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Cilomilast is an orally active, second-generation small molecule drug developed as a selective phosphodiesterase 4 (PDE4) inhibitor. It was primarily investigated for the treatment of respiratory disorders such as chronic obstructive pulmonary disease (COPD) and asthma. Cilomilast acts by inhibiting PDE4, an enzyme that degrades cyclic AMP in pro-inflammatory and immune cells; this inhibition leads to anti-inflammatory effects targeting bronchoconstriction, mucus hypersecretion, and airway remodeling associated with COPD. The drug demonstrated reasonable efficacy in clinical trials but was discontinued due to its side effect profile and has never been marketed[1][2][3][5].
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