To study the efficacy and anti-inflammation action of a selective phosphodiesterase-4 inhibitor cilomilast in treatment of COPD.
38 patients were randomized into a double-blind, placebo-controlled, parallel-group trial. Twenty-four patients were randomized to treat by cilomilast 15mg b.i.d., for 24 weekd, and fourteen patients to placebo b.i.d.. Pulmonary function tests and symptoms such as cough, sputum, breathlessness were assessed at every visit. The levels of IL-8, TNF-α, LTB4 and IL-6 induced sputum were assessed using ELISA.
After treatment, the score of dyspnea, cough and sputum in the cilomilast group improved significantly, but there no difference in the control group.Though there was no significant change in FEV1 and FEV1% predicted after treatment in the cilomilast group. But compared with baseline, significant decrease in FEV1 was observed in the control group after 24 weeks of treatment (p<0.01). Also, no significant change in RV and FRC was observed in the control group after treatment. However, RV and FRC was significantly improved in the cilomilast group (p<0.01). After the treatment, significant decrease was observed for the level of IL-8, TNF-α, LTB4 and IL-6 in induced sputum in cilomilast group (p<0.01) and there was no significant difference in control group.
Cilomilast has clinical efficacy on COPD and could modify decline of pulmonary function for COPD, which effects may be due to its anti-inflammation activity.
Cilomilast as a new selective phosphodiesterase-4 inhibitor might be an effective long-term treatment for COPD.
Changzheng Wang, Grant monies (from industry related sources)