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Effectiveness of Oral Roflumilast Among Chronic Obstructive Pulmonary Disease Patients to Prevent Exacerbations
Talha Laique1, Hina Latif2, Maimoona Z Khan1
1Internal Medicine, Mayo Hospital, Lahore, PAK.
None:
Background Chronic obstructive pulmonary disease (COPD) is a common and severely incapacitating respiratory illness that is characterized by ongoing, non-reversible airflow restrictions. Various medical treatment options include bronchodilators, anti-cholinergic drugs, and steroids. This study aimed to evaluate the effectiveness of oral roflumilast in addition to standard therapy among COPD patients to prevent exacerbations and improve pulmonary function tests (forced expiratory volume in one second (FEV1) and forced vital capacity (FVC)). Methodology This quasi-experimental study enrolled 80 moderate-to-severe COPD patients through non-probability sampling. They were divided into two groups. In Group A, participants received standard treatment as per the operational definition for six months. In Group B, participants received once-daily roflumilast, 500 µg, while maintaining background medications of COPD as per the operational definition for six months. Quantitative variables, including age, post-bronchodilator FEV1, and FVC, were expressed as mean ± SD. An independent-sample t-test was used to compare the outcome variables (FEV1 and FVC) between the two groups. The number of COPD exacerbations was analyzed using an appropriate statistical test, such as the Mann-Whitney U test. All the data were analyzed using SPSS version 28.0. Results Both groups showed a significant increment in mean FEV1 and FVC from day zero to six months; however, mean FEV1 and FVC were significantly higher for Group B patients from the fourth to sixth months. A decreasing trend was observed in the frequency of exacerbations in both groups. At the fifth and sixth months of treatment, Group B patients showed significantly lower frequency of exacerbations compared to Group A patients. Conclusions Oral roflumilast as an adjunct to standard COPD therapy improved clinical outcomes by enhancing pulmonary function (particularly FEV1) and reducing exacerbation frequency. Reduction in recurrent exacerbations may contribute to better symptom control, improved quality of life, and decreased healthcare burden. Therefore, roflumilast 500 µg once daily may be considered a useful add-on option in selected COPD patients, although larger studies with longer follow-up are warranted to establish long-term benefits.
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