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array:22 [ "pii" => "S001425651170008X" "issn" => "00142565" "doi" => "10.1016/S0014-2565(11)70008-X" "estado" => "S300" "fechaPublicacion" => "2011-03-01" "aid" => "70008" "copyright" => "Elsevier España S.L." "copyrightAnyo" => "2011" "documento" => "article" "crossmark" => 0 "subdocumento" => "fla" "cita" => "Rev Clin Esp. 2011;211 Supl 2:22-30" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:2 [ "total" => 1845 "formatos" => array:2 [ "HTML" => 1670 "PDF" => 175 ] ] "itemAnterior" => array:18 [ "pii" => "S0014256511700078" "issn" => "00142565" "doi" => "10.1016/S0014-2565(11)70007-8" "estado" => "S300" "fechaPublicacion" => "2011-03-01" "aid" => "70007" "copyright" => "Elsevier España S.L." "documento" => "article" "crossmark" => 0 "subdocumento" => "fla" "cita" => "Rev Clin Esp. 2011;211 Supl 2:13-21" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:2 [ "total" => 400 "formatos" => array:2 [ "HTML" => 275 "PDF" => 125 ] ] "es" => array:11 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Nuevos tratamientos en epoc</span>" "titulo" => "Complejidad de la EPOC. Tratamiento individualizado, nuevas aproximaciones, fenotipos, comorbilidades" "tienePdf" => "es" "tieneTextoCompleto" => 0 "tieneResumen" => array:2 [ 0 => "es" 1 => "en" ] "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "13" "paginaFinal" => "21" ] ] "titulosAlternativos" => array:1 [ "en" => array:1 [ "titulo" => "Complexity in chronic obstructive pulmonary disease. Individualized treatment, new approaches, phenotypes and comorbidities" ] ] "contieneResumen" => array:2 [ "es" => true "en" => true ] "contienePdf" => array:1 [ "es" => true ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "J.C. Martín-Escudero" "autores" => array:1 [ 0 => array:2 [ "nombre" => "J.C." "apellidos" => "Martín-Escudero" ] ] ] ] ] "idiomaDefecto" => "es" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0014256511700078?idApp=WRCEE" "url" => "/00142565/00000211000000S2/v1_201302081053/S0014256511700078/v1_201302081053/es/main.assets" ] "es" => array:13 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Nuevos tratamientos en epoc</span>" "titulo" => "Inhibidores de la PDE4: roflumilast" "tieneTextoCompleto" => 0 "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "22" "paginaFinal" => "30" ] ] "autores" => array:1 [ 0 => array:3 [ "autoresLista" => "J.L. Izquierdo Alonso" "autores" => array:1 [ 0 => array:3 [ "nombre" => "J.L." "apellidos" => "Izquierdo Alonso" "email" => array:1 [ 0 => "jlizquierdo@sescam.org" ] ] ] "afiliaciones" => array:1 [ 0 => array:1 [ "entidad" => "Servicio de Neumología, Hospital Universitario, Guadalajara, España" ] ] ] ] "titulosAlternativos" => array:1 [ "en" => array:1 [ "titulo" => "Phosphodiesterase-4 inhibitors: roflumilast" ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "PalabrasClave" => array:2 [ "es" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Palabras clave" "identificador" => "xpalclavsec18128" "palabras" => array:4 [ 0 => "Roflumilast" 1 => "EPOC" 2 => "Bronquitis crónica" 3 => "Tratamiento" ] ] ] "en" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Keywords" "identificador" => "xpalclavsec18129" "palabras" => array:4 [ 0 => "Roflumilast" 1 => "COPD" 2 => "Chronic bronchitis" 3 => "Treatment" ] ] ] ] "tieneResumen" => true "resumen" => array:2 [ "es" => array:2 [ "titulo" => "Resumen" "resumen" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">La enfermedad pulmonar obstructiva crónica (EPOC) es un término que engloba un grupo de trastornos caracterizados por la presencia de obstrucción crónica de las vías aéreas. Este amplio paraguas diagnóstico incluye varios fenotipos clínicos que se solapan y que responden de forma diferente a cada tipo de intervención terapéutica. Roflumilast es un fármaco perteneciente a la nueva clase terapéutica de los inhibidores de la fosfodiesterasa 4 (PDE4). Se puede considerar el primer fármaco desarrollado para el tratamiento de un fenotipo específico de la EPOC (EPOC asociada a bronquitis crónica). En modelos preclínicos, roflumilast ha mostrado una potente acción antiinflamatoria sobre una amplia variedad de células y mediadores inflamatorios, así como sobre otros mecanismos etiopatogénicos propios de la EPOC. El presente documento revisa la evidencia generada durante el desarrollo clínico de roflumilast, con un énfasis especial en los estudios que valoran el fármaco en el contexto similar a nuestra práctica clínica habitual.</p>" ] "en" => array:2 [ "titulo" => "Abstract" "resumen" => "<p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Chronic obstructive pulmonary disease (COPD) encompasses a group of diseases characterized by chronic airway obstruction. This broad diagnostic umbrella includes several clinical phenotypes that overlap and respond differently to each type of therapeutic intervention. Roflumilast is a drug belonging to the new therapeutic class of phosphyldiesterase-4 (PDE4) inhibitors and can be considered the first drug to be developed for a specific COPD phenotype (COPD associated with chronic bronchitis). In preclinical models, roflumilast has shown potent antiinflammatory action against a wide variety of cells and inflammatory mediators, as well as against the etiopathogenic mechanisms of COPD. The present article reviews the evidence generated during the clinical development of roflumilast, with special emphasis on studies evaluating the drug in a context similar to that of routine clinical practice.</p>" ] ] "bibliografia" => array:2 [ "titulo" => "Bibliografía" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:29 [ 0 => array:3 [ "identificador" => "bib1" "etiqueta" => "1." "referencia" => array:1 [ 0 => array:1 [ "referenciaCompleta" => "Global Initiative for chronic obstructive lung disease. Global strategy for the diagnosis, management and prevention of COPD. Disponible en: <a class="elsevierStyleInterRef" href="http://www.goldcopd.com/">www.goldcopd.com</a>" ] ] ] 1 => array:3 [ "identificador" => "bib2" "etiqueta" => "2." 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