Effect of Pancrelipase Therapy on Exocrine Pancreatic Insufficiency Symptoms and Coefficient of Fat Absorption Associated With Chronic Pancreatitis.

Abstract

OBJECTIVE:

The aim of this study was to evaluate whether improvement in coefficient of fat absorption (CFA) with pancreatic enzyme replacement therapy correlates with clinical symptoms in patients with chronic pancreatitis with moderate to severe exocrine pancreatic insufficiency.

METHODS:

Data were pooled from 2 randomized double-blind trials of the effects of 1 week of pancrelipase (n = 59) versus placebo (n = 57) on CFA and stool frequency, stool consistency, abdominal pain, and flatulence; 1 trial included a 51-week open-label pancrelipase treatment period (n = 34).

RESULTS:

Compared with placebo, significantly more patients receiving pancrelipase reported decreased stool frequency at week 1 (72% vs 38%; P < 0.001). Although 30% of patients receiving pancrelipase and 20% receiving placebo reported improved stool consistency, changes in stool consistency, abdominal pain, and flatulence were not different between groups. Mean CFA absolute change from baseline was significantly greater with pancrelipase versus placebo (24.7% vs 6.4%; P < 0.001). Improvements in stool consistency and frequency correlated with CFA improvement. Symptom improvements persisted or further improved through 52 weeks of treatment.

CONCLUSIONS:

Pancrelipase significantly improved exocrine pancreatic insufficiency maldigestive symptoms. Improvements in objective stool symptoms with pancreatic enzyme replacement therapy correlated with CFA improvement at 1 week.

• Authors: Jodie A Barkin, Jamie S Barkin
• Journal: Pancreas (Pancreas) Vol. 50 Issue 2 Pg. 176-182 (02 01 2021) ISSN: 1536-4828 [Electronic] United States
• PMID: 33560089 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
• Copyright: Copyright © 2021 The Author(s). Published by Wolters Kluwer Health, Inc.

Chemical References

• Gastrointestinal Agents
• Pancrelipase

Topics

• Abdominal Pain (drug therapy, physiopathology)
• Adolescent
• Adult
• Aged
• Defecation (drug effects)
• Exocrine Pancreatic Insufficiency (diagnosis, drug therapy, metabolism, physiopathology)
• Feces
• Female
• Flatulence (drug therapy, physiopathology)
• Gastrointestinal Agents (adverse effects, therapeutic use)
• Humans
• Intestinal Absorption (drug effects)
• Lipid Metabolism (drug effects)
• Male
• Middle Aged
• Pancreatitis, Chronic (diagnosis, drug therapy, metabolism, physiopathology)
• Pancrelipase (adverse effects, therapeutic use)
• Randomized Controlled Trials as Topic
• Time Factors
• Treatment Outcome
• Young Adult