Azithromycin or Roflumilast to Prevent COPD Exacerbations?

Chronic obstructive pulmonary disease (COPD) exacerbations can affect patients’ quality of life, jeopardize their lung function, and increase mortality. For patients who continue to have exacerbations despite inhaler therapy, two oral options are available for add-on therapy: azithromycin and roflumilast (Figure 1). A randomized trial is ongoing to compare the two, but in the meantime, observational data provide some insight.

Using insurance claims data, researchers compared 7500 patients with COPD who were started on azithromycin after previously filling prescriptions for inhaler therapy and a similar group of patients who were started on roflumilast. The primary outcome was the occurrence of a first moderate exacerbation (requiring …