Phosphodiesterase Inhibitors: Present and Future

Abstract

Phosphodiesterase (PDE) inhibitors act on specific phosphodiesterase enzymes (fundamentally 3, 4 and 5), which are characterized by their expression in different organs. Currently, their use is approved for the treatment of chronic obstructive pulmonary disease (COPD), erectile dysfunction, pulmonary arterial hypertension, psoriasis, psoriatic arthritis and atopic dermatitis. Although the experiences with most have been negative, phosphodiesterase inhibitors (especially type 4) have shown positive results, as they are able to provide additional benefits in patients who are not adequately controlled with bronchodilators, either with or without inhaled corticosteroids. To date, roflumilast is the only drug that has met these expectations in the treatment of a specific COPD phenotype (COPD associated with chronic bronchitis). Work is currently underway to develop more selective inhibitors that, by modulating PDE in specific tissues and cells, can improve the therapeutic effect in a specific organ with fewer side effects.

Keywords

• Asthma. COPD. Inhibitors. Roflumilast.