Cochrane · systematic review · CD002309

Phosphodiesterase‐4 inhibitors for chronic obstructive pulmonary disease

Janjua, S, Fortescue, R, Poole, P · Cochrane Database of Systematic Reviews · 2020 · Cochrane Library

Airways3 versionsAMSTAR 2: not assessed
SoF tableOnly the outcomes this review put in its Summary of Findings table are listed (the Cochrane Handbook caps them at about seven per comparison). Its other analyses are not shown here.
Questions
9
current version
GRADE rated
9
No studies
0
Included studies
NR
No studies 0 · 0%Ungraded 0 · 0%Very low 0 · 0%Low 2 · 22.2%Moderate 4 · 44.4%High 3 · 33.3%

Ungraded means an effect was reported without a GRADE rating; it is not a gap. No studies means the review found nothing to answer the question. The six categories are a display order, not a score.

Questions and results

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Phosphodiesterase‐4 inhibitors compared to placebo for chronic obstructive pulmonary disease

Population: people with stable chronic obstructive pulmonary disease
9 questions
OutcomeEffectEvidenceStatus / GRADE
Change in FEV₁
Phosphodiesterase‐4 inhibitors vs placebo
no estimate extracted29 studies · 20815 participantsModerate
Downgraded: inconsistency
Change in FVC
Phosphodiesterase‐4 inhibitors vs placebo
no estimate extracted17 studies · 22108 participantsHigh
Change in PEF
Phosphodiesterase‐4 inhibitors vs placebo
no estimate extracted5 studies · 4245 participantsLow
Downgraded: imprecision, inconsistency, publication bias
Change in SGRQ total score
Phosphodiesterase‐4 inhibitors vs placebo
no estimate extracted12 studies · 7645 participantsModerate
Downgraded: inconsistency
Number of participants with 1 or more exacerbations
Phosphodiesterase‐4 inhibitors vs placebo
OR 0.78 [0.73, 0.84]27 studies · 20382 participantsHigh
Number of participants experiencing an adverse event
Phosphodiesterase‐4 inhibitors vs placebo
OR 1.3 [1.22, 1.38]30 studies · 21310 participantsLow
Downgraded: imprecision, inconsistency, publication bias
Gastrointestinal adverse effects: diarrhoea
Phosphodiesterase‐4 inhibitors vs placebo
OR 3.1 [2.74, 3.5]29 studies · 20623 participantsHigh
Psychiatric adverse effects (roflumilast 500 µg)
Phosphodiesterase‐4 inhibitors vs placebo
OR 2.13 [1.79, 2.54]14 studies · 11168 participantsModerate
Downgraded: imprecision, inconsistency, publication bias
Mortality
Phosphodiesterase‐4 inhibitors vs placebo
OR 0.98 [0.77, 1.24]27 studies · 19786 participantsModerate
Downgraded: imprecision, inconsistency, publication bias