title: Pancreatic enzyme replacement therapy for young cystic fibrosis patients.
abstract: 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).
  
  
  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.
  
  
  CONCLUSIONS
  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.
authors: Centre de Ressources et de Compétence pour la Mucoviscidose Hôpital Robert Debré, AP-HP, Paris, France. anne.munck@rdb.aphp.fr
authors: Anne
authors: A
authors: Munck
authors: Jean-Francois
authors: JF
authors: Duhamel
authors: Thierry
authors: T
authors: Lamireau
authors: Bernard
authors: B
authors: Le Luyer
authors: Claire
authors: C
authors: Le Tallec
authors: Gabriel
authors: G
authors: Bellon
authors: Michel
authors: M
authors: Roussey
authors: Pierre
authors: P
authors: Foucaud
authors: Jean Louis
authors: JL
authors: Giniès
authors: Anne
authors: A
authors: Houzel
authors: Christophe
authors: C
authors: Marguet
authors: Marcel
authors: M
authors: Guillot
authors: Valerie
authors: V
authors: David
authors: Nathalie
authors: N
authors: Kapel
authors: François
authors: F
authors: Dyard
authors: Friederike
authors: F
authors: Henniges
mesh_terms: D000284:Administration, Oral; D002675:Child, Preschool; D003258:Consumer Behavior; D018592:Cross-Over Studies; D003550:Cystic Fibrosis / Q000188:drug therapy* / Q000378:metabolism; D005260:Female; D005765:Gastrointestinal Agents / Q000008:administration & dosage*; D006801:Humans; D007223:Infant; D050356:Lipid Metabolism / Q000187:drug effects; D008297:Male; D008863:Microspheres; D020799:Pancrelipase / Q000008:administration & dosage*; D010290:Parents; D016896:Treatment Outcome
chemical_list: D005765:Gastrointestinal Agents; D020799:Pancrelipase