azithromycin + roflumilast

Azithromycin and roflumilast are two separate medications used to reduce the risk of COPD exacerbations in patients with severe COPD. Roflumilast is a selective phosphodiesterase-4 (PDE4) inhibitor recommended specifically for patients with severe COPD associated with chronic bronchitis and a history of exacerbations. Azithromycin is a macrolide antibiotic that, when used chronically, has anti-inflammatory properties that can help reduce COPD exacerbations. Both medications have been shown to reduce the risk of COPD exacerbations compared to placebo, but they have different mechanisms of action and side effect profiles. The RELIANCE trial is an ongoing pragmatic, non-inferiority trial comparing the effectiveness of these two medications in preventing hospitalization or death in patients with COPD at high risk for exacerbations.