ReviewCureus2026
Clinical Effectiveness of Roflumilast in Patients With Chronic Obstructive Pulmonary Disease: A Systematic Review and Meta-Analysis.
Review in Cureus, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
0 citing papers in PubMed.
No citing paper in PubMed yet.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
8 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Chronic obstructive pulmonary disease (COPD) is a major contributor to global morbidity and mortality, with acute exacerbations accelerating disease progression and substantially increasing healthcare utilization and costs. To evaluate the available evidence on roflumilast, an oral phosphodiesterase-4 inhibitor, we performed a systematic review and meta-analysis. We searched PubMed/MEDLINE, Embase, CENTRAL, Web of Science, Scopus, and ClinicalTrials.gov from 1 January 2011 to 15 July 2026 for studies evaluating roflumilast in adults with COPD. Ten studies met the inclusion criteria, comprising randomized controlled trials, a quasi-experimental trial, and an observational cohort study. Roflumilast was associated with statistically significant improvements in forced expiratory volume in one second (FEV1) compared with control (pooled mean difference: 0.06 L, 95% CI: 0.04-0.08; I² = 72%) and forced vital capacity (FVC) (mean difference: 0.07 L, 95% CI: 0.02-0.12; I² = 78%), although these improvements approximate or fall below the established minimal clinically important difference for FEV1 (100 mL), suggesting modest clinical benefit at the population level. No statistically significant reduction in exacerbation risk was observed (risk ratio: 1.31, 95% CI: 0.73-2.36; I² = 76%); however, given the substantial heterogeneity and wide confidence interval, this finding should not be interpreted as evidence of no effect, particularly as individual trial data suggest exacerbation benefit may be concentrated in patients with more severe disease or frequent prior exacerbations. No significant differences were found for quality of life as measured by the St. George's Respiratory Questionnaire (mean difference: -6.26, 95% CI: -21.70 to 9.18; I² = 78%) or all-cause mortality (risk ratio: 1.02, 95% CI: 0.54-1.91; I² = 0%). Roflumilast produces statistically significant but modest improvements in lung function in patients with COPD; its effects on exacerbations, quality of life, and mortality remain uncertain, given substantial heterogeneity across studies. These findings support current guideline recommendations restricting roflumilast use to specific patient phenotypes, and further large-scale trials in more homogeneous populations are warranted to clarify its role in COPD management.
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