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Phosphodiesterase 4 inhibitors for chronic obstructive pulmonary disease

  1. Jimmy Chong1,
  2. Bonnie Leung1,
  3. Phillippa Poole2,*

Editorial Group: Cochrane Airways Group

Published Online: 4 NOV 2013

Assessed as up-to-date: 6 JUN 2013

DOI: 10.1002/14651858.CD002309.pub4


How to Cite

Chong J, Leung B, Poole P. Phosphodiesterase 4 inhibitors for chronic obstructive pulmonary disease. Cochrane Database of Systematic Reviews 2013, Issue 11. Art. No.: CD002309. DOI: 10.1002/14651858.CD002309.pub4.

Author Information

  1. 1

    Tauranga Hospital, Tauranga, New Zealand

  2. 2

    University of Auckland, Department of Medicine, Auckland, New Zealand

*Phillippa Poole, Department of Medicine, University of Auckland, Private Bag 92019, Auckland, New Zealand. p.poole@auckland.ac.nz.

Publication History

  1. Publication Status: Edited (no change to conclusions)
  2. Published Online: 4 NOV 2013

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[Figure 1]
Figure 1. Study flow diagram.
[Figure 2]
Figure 2. Methodological quality summary: review authors' judgements about each methodological quality item for each included study.
[Figure 3]
Figure 3. Funnel plot of comparison: 1 PDE4 inhibitor versus placebo, outcome: 1.6 FEV1 (published versus unpublished).
[Analysis 1.1]
Analysis 1.1. Comparison 1 PDE4 inhibitor versus placebo, Outcome 1 FEV1 (by drug).
[Analysis 1.2]
Analysis 1.2. Comparison 1 PDE4 inhibitor versus placebo, Outcome 2 FEV1 (by mean COPD severity).
[Analysis 1.3]
Analysis 1.3. Comparison 1 PDE4 inhibitor versus placebo, Outcome 3 FEV1 (Roflumilast 500 μg by mean COPD severity).
[Analysis 1.4]
Analysis 1.4. Comparison 1 PDE4 inhibitor versus placebo, Outcome 4 FEV1 (by study duration).
[Analysis 1.5]
Analysis 1.5. Comparison 1 PDE4 inhibitor versus placebo, Outcome 5 FEV1 (additional medication).
[Analysis 1.6]
Analysis 1.6. Comparison 1 PDE4 inhibitor versus placebo, Outcome 6 FEV1 (published versus unpublished).
[Analysis 1.7]
Analysis 1.7. Comparison 1 PDE4 inhibitor versus placebo, Outcome 7 FEV1 (random-effects model).
[Analysis 1.8]
Analysis 1.8. Comparison 1 PDE4 inhibitor versus placebo, Outcome 8 FEV1 (roflumilast 500 μg versus 250 μg).
[Analysis 1.9]
Analysis 1.9. Comparison 1 PDE4 inhibitor versus placebo, Outcome 9 FVC.
[Analysis 1.10]
Analysis 1.10. Comparison 1 PDE4 inhibitor versus placebo, Outcome 10 PEF.
[Analysis 1.11]
Analysis 1.11. Comparison 1 PDE4 inhibitor versus placebo, Outcome 11 SGRQ total score.
[Analysis 1.12]
Analysis 1.12. Comparison 1 PDE4 inhibitor versus placebo, Outcome 12 SGRQ total score (by mean COPD severity).
[Analysis 1.13]
Analysis 1.13. Comparison 1 PDE4 inhibitor versus placebo, Outcome 13 SGRQ total score (by published versus unpublished).
[Analysis 1.14]
Analysis 1.14. Comparison 1 PDE4 inhibitor versus placebo, Outcome 14 SGRQ total score (by duration).
[Analysis 1.15]
Analysis 1.15. Comparison 1 PDE4 inhibitor versus placebo, Outcome 15 No. people with one or more exacerbations (by drug).
[Analysis 1.16]
