磷酸二酯酶4抑制剂对慢性阻塞性肺疾病。

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Chong J,普尔P,梁B,黑色的PN

磷酸二酯酶4抑制剂对慢性阻塞性肺疾病。

科克伦数据库系统启2011年5月11日;(5):CD002309。cd002309.pub3 doi: 10.1002/14651858.。

PubMed ID

21563134 (在PubMed

]

文摘

背景:慢性阻塞性肺疾病(COPD)影响症状、肺功能、生活质量和寿命。除了戒烟,没有其他治疗缓慢肺功能下降。Roflumilast和cilomilast口服磷酸二酯酶4抑制剂(PDE(4))提出减少COPD气道炎症和支气管收缩。目的:评价PDE(4)抑制剂的疗效和安全性管理和稳定的慢性阻塞性肺病的人。结果包括肺功能、生活质量,症状,急性加重和不利影响。必威国际app搜索策略:我们确定了随机对照试验(相关的)Cochrane航空集团专门注册试验(去年搜索日期2010年8月6日)。我们发现基于web的临床试验注册的其他试验。选择标准:包括相关的如果他们口头PDE(4)抑制剂与安慰剂相比在患有慢性阻塞性肺病。我们允许合并施打标准的慢性阻塞性肺病治疗。数据收集和分析:一个评论作者提取数据和第二个评论作者检查了数据,在进入之前Cochrane协作软件项目(RevMan版本5.1)。 We reported pooled data as mean differences (MD), standardised mean differences (SMD), or odds ratios (OR). MAIN RESULTS: Twenty-three separate RCTs studying roflumilast (nine trials, 9211 patients) or cilomilast (fourteen trials, 6457 patients) met the inclusion criteria. None of the trials exceeded a year in duration.Treatment with a PDE(4) inhibitor was associated with a significant improvement in FEV(1)over the trial period compared with placebo (MD 45.59 mL; 95% confidence interval (CI) 39.15 to 52.03), regardless of COPD severity or concomitant COPD treatment. There were some small improvements in quality of life (St George's Respiratory Questionnaire MD -1.04; 95% CI -1.66 to -0.41) and COPD-related symptoms, but no change in exercise tolerance. Treatment with a PDE(4) inhibitor was associated with a reduced likelihood of COPD exacerbation (OR 0.78; 95% CI 0.72 to 0.85). More participants in the treatment groups experienced non-serious adverse events compared with controls, particularly gastrointestinal symptoms and headache. Roflumilast was associated with weight loss during the trial period. AUTHORS' CONCLUSIONS: In people with COPD, PDE(4) inhibitors offered benefit over placebo in improving lung function and reducing likelihood of exacerbations, however, they had little impact on quality of life or symptoms. Gastrointestinal adverse effects and weight loss were common. The optimum place of PDE(4) inhibitors in COPD management remains to be defined. Longer-term trials are needed to determine whether or not PDE(4) inhibitors modify FEV(1) decline, healthcare utilisation or mortality in COPD.

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药物

Roflumilast