Phosphodiesterase 4 Inhibitor, Roflumilast, and the Effects of Inhibition in Severe Asthma

Inclusion Criteria: * Have a physician diagnosis of asthma. * Require treatment with moderate to high-dose \>2500mcg/day of fluticasone or equivalent, or use of oral steroids Also two of the following: * Requirement for additional daily treatment with other controller medication * Daily Asthma symptoms * Forced Expiratory Volume / Forced Vital Capacity (FEV1/FVC) \< 70% and FEV1\< 80% predicted * ≥1 urgent care visits/year * ≥3 oral steroid bursts/year * Near-fatal asthma event. * Exhaled Nitric oxide (FeNO)\<30 ppb * Peripheral blood eosinophil count \< 300 (x10-6/ul) * Obesity, BMI≥30 Exclusion Criteria: * Less than 18 years of age * baseline FEV1 \<30% predicted * pregnant or nursing women * current smokers or subject with \>20 pack year history * any history of intolerance of, or reaction to, Roflumilast. * Prisoners * Patients with liver disease * Subjects with Hepatic impairment (contraindicated in moderate-to-severe liver impairment: Child-Pugh Score Class B/C) for example. * Patients with clinically significant psychiatric history (i.e., suicidality, etc.) and psychiatric illness * Patients using strong CYP 450 enzyme inducers (e.g., rifampicin, phenobarbital, carbamazepine, phenytoin).