Phosphodiesterase 4 inhibitors increased the rate of withdrawal due to adverse effects compared to placebo (14% vs 8%).
Systematic Review
Do Phosphodiesterase 4 inhibitors improve outcomes in people with stable COPD?
PDE4 inhibitors for COPD are associated with a higher rate of withdrawal due to adverse effects compared to placebo.
Absolute Event Rate: 14% vs 8%
BACKGROUND: ) inhibitors proposed to reduce the airway inflammation and bronchoconstriction seen in COPD. This is an update of a Cochrane review first published in 2011 and updated in 2013. OBJECTIVES: inhibitors in the management of stable COPD. SEARCH METHODS: We identified randomised controlled trials (RCTs) from the Cochrane Airways Trials Register (date of last search October 2016). We found other trials from web-based clinical trials registers. SELECTION CRITERIA: inhibitors with placebo in people with COPD. We allowed co-administration of standard COPD therapy. DATA COLLECTION AND ANALYSIS: One review author extracted data and a second review author checked the data. We reported pooled data in Review Manager as mean differences (MD), standardised mean differences (SMD) or odds ratios (OR). We converted the odds ratios into absolute treatment effects in a 'Summary of findings' table. MAIN RESULTS: inhibitors were more likely to withdraw from the trials because of adverse effects; on average 14% in the treatment groups withdrew compared with 8% in the control groups. AUTHORS' CONCLUSIONS: decline, hospitalisation or mortality in COPD.
Chong et al. (Mon,) conducted a systematic review in chronic obstructive pulmonary disease. Phosphodiesterase 4 inhibitors vs. placebo was evaluated on withdrawal due to adverse effects. Phosphodiesterase 4 inhibitors increased the rate of withdrawal due to adverse effects compared to placebo (14% vs 8%).