Source: Annual Congress 2002 - Asthma and COPD: pharmacology
Disease area: Airway diseases

Abstract

Rationale: Asthma is a chronic inflammatory disorder of the airways and current therapeutical approaches are directed at inhibiting airway inflammation. The present trial evaluated the anti-inflammatory potential of Roflumilast, a selective phosphodiesterase (PDE) 4 inhibitor, which has demonstrated clinical efficacy in asthma patients. Methodology: Twenty-three mild asthma patients (median age 28 years, positive skin prick test, FEV₁ > 70 % of predicted and methacholine PC₂₀ < 16 mg/ml) were included. According to a double-blind, randomized, three period crossover design, patients received for a 7-10 day-treatment period each, placebo, 250 μg/d and 500 μg/d Roflumilast. Allergen challenge was performed using standard protocols. The early asthmatic reaction (EAR) and late asthmatic reaction (LAR) were determined by consecutive measurements of FEV₁ for 12 h. Results: Roflumilast reduced both, the LAR and EAR with a clear monotone dose-response and to a statistical significant degree vs placebo. The inhibition in EAR vs placebo amounted to 25% and 28% with 250 μg (p = 0.008) and 500 μg Roflumilast (p = 0.009), respectively. For LAR, assumed to be associated with mucosal inflammation, an inhibition of 27% and 43% was seen with 250 μg (p = 0.022) and 500 μg Roflumilast (p = 0.002), respectively. Conclusions: Roflumilast attenuated both, EAR and LAR in a dose-dependent manner. Compared to placebo, EAR and LAR were significantly reduced by both doses tested i.e. 250 μg and 500 μg Roflumilast once-daily. The more pronounced inhibition of LAR suggests that the clinical efficacy of Roflumilast in asthma is based on its anti-inflammatory activity.

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E. M. van Schalkwyk, K. van Heerden, D. Bredenbröker, S. Leichtl, W. Wurst, L. Venter, P. G. Bardin (Tygerberg, Rivonia, South Africa; Konstanz, Germany; Melbourne, Australia). Dose-dependent inhibitory effect of Roflumilast, a new, orally active, selective phosphodiesterase 4 inhibitor, on allergen-induced early and late asthmatic reaction. Eur Respir J 2002; 20: Suppl. 38, 751

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