Replacement therapy in pancreatic insufficiency with a new pancreatin preparation respecting the physiological ratio of lipase/trypsin activity.

An open, intraindividually controlled study with two doses of Creon (5 X 2 and 5 X 3 capsules/day) was performed in 15 patients suffering from severe pancreatic steatorrhea. A diet containing 70 g of fat/day was offered and the means of 3-day fat loss of daily collected stools were measured in the last 3 days of 5-day equilibration periods with and without replacement therapy. After these short-term periods, patients were treated with 5 X 2 capsules of Creon for 3 months at home, and fat loss was then measured as previously on a 70 g fat/day diet. Stool weight and stool frequency significantly decreased already during the short-term periods. The fat loss decreased dose-dependently during the short periods, more after 5 X 3 capsules/day than after 5 X 2 capsules/day. However, after 3-month replacement therapy the effect of 5 X 2 capsules of Creon was similar (16.5%), possibly because of improved intes-tinal function. Weight increases and patients' appraisal were also favorable. The excellent results with Creon treatment were attributed to a better lipase/trypsin ratio of the pancreatin pre-aration which, together with the favorable galenic properties, can diminish proteolytic inactivation of lipase during passage through the gastrointestinal tract.