Analysis 1.16. Comparison 1 PDE4 inhibitor versus placebo, Outcome 16 Exacerbation rate (inverse variance).
[Analysis 1.17]
Analysis 1.17. Comparison 1 PDE4 inhibitor versus placebo, Outcome 17 Exacerbation rate.
[Analysis 1.18]
Analysis 1.18. Comparison 1 PDE4 inhibitor versus placebo, Outcome 18 Exacerbation rate (roflumilast 500 μg versus 250 μg).
[Analysis 1.19]
Analysis 1.19. Comparison 1 PDE4 inhibitor versus placebo, Outcome 19 Number of people on roflumilast with one or more exacerbations (additional medication).
[Analysis 1.20]
Analysis 1.20. Comparison 1 PDE4 inhibitor versus placebo, Outcome 20 SGRQ symptom score.
[Analysis 1.21]
Analysis 1.21. Comparison 1 PDE4 inhibitor versus placebo, Outcome 21 Borg Scale.
[Analysis 1.22]
Analysis 1.22. Comparison 1 PDE4 inhibitor versus placebo, Outcome 22 Summary symptom score.
[Analysis 1.23]
Analysis 1.23. Comparison 1 PDE4 inhibitor versus placebo, Outcome 23 Shortness of breath questionnaire.
[Analysis 1.24]
Analysis 1.24. Comparison 1 PDE4 inhibitor versus placebo, Outcome 24 6-minute walk test.
[Analysis 1.25]
Analysis 1.25. Comparison 1 PDE4 inhibitor versus placebo, Outcome 25 No. of patients experiencing an adverse effect.
[Analysis 1.26]
Analysis 1.26. Comparison 1 PDE4 inhibitor versus placebo, Outcome 26 No of patients experiencing an adverse event (Roflumilast 500 μg versus 250 μg).
[Analysis 1.27]
Analysis 1.27. Comparison 1 PDE4 inhibitor versus placebo, Outcome 27 Diarrhoea.
[Analysis 1.28]
Analysis 1.28. Comparison 1 PDE4 inhibitor versus placebo, Outcome 28 Nausea.
[Analysis 1.29]
Analysis 1.29. Comparison 1 PDE4 inhibitor versus placebo, Outcome 29 Headache.
[Analysis 1.30]
Analysis 1.30. Comparison 1 PDE4 inhibitor versus placebo, Outcome 30 Vomiting.
[Analysis 1.31]
Analysis 1.31. Comparison 1 PDE4 inhibitor versus placebo, Outcome 31 Dyspepsia.
[Analysis 1.32]
Analysis 1.32. Comparison 1 PDE4 inhibitor versus placebo, Outcome 32 Abdominal pain.
[Analysis 1.33]
Analysis 1.33. Comparison 1 PDE4 inhibitor versus placebo, Outcome 33 Weight loss.
[Analysis 1.34]
Analysis 1.34. Comparison 1 PDE4 inhibitor versus placebo, Outcome 34 Influenza-like symptoms.
[Analysis 1.35]
Analysis 1.35. Comparison 1 PDE4 inhibitor versus placebo, Outcome 35 Upper respiratory tract infection.
[Analysis 1.36]
Analysis 1.36. Comparison 1 PDE4 inhibitor versus placebo, Outcome 36 Withdrawals due to adverse events.
[Analysis 1.37]
Analysis 1.37. Comparison 1 PDE4 inhibitor versus placebo, Outcome 37 Non-fatal serious adverse events.
[Analysis 1.38]
Analysis 1.38. Comparison 1 PDE4 inhibitor versus placebo, Outcome 38 Mortality.
[Analysis 1.39]
Analysis 1.39. Comparison 1 PDE4 inhibitor versus placebo, Outcome 39 All psychiatric disorders (roflumilast).
[Analysis 1.40]
Analysis 1.40. Comparison 1 PDE4 inhibitor versus placebo, Outcome 40 Insomnia and sleep disorders (roflumilast).
[Analysis 1.41]
Analysis 1.41. Comparison 1 PDE4 inhibitor versus placebo, Outcome 41 Anxiety or anxiety disorder (roflumilast).
[Analysis 1.42]
Analysis 1.42. Comparison 1 PDE4 inhibitor versus placebo, Outcome 42 Depression (roflumilast).