Phase 4
N=80
Effects of ROFLUMILAST on Subclinical Atherosclerosis in Chronic Obstructive Pulmonary Disease (COPD)
Chronic Obstructive Pulmonary Disease and Allied Conditions
Bottom Line
View on ClinicalTrials.gov: NCT01630200 ↗Enrolled (actual)
80
Serious AEs
27.5%
Results posted
Apr 2019
Primary outcome: Primary: Change From Baseline in Carotid Femoral-Pulse Wave Velocity at Month 6 — 1.07; 0.99 meters per second (m/s)
Study Design & Population
- Study type
- Interventional
- Phase
- Phase 4
- Interventions
- Roflumilast (Drug); Placebo (Drug)
- Age
- Adult, Older Adult · 40+ yrs
- Sex
- All
- Sponsor
- LudwLudwig Boltzmann Institute for COPD and Respiratory Epidemiology
- Primary completion
- Jan 2016
Outcome Measures
| Outcome | Result | p-value |
|---|---|---|
| PRIMARY Change From Baseline in Carotid Femoral-Pulse Wave Velocity at Month 6 |
1.07; 0.99 | — |
| SECONDARY Change From Baseline in Reactive Hyperemia Index at Month 6 |
0.99; 1.02 | — |
| SECONDARY Change From Baseline in Augmentation Index at Month 6 |
-1.11; -1.99 | — |
| SECONDARY Change From Baseline in Matrix Metalloproteinase-9 |
-143; -77 | — |
| SECONDARY Change From Baseline in Asymmetric Dimethylarginine at Month 6 |
0.97; 0.91 | — |
| SECONDARY Change From Baseline in Tumor Necrosis Factor-alpha at Month 6 |
0.95; 1.06 | — |
| SECONDARY Change From Baseline in Forced Expiratory Volume in 1 Second at Month 6 |
1.02; 1.01 | — |
| SECONDARY Change From Baseline in 6-Minute Walk Test at Month 6 |
59.2; 0.69 | — |
| SECONDARY Change From Baseline in COPD Assessment Test at Month 6 |
0.42; 1.2 | — |
Summary
Chronic obstructive pulmonary disease is associated with a low grade systemic inflammatory process. Systemic inflammation is hypothesized to maintain cardiovascular morbidity and mortality in COPD. Early changes of vascular integrity can be detected via markers of subclinical atherosclerosis.
Selective Inhibition of phosphodiesterase subtype 4 describes a promising therapeutic option in COPD with beneficial impact on lung function and exacerbation rate. Moreover, an anti-inflammatory effect of phosphodiesterase-4 inhibition was confirmed by recent data.
The aim of this study is to assess the effects of the phosphodiesterase-4 inhibitor Roflumilast on firstly surrogates of subclinical atherosclerosis and secondly markers of systemic inflammation in the peripheral circulation of patients with stable chronic obstructive pulmonary disease.
Eligibility Criteria
Inclusion Criteria
- Over 40 years of age
- Smoking history of at least 10 pack years
- Chronic obstructive pulmonary disease at Global Initiative for Chronic Obstructive Lung Disease (GOLD) stage II - IV diagnosed according to standard criteria.
- History of at least one COPD exacerbation requiring systemic corticosteroid treatment or hospitalisation in the previous year
Exclusion Criteria
- Insufficient compliance to study medication (≤70% of tablets used) during 4 weeks run-in period
- History of acute exacerbation 4 weeks prior to run-in period
- Diagnosis of alpha-1-antitrypsin deficiency
- Diagnosis of asthma
- Acute respiratory infections (e.g. pneumonia)
- Severe acute infectious diseases (e.g. active hepatitis, HIV)
- Lung cancer
- Bronchiectasis
- Interstitial lung disease
- Any other relevant lung disease
- Acute myocardial infarction
- Systolic left ventricular dysfunction
- Congestive heart failure New York Heart Association Functional Classification (NYHA) severity grade IV
- Haemodynamically significant cardiac arrhythmias or heart valve deformations
- Peripheral arterial occlusive disease
- Acute or chronic renal/hepatic failure
- Active malignancy
- Autoimmune disease
- Pregnant or breastfeeding women
- Women no using or not willing to use adequate contraceptive measures for the duration of the trial
- Hypersensitivity to study medication or placebo
- Severe psychiatric or neurological disorders or history of depression associated with suicidal ideation or behaviour
- Galactose intolerance, lactase insufficiency or glucose-galactose malabsorption
Data sourced from ClinicalTrials.gov (NCT01630200). Outcome figures and adverse-event rates are extracted automatically from the registry's posted results and are provided for clinician reference, not as a substitute for the primary publication.