Pancreatic enzyme therapy and clinical outcomes in patients with cystic fibrosis.

Abstract

OBJECTIVE:

To assess the relationship between pancreatic enzyme therapy (PET) and the clinical outcomes of growth, abdominal pain, constipation, gassiness, and number of stools in cystic fibrosis (CF).

STUDY DESIGN:

Patients (n = 1215) >4 weeks of age from 33 Cystic Fibrosis Foundation accredited sites who had a sweat chloride >60 mmol/L or two CF-causing mutations were enrolled using a proportionate sampling strategy in a nonblinded study. Patients submitted a stool sample and completed a questionnaire. The study coordinator also completed a questionnaire for each patient. Enzyme dosing and growth, abdominal pain, gassiness, constipation, and number of stools were compared.

RESULTS:

Of the 1215 enrolled patients, 1131 (93.1%) were prescribed PET. Only 14.9% had pancreatic function assessed before enrolling in this study. Stool elastase-1 analysis identified 1074 (89%) patients as pancreatic insufficient (PI). There was no association between PET and the outcomes: growth, abdominal pain, gassiness, constipation, and number of stools.

CONCLUSION:

PET dose is not correlated with growth or gastrointestinal symptoms. More sensitive outcome measures of the effectiveness of PET in patients with CF are needed to guide treatment of PI.

• Authors: Susan S Baker, Drucy Borowitz, Linda Duffy, Laura Fitzpatrick, Joyce Gyamfi, Robert D Baker
• Journal: The Journal of pediatrics (J Pediatr) Vol. 146 Issue 2 Pg. 189-93 (Feb 2005) ISSN: 0022-3476 [Print] United States
• PMID: 15689904 (Publication Type: Clinical Trial, Journal Article, Research Support, Non-U.S. Gov't)

Chemical References

• Pancreatic Elastase

Topics

• Abdominal Pain (etiology)
• Adolescent
• Child
• Child, Preschool
• Constipation (etiology)
• Cystic Fibrosis (complications, drug therapy)
• Diarrhea (etiology)
• Dose-Response Relationship, Drug
• Exocrine Pancreatic Insufficiency (complications, drug therapy)
• Humans
• Infant
• Pancreas (drug effects, physiopathology)
• Pancreatic Elastase (therapeutic use)
• Pancreatic Function Tests
• Surveys and Questionnaires
• Treatment Outcome