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
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
Current version onlyPhosphodiesterase‐4 inhibitors compared to placebo for chronic obstructive pulmonary disease
Population: people with stable chronic obstructive pulmonary disease
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Change in FEV₁ Phosphodiesterase‐4 inhibitors vs placebo | no estimate extracted | 29 studies · 20815 participants | Moderate Downgraded: inconsistency |
Change in FVC Phosphodiesterase‐4 inhibitors vs placebo | no estimate extracted | 17 studies · 22108 participants | High |
Change in PEF Phosphodiesterase‐4 inhibitors vs placebo | no estimate extracted | 5 studies · 4245 participants | Low Downgraded: imprecision, inconsistency, publication bias |
Change in SGRQ total score Phosphodiesterase‐4 inhibitors vs placebo | no estimate extracted | 12 studies · 7645 participants | Moderate 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 participants | High |
Number of participants experiencing an adverse event Phosphodiesterase‐4 inhibitors vs placebo | OR 1.3 [1.22, 1.38] | 30 studies · 21310 participants | Low Downgraded: imprecision, inconsistency, publication bias |
Gastrointestinal adverse effects: diarrhoea Phosphodiesterase‐4 inhibitors vs placebo | OR 3.1 [2.74, 3.5] | 29 studies · 20623 participants | High |
Psychiatric adverse effects (roflumilast 500 µg) Phosphodiesterase‐4 inhibitors vs placebo | OR 2.13 [1.79, 2.54] | 14 studies · 11168 participants | Moderate Downgraded: imprecision, inconsistency, publication bias |
Mortality Phosphodiesterase‐4 inhibitors vs placebo | OR 0.98 [0.77, 1.24] | 27 studies · 19786 participants | Moderate Downgraded: imprecision, inconsistency, publication bias |
Phosphodiesterase 4 inhibitors compared to placebo for chronic obstructive pulmonary disease
Population: people with stable chronic obstructive pulmonary disease
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Change in FEV1 lung function (mL) Phosphodiesterase 4 inhibitors vs placebo | no estimate extracted | 27 studies · 20585 participants | Moderate Downgraded: inconsistency |
Change in quality of life St George's Respiratory Questionnaire Phosphodiesterase 4 inhibitors vs placebo | no estimate extracted | 11 studies · 7645 participants | Moderate Downgraded: inconsistency |
COPD exacerbations No. of participants with exacerbations Phosphodiesterase 4 inhibitors vs placebo | OR 0.78 [0.73, 0.83] | 23 studies · 19948 participants | High |
Adverse events No. of participants experiencing any adverse event Phosphodiesterase 4 inhibitors vs placebo | OR 1.29 [1.22, 1.37] | 27 studies · 20988 participants | Moderate Downgraded: inconsistency |
Gastrointestinal side effects No. of participants experiencing diarrhoea Phosphodiesterase 4 inhibitors vs placebo | OR 3.13 [2.76, 3.54] | 25 studies · 20181 participants | High |
Psychiatric adverse events (roflumilast 500 µg) No. of participants Phosphodiesterase 4 inhibitors vs placebo | OR 2.13 [1.79, 2.54] | 14 studies · 11168 participants | Moderate |
Mortality (all‐cause) No. of participants Phosphodiesterase 4 inhibitors vs placebo | OR 0.97 [0.76, 1.23] | 23 studies · 19344 participants | Moderate Downgraded: imprecision, inconsistency |
Phosphodiesterase 4 inhibitors compared to placebo for chronic obstructive pulmonary disease
Population: patients with stable chronic obstructive pulmonary disease
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Change in FEV1 lung function (mL) Phosphodiesterase 4 inhibitors vs placebo | no estimate extracted | 22 studies · 15670 participants | Moderate Downgraded: inconsistency |
Change in quality of life St George's Respiratory Questionnaire Phosphodiesterase 4 inhibitors vs placebo | no estimate extracted | 10 studies · 7618 participants | Moderate Downgraded: inconsistency |
COPD exacerbations No. of patients with exacerbations Phosphodiesterase 4 inhibitors vs placebo | OR 0.77 [0.71, 0.83] | 20 studies · 15035 participants | High |
Mortality (all‐cause) No. of participants Phosphodiesterase 4 inhibitors vs placebo | OR 0.92 [0.69, 1.22] | 20 studies · 15030 participants | Moderate Downgraded: imprecision |
Adverse events No. of participants experiencing any adverse event Phosphodiesterase 4 inhibitors vs placebo | OR 1.27 [1.19, 1.36] | 23 studies · 16048 participants | Moderate Downgraded: inconsistency |
Gastrointestinal side effects No. of participants experiencing diarrhoea Phosphodiesterase 4 inhibitors vs placebo | OR 3.07 [2.66, 3.53] | 21 studies · 15241 participants | High |
Psychiatric adverse events (roflumilast) No. of participants Phosphodiesterase 4 inhibitors vs placebo | OR 2.13 [1.79, 2.54] | 14 studies · 11168 participants | Moderate |