Literature DB >> 18718819

Pancreatic enzyme replacement therapy for young cystic fibrosis patients.

Anne Munck1, Jean-Francois Duhamel, Thierry Lamireau, Bernard Le Luyer, Claire Le Tallec, Gabriel Bellon, Michel Roussey, Pierre Foucaud, Jean Louis Giniès, Anne Houzel, Christophe Marguet, Marcel Guillot, Valerie David, Nathalie Kapel, François Dyard, Friederike Henniges.   

Abstract

UNLABELLED: Maldigestion in cystic fibrosis (CF) affects approximately 90% of patients. As soon as pancreatic insufficiency is identified, enzyme supplementation is prescribed even with breast fed infants. A pancreatic enzyme preparation developed particularly for infants, Creon for children (CfC), contains smaller granules to be administered with a dosing spoon (5000 lipase units per scoop). PATIENTS AND METHODS: In a prospective, randomised, multi-centre study, 40 infants and toddlers received both CfC and Creon 10000 (C10) for two weeks each in a cross-over design. Dosing of pancreatic enzymes was continued as applied before the study. The primary endpoint was the parents' treatment preference. Secondary endpoints included coefficient of fat absorption (CFA), clinical symptoms and safety parameters.
RESULTS: 20 parents (51%) from the N=39 intent to treat sample preferred CfC, 9 (23%) preferred C10, and 10 (26%) had no preference The applied doses led to a mean CFA with similar results for both treatments (77.8% vs. 78.7%). Gastrointestinal symptoms were reported on a number of study days, and some children had abnormal results for laboratory parameters of malabsorption. Safety and tolerability of the preparations were good and all these parameters were comparable for both treatments.
CONCLUSION: Those parents who had a preference favoured CfC over C10. Both enzyme preparations improved malabsorption to a similar degree, although the applied dosages could have been too low in some children reflected in a suboptimal CFA. These data support the use of CfC for young patients with cystic fibrosis improving the daily care of this cohort detected mainly now through neonatal screening programmes.

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Year:  2008        PMID: 18718819     DOI: 10.1016/j.jcf.2008.07.003

Source DB:  PubMed          Journal:  J Cyst Fibros        ISSN: 1569-1993            Impact factor:   5.482


  7 in total

Review 1.  Potential for Screening for Pancreatic Exocrine Insufficiency Using the Fecal Elastase-1 Test.

Authors:  J Enrique Domínguez-Muñoz; Philip D Hardt; Markus M Lerch; Matthias J Löhr
Journal:  Dig Dis Sci       Date:  2017-03-17       Impact factor: 3.199

2.  Safety and tolerability of a new formulation of pancrelipase delayed-release capsules (CREON) in children under seven years of age with exocrine pancreatic insufficiency due to cystic fibrosis: an open-label, multicentre, single-treatment-arm study.

Authors:  Gavin R Graff; John McNamara; James Royall; Steven Caras; Kristin Forssmann
Journal:  Clin Drug Investig       Date:  2010       Impact factor: 2.859

3.  Administration of CREON® pancrelipase pellets via gastrostomy tube is feasible with no loss of gastric resistance or lipase activity: an in vitro study.

Authors:  George Shlieout; Andreas Koerner; Mario Maffert; Kristin Forssmann; Steven Caras
Journal:  Clin Drug Investig       Date:  2011       Impact factor: 2.859

4.  Study design considerations for evaluating the efficacy and safety of pancreatic enzyme replacement therapy in patients with cystic fibrosis.

Authors:  Michael W Konstan; Drucy Borowitz; Nicole Mayer-Hamblett; Carlos Milla; Leslie Hendeles; Susan Murray; Richard A Kronmal; Susan Casey; Lynn M Rose; Wayne J Morgan; Bonnie W Ramsey
Journal:  Clin Investig (Lond)       Date:  2013-08

5.  Randomised clinical trial: the efficacy and safety of pancreatin enteric-coated minimicrospheres (Creon 40000 MMS) in patients with pancreatic exocrine insufficiency due to chronic pancreatitis--a double-blind, placebo-controlled study.

Authors:  V Thorat; N Reddy; S Bhatia; A Bapaye; J S Rajkumar; D D Kini; M M Kalla; H Ramesh
Journal:  Aliment Pharmacol Ther       Date:  2012-07-04       Impact factor: 8.171

6.  Pancreatic enzyme replacement therapy for people with cystic fibrosis.

Authors:  Usha Rani R Somaraju; Arturo Solis-Moya
Journal:  Cochrane Database Syst Rev       Date:  2020-08-05

Review 7.  It's not all about inhaled treatment: challenges with oral therapy in paediatric respiratory medicine.

Authors:  Anneka Sareen; Manisha Ramphul; Jayesh Mahendra Bhatt
Journal:  Breathe (Sheff)       Date:  2021-03
  7 in total

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