes: vascular function markers (Aix, RHI), systemic inflammation (IL-6, TNF-α), and COPD clinical characteristics (CAT, 6MWT).
Main Results:
- No significant difference in cf-PWV change between roflumilast and placebo groups (P=0.268).
- Roflumilast did not improve vascular function markers or systemic inflammation.
- Significant improvement in 6-minute walk test (6MWT) distance observed with roflumilast versus placebo (P=0.026).
Conclusions:
- Roflumilast does not appear to benefit arterial stiffness in COPD patients.
- Further research is warranted to explore roflumilast's potential to improve exercise capacity in COPD.
- The findings suggest a dissociation between vascular effects and exercise tolerance improvements with roflumilast.
Background And Objective:
Cardiovascular risk is substantially increased in patients with COPD and can be quantified via arterial stiffness. The PDE-IV inhibitor roflumilast revealed a potential reduction of COPD-related cardiovascular risk. We aimed to investigate the effects of roflumilast on arterial stiffness by quantification of pulse wave velocity (PWV) in stable COPD.
Methods:
In this randomized placebo-controlled trial, 80 COPD patients received roflumilast or placebo for 24 weeks. The primary outcome was the change in cf-PWV. Secondary outcomes comprised markers of vascular function (e.g. Aix and RHI), systemic inflammation (e.g. IL-6 and TNF-α) and clinical characteristics of COPD (e.g. CAT and 6MWT).
Results:
A total of 33 and 34 patients completed the roflumilast and placebo arm, respectively (age, median (IQR): 64.5 (61-69.5) vs 64.5 (56-72) years; FEV1 , median (IQR): 34.5 (25.5-48.6) vs 35.3 (27-46.8) % predicted; 6MWT, median (IQR): 428 (340-558) vs 456 (364-570) m). Change from baseline PWV did not show a significant difference between roflumilast and placebo (+5.0 (95% CI: -2.0 to +13.0) vs 0.0 (95% CI: -7.0 to +7.0)%, P = 0.268). Roflumilast did not improve markers of vascular function or systemic inflammation. We observed a significant improvement in change from baseline 6MWT with roflumilast versus placebo (+53.0 (95% CI: +19.1 to +86.9) vs -0.92 (95% CI: -35.1 to +33.3) m, P = 0.026).
Conclusion:
Our study revealed no beneficial effects of roflumilast on arterial stiffness. Further studies are needed to test a potential improvement of exercise capacity with roflumilast in COPD.
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