The rate of moderate-to-severe chronic obstructive pulmonary disease exacerbations was 132 % lower in the roflumilast group than in the placebo group according to a Poisson regression analysis ( roflumilast 0805 vs placebo 0927 ; rate ratio [ RR ] 0868 [ 95 % CI 0753-1002 ] , p = 00529 ) , and 142 % lower according to a predefined sensitivity analysis using negative binomial regression ( 0823 vs 0959 ; 0858 [ 0740-0995 ] , p = 00424 ) .