Summary
Roflumilast has reached the approved stage (maximum clinical phase 4) for at least one indication, so its use in COPD would be drug repurposing rather than first-in-human development. This does not mean it is approved for COPD. ClinicalTrials.gov lists 8 registered trials linking Roflumilast to COPD: 6 have completed; 2 are terminated, withdrawn, suspended or of unknown status. The most advanced is Phase 4 (NCT04069312). The largest enrolment is 1837 participants (NCT02068456). Registration activity spans 2003 to 2020. The literature layer holds 11 publications for this pair: 5 Cochrane reviews, 1 meta-analysis and 5 clinical trial publications. Publication years run from 2018 to 2024. Because at least one synthesis-level source exists (systematic review, meta-analysis or Cochrane review), this pair has been assessed beyond single studies, although the synthesis may concern a different indication.
The RepurpOS disease-intelligence file for Chronic Obstructive Pulmonary Disease ranks 505 candidate therapeutics from Open Targets, ChEMBL, DGIdb and PubMed; only a minority carry direct clinical evidence, and this page covers one of those. Spontaneous remission context recorded for the condition: Effectively zero — airflow obstruction is irreversible by definition in COPD; FEV1 decline continues at 30-60 mL/year on standard care.
Evidence table
| Evidence tier | A · Strong |
|---|---|
| Evidence score | 77.5 (trials 27.5, literature 30.0, tier 15, approved bonus 5.0) |
| Registered trials | 8 total: 0 recruiting, 0 active / not yet recruiting, 6 completed, 2 other |
| Linked publications | 11 (5 Cochrane reviews, 5 clinical trial publications, 1 meta-analysis) |
| Agent type | Drug (Small molecule) |
| Development stage (any indication) | Approved |
| Mechanism / class | Not recorded |
| Data sources | Open Targets, ChEMBL |
How the evidence score is calculated
- Each registered trial scores by status (recruiting / active / enrolling 3, completed 2.5, not yet recruiting 2, unknown 1, terminated / withdrawn / suspended 0.5) plus a phase bonus (phase 3-4 +2, phase 2 +1, phase 1 +0.5). The trial component is capped at 30.
- Each literature item scores by design (Cochrane review 5, meta-analysis 4, systematic review 3, RCT 3, clinical trial publication 2, curated reference 1.5, other PubMed record 1). The literature component is capped at 30.
- The existing evidence tier adds 15 (A / Strong), 10 (B / Moderate), 5 (C / Preliminary) or 0 (D / Anecdotal).
- Agents approved for any indication (max clinical phase 4) add 5, because an approved agent has an established safety profile that lowers the barrier to repurposing trials.
- The score ranks what has been studied, not what works. It does not read effect sizes or directions of effect.
Registered clinical trials
| NCT ID | Title | Status | Phase | Enrolment |
|---|---|---|---|---|
| NCT04069312 | Roflumilast or Azithromycin to Prevent COPD Exacerbations (RELIANCE) 2020 | completed | Phase 4 | 1,032 |
| NCT02018432 | Strategy to Improve Adherence of Roflumilast 2013 | status unknown | Phase 4 | 80 |
| NCT00430729 | Effect of Roflumilast on Exacerbation Rate in Patients With Chronic Obstructive Pulmonary Disease. Ratio-Study. (BY217/M2-112) 2003 | completed | Phase 3 | 1,100 |
| NCT02165826 | Evaluation of Tolerability and Pharmacokinetics of Roflumilast, 250μg and 500μg, as add-on to Standard COPD Treatment to Treat Severe COPD 2014 | completed | Phase 3 | 1,323 |
| NCT01313494 | A Chronic Obstructive Pulmonary Disease (COPD) Trial Investigating Roflumilast on Safety and Effectiveness in China, Hong Kong and Singapore: 2011 | completed | Phase 3 | 626 |
| NCT02451540 | Evaluation of the Effect of Roflumilast in Hyperinflated COPD Patients Using Functional Respiratory Imaging 2015 | terminated | Phase 2 | 13 |
| NCT01572948 | A Placebo-controlled Trial of Daliresp on Chronic Obstructive Pulmonary Disease (COPD) 2012 | completed | Not applicable | 27 |
| NCT02068456 | Post Marketing Surveillance of Roflumilast in Korea 2012 | completed | Not applicable | 1,837 |
Published literature
- Cochrane review The Dosing Strategy to Improve Adherence to Roflumilast in Treatment for Chronic Obstructive Lung Disease: A Systemic Review and Meta-AnalysisLee J, Song JU · International journal of chronic obstructive pulmonary disease · 2024 · PMID 38476122
