Systematic review: efficacy and safety of pancreatic enzyme supplements for exocrine pancreatic insufficiency

Taylor, Jeremy; Gardner, Timothy B.; Waljee, Akbar K.; DiMagno, Matthew; Schoenfeld, Philip

doi:10.1111/j.1365-2036.2009.04157.x

Cited by 50 publications

(34 citation statements)

References 31 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…22 23 We have therefore used CFA as the primary outcome measure, calculated from fat intake (∼100 g/day of dietary fat) and excretion (from 72 hours faecal collection) using the following equation:…”

Section: Outcomes Of Interestmentioning

confidence: 99%

Efficacy of pancreatic enzyme replacement therapy in chronic pancreatitis: systematic review and meta-analysis

Iglesia‐García

Huang

Szatmary

et al. 2016

Gut

146

101

View full text Add to dashboard Cite

ObjectiveThe benefits of pancreatic enzyme replacement therapy (PERT) in chronic pancreatitis (CP) are inadequately defined. We have undertaken a systematic review and meta-analysis of randomised controlled trials of PERT to determine the efficacy of PERT in exocrine pancreatic insufficiency (EPI) from CP.DesignMajor databases were searched from 1966 to 2015 inclusive. The primary outcome was coefficient of fat absorption (CFA). Effects of PERT versus baseline and versus placebo, and of different doses, formulations and schedules were determined.ResultsA total of 17 studies (511 patients with CP) were included and assessed qualitatively (Jadad score). Quantitative data were synthesised from 14 studies. PERT improved CFA compared with baseline (83.7±6.0 vs 63.1±15.0, p<0.00001; I2=89%) and placebo (83.2±5.5 vs 67.4±7.0, p=0.0001; I2=86%). PERT improved coefficient of nitrogen absorption, reduced faecal fat excretion, faecal nitrogen excretion, faecal weight and abdominal pain, without significant adverse events. Follow-up studies demonstrated that PERT increased serum nutritional parameters, improved GI symptoms and quality of life without significant adverse events. High-dose or enteric-coated enzymes showed a trend to greater effectiveness than low-dose or non-coated comparisons, respectively. Subgroup, sensitive and meta-regression analyses revealed that sample size, CP diagnostic criteria, study design and enzyme dose contributed to heterogeneity; data on health inequalities were lacking.ConclusionsPERT is indicated to correct EPI and malnutrition in CP and may be improved by higher doses, enteric coating, administration during food and acid suppression. Further studies are required to determine optimal regimens, the impact of health inequalities and long-term effects on nutrition.

show abstract

Section: Outcomes Of Interestmentioning

confidence: 99%

Efficacy of pancreatic enzyme replacement therapy in chronic pancreatitis: systematic review and meta-analysis

Iglesia‐García

Huang

Szatmary

et al. 2016

Gut

146

101

View full text Add to dashboard Cite

show abstract

“…Finally, measuring the fecal fat excretion is cumbersome because it requires a 72 h collection of stool after a standardised fixed diet of 80e100 g of fat/day. Qualitative measurement of a single stool specimen is useless because fat content varies with the dietary fat intake [44].…”

Section: Practice Pointsmentioning

confidence: 99%

Pancreatic enzyme replacement therapy in chronic pancreatitis

Sikkens

Cahen

Kuipers

et al. 2010

Best Practice & Research Clinical Gastroenterology

115

View full text Add to dashboard Cite

“…10 Therefore, nutritional interventions, such as low-fat diets and pancreatic enzyme replacement therapy (PERT), are used to improve the clinical symptoms. 11 Pancreatic enzyme replacement therapy with delayed pancrelipase release is a standard therapy for PEI because it significantly improves the coefficients of fat and nitrogen absorption as well as clinical symptoms. 12,13 Pancrelipase delayed-release capsules (CREON; Abbott, Marietta, Ga) have been available in Europe since 1984 and in the United States since 1987.…”

mentioning

confidence: 99%

Clinical Characteristics and Risk Factors for the Development of Postoperative Hepatic Steatosis After Total Pancreatectomy

Hata¹,

Ishida²,

Motoi³

et al. 2016

Pancreas

View full text Add to dashboard Cite

show abstract

Systematic review: efficacy and safety of pancreatic enzyme supplements for exocrine pancreatic insufficiency

Abstract: SUMMARY BackgroundPancreatic enzyme supplements are standard therapy for fat malabsorption in patients with exocrine pancreatic insufficiency. The FDA determined that published data are insufficient to support the efficacy and safety of these agents.

Cited by 50 publications

References 31 publications

Efficacy of pancreatic enzyme replacement therapy in chronic pancreatitis: systematic review and meta-analysis

Efficacy of pancreatic enzyme replacement therapy in chronic pancreatitis: systematic review and meta-analysis

Pancreatic enzyme replacement therapy in chronic pancreatitis

Clinical Characteristics and Risk Factors for the Development of Postoperative Hepatic Steatosis After Total Pancreatectomy

Contact Info

Product

Resources

About