Use of Roflumilast to Prevent Exacerbations in Fibrotic Sarcoidosis Patients (REFS)

University of Cincinnati

Status and phase

Unknown

Phase 4

Conditions

Sarcoidosis

Treatments

Drug: Placebo

Drug: Roflumilast

Study type

Interventional

Funder types

Other

Identifiers

NCT01830959

WIRB Pr #: 20130426 (Other Identifier)

REFS-1

Details and patient eligibility

About

Pulmonary sarcoidosis patients with fibrosis often develop recurrent episodes of bronchitis. These can lead to worsening of disease for both the short and long term.

Roflumilast has been shown to reduce the number of acute bronchitis episodes in patients with COPD.

Drugs similar to Roflumilast have been shown to help sarcoidosis. The current study is to determine if Roflumilast will reduce number of episodes of bronchitis and help fibrotic sarcoidosis.

Full description

This will be a multicenter, double blind, placebo controlled study. Patients would be randomized 1:1 to receive either roflumilast 500 mcg per day or placebo added to their current treatment regimen for twelve months.

Enrollment

50 estimated patients

Sex

All

Ages

18 to 70 years old

Volunteers

No Healthy Volunteers

Inclusion criteria

Patients with sarcoidosis as defined by the American Thoracic Society criteria
Patients with an FEV1/FVC ratio of less than 80%
Patients with fibrosis on chest x-ray and/or high resolution CT scan.
Patients have had at least two exacerbations of their sarcoidosis in the prior year. An exacerbation is defined as an acute event requiring increase of prednisone with or without use of antibiotics.
Patients must be on a stable dose of corticosteroids and other agents for their sarcoidosis at least 4 weeks prior to first visit.
For patients on prednisone alone, the dose has to be the equivalent of 5 mg prednisone a day. For those on other immunosuppressants, they can be on any dose of prednisone.
Patients must be between ages of 18 and 70 years of age.
Willing to take prednisone at increased dosage for exacerbations of their sarcoidosis.
Patients must be able to provide written informed consent to participate in the study.

Exclusion criteria

Patients with known hypersensitivity to theophylline or pentoxifylline will not be eligible. Patients with dose dependent nausea from these drugs may still participate in the trial.
Patients will not be able to take theophylline or pentoxifylline during the time of the study. They will be allowed to take drugs for sarcoidosis including prednisone, methotrexate, azathioprine, leflunomide, hydroxychloroquine, thalidomide, infliximab, adalimumab, and rituximab.
Patients with serum creatinine of greater than 3 mg/dL
Patients with moderate or severe liver disease as defined Child Pugh class 3 or 4.
Patients with unstable cardiac disease
Patients with non cutaneous malignancy treated in the past two years.
Patients unable to complete the questionnaires and six minute walks detailed in the study.Women of child bearing potential unable to use adequate birth control as determined by the investigator.