- Clinical trial publication Roflumilast May Increase Risk of Exacerbations When Used to Treat Poorly Controlled Asthma in People with ObesityDixon AE, Que LG, Kalhan R et al. · Annals of the American Thoracic Society · 2023 · PMID 36170654
- Meta-analysis 2023 Canadian Thoracic Society Guideline on Pharmacotherapy in Patients With Stable COPDBourbeau J, Bhutani M, Hernandez P et al. · Chest · 2023 · PMID 37690008
- Cochrane review Effects of Roflumilast on Patients with Chronic Obstructive Pulmonary Disease Treated with Inhaled Corticosteroid/Long-Acting β2 Agonist: A Meta-analysisZeng S, Bai H, Zou M · Computational and mathematical methods in medicine · 2022 · PMID 35915771
- Cochrane review What conservative interventions can improve the long-term quality of life, depression, and anxiety of individuals with stable COPD? A systematic review and meta-analysisLiang Z, Wang Q, Fu C et al. · Quality of life research : an international journal of quality of life aspects of treatment, care and rehabilitation · 2022 · PMID 34383225
- Clinical trial publication Effects of roflumilast on arterial stiffness in COPD (ELASTIC): A randomized trialUrban MH, Kreibich N, Gleiss A et al. · Respirology (Carlton, Vic.) · 2021 · PMID 32725799
- Cochrane review Interventions to improve adherence to pharmacological therapy for chronic obstructive pulmonary disease (COPD)Janjua S, Pike KC, Carr R et al. · The Cochrane database of systematic reviews · 2021 · PMID 34496032
- Cochrane review Phosphodiesterase-4 inhibitors for chronic obstructive pulmonary diseaseJanjua S, Fortescue R, Poole P · The Cochrane database of systematic reviews · 2020 · PMID 32356609
- Clinical trial publication Adherence to roflumilast under dose-escalation strategy in Korean patients with COPDPark TS, Kang J, Lee JS et al. · International journal of chronic obstructive pulmonary disease · 2019 · PMID 31354255
- Clinical trial publication Mucociliary Clearance in Former Tobacco Smokers with Both Chronic Obstructive Pulmonary Disease and Chronic Bronchitis and the Effect of RoflumilastLaube BL, Carson KA, Sharpless G et al. · Journal of aerosol medicine and pulmonary drug delivery · 2019 · PMID 30964381
- Clinical trial publication Anti-inflammatory effects of roflumilast in chronic obstructive pulmonary disease (ROBERT): a 16-week, randomised, placebo-controlled trialRabe KF, Watz H, Baraldo S et al. · The Lancet. Respiratory medicine · 2018 · PMID 30224319
Mechanism and notes
No mechanism of action is recorded for this pair in the source databases.
OSMF's existing evidence tier for this pair is A (Strong), derived from the strength of the disease association recorded in Open Targets and ChEMBL. The tier describes how well the drug-disease link is documented, not how well the drug works.
Frequently asked questions
Is Roflumilast approved for COPD?
Roflumilast has reached the approved stage (maximum clinical phase 4) for at least one indication, so its use in COPD would be drug repurposing rather than first-in-human development. This does not mean it is approved for COPD. Approval status for the specific indication should always be confirmed with the relevant regulator and prescribing information.
Is Roflumilast in clinical trials for COPD?
ClinicalTrials.gov lists 8 registered trials linking Roflumilast to COPD: 6 have completed; 2 are terminated, withdrawn, suspended or of unknown status. The most advanced is Phase 4 (NCT04069312). The largest enrolment is 1837 participants (NCT02068456). Registration activity spans 2003 to 2020.
What does the evidence show for Roflumilast in COPD?
Roflumilast has both completed registered trials and synthesis-level publications linked to COPD. That is the strongest profile in this database, but the summaries here do not extract effect sizes, so read the linked reviews for direction and magnitude of benefit. OSMF's existing evidence tier for this pair is A (Strong), derived from the strength of the disease association recorded in Open Targets and ChEMBL. The tier describes how well the drug-disease link is documented, not how well the drug works.
Cite this page
Data: ClinicalTrials.gov, PubMed, Open Targets, ChEMBL, DGIdb and the OSMF therapeutic agent database. Last updated 2026-07-05. Page built 2026-10-07.