Effects of Roflumilast on Patients with Chronic Obstructive Pulmonary Disease Treated with Inhaled Corticosteroid/Long-Acting beta 2 Agonist: A Meta-analysis

作者全名："Zeng, Shasha; Bai, Haibing; Zou, Mi"

作者地址："[Zeng, Shasha; Bai, Haibing] Chongqing Nanan Tradit Chinese Med Hosp, Dept Internal Med, Chongqing 400060, Peoples R China; [Zou, Mi] Chongqing Med Univ, Branch 1, Resp Dept, Affiliated Hosp 1, Chongqing 400015, Peoples R China"

通信作者："Zou, M (通讯作者)，Chongqing Med Univ, Branch 1, Resp Dept, Affiliated Hosp 1, Chongqing 400015, Peoples R China."

来源：COMPUTATIONAL AND MATHEMATICAL METHODS IN MEDICINE

ESI学科分类：MATHEMATICS

WOS号：WOS:000881361100001

JCR分区：Q2

影响因子：2.809

年份：2022

卷号：2022

期号：　

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结束页：　

文献类型：Article

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摘要："Objective. Roflumilast is a novel therapeutic drug for chronic obstructive pulmonary disease (COPD). This study was designed to evaluate the efficacy and safety of roflumilast combining inhaled corticosteroid (ICS)/long-acting beta 2 agonist (LABA) in treating COPD patients through the meta-analysis. Methods. Randomized controlled trials of roflumilast combining ICS/LABA in treating patients with severe and profound COPD were searched from PubMed, Cochrane Library, and Embase databases from their establishment to February 2022. The quality of included studies was assessed by Cochrane risk bias assessment tool. The main outcomes of these studies should include at least one of the following clinical outcome indicators: forced expiratory volume in one second (FEV1), exacerbation rate, and adverse events (AEs) such as diarrhea, nasopharyngitis, and headache. Results. Six articles were included in the study, including 9,715 patients. Meta-analysis revealed that compared with placebo, roflumilast gained superiority for severe COPD patients treated with ICS/LABA combinations in FEV1 before bronchodilator administration (MD= 46:62, 95% CI (30.69, 62.55), P < 0:00001), FEV1 after bronchodilator administration (MD= 45:62, 95% CI (34.95, 56.28), P < 0:00001), and COPD exacerbation rate (RR = 0:90, 95% CI (0.87, 0.94), P = 0:001). In terms of safety, the incidence of diarrhea, headache, nausea, weight loss, back pain, loss of appetite, and insomnia was notably higher in the roflumilast group than in the placebo group. Conclusion. Roflumilast is suggested to be significantly effective for severe COPD patients with ICS/LABA combination therapy, which reduces the exacerbation rate but also leads to PDE4 inhibitor-related adverse reactions."

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