title: A 6-month, open-label clinical trial of pancrelipase delayed-release capsules (Creon) in patients with exocrine pancreatic insufficiency due to chronic pancreatitis or pancreatic surgery.
abstract: BACKGROUND
  Pancreatic enzyme replacement therapy (PERT) is necessary to prevent severe maldigestion and unwanted weight loss associated with exocrine pancreatic insufficiency (EPI) due to chronic pancreatitis (CP) or pancreatic surgery (PS).
  
  
  OBJECTIVE
  To assess the long-term safety and efficacy of pancrelipase (pancreatin) delayed-release capsules (Creon) in this population.
  
  
  METHODS
  This was a 6-month, open-label extension of a 7-day, double-blind, placebo-controlled study enrolling patients ≥18 years old with confirmed EPI due to CP or PS who were previously receiving PERT. Patients received individualised pancrelipase doses as directed by investigators (administered as Creon 24 000-lipase unit capsules).
  
  
  RESULTS
  Overall, 48 of 51 patients completed the open-label phase; one withdrew due to the unrelated treatment-emergent adverse event (TEAE) of cutaneous burns and two were lost to follow-up. The mean age was 50.9 years, 70.6% of patients were male, 76.5% had CP and 23.5% had undergone PS. The mean±s.d. pancrelipase dose was 186960±74640 lipase units/day. TEAEs were reported by 22 patients (43.1%) overall. Only four patients (7.8%) had TEAEs that were considered treatment related. From double-blind phase baseline to end of the open-label period, subjects achieved a mean±s.d. body weight increase of 2.7±3.4 kg (P<0.0001) and change in daily stool frequency of -1.0±1.3 (P<0.001). Improvements in abdominal pain, flatulence and stool consistency were observed.
  
  
  CONCLUSIONS
  Pancrelipase was well tolerated over 6 months and resulted in statistically significant weight gain and reduced stool frequency in patients with EPI due to CP or PS previously managed with standard PERT.
authors.affiliation: Department of Internal Diseases, Donetsk National Medical University, Donetsk, Ukraine.
authors.forename: N
authors.initials: N
authors.lastname: Gubergrits
authors.forename: E
authors.initials: E
authors.lastname: Malecka-Panas
authors.forename: G A
authors.initials: GA
authors.lastname: Lehman
authors.forename: G
authors.initials: G
authors.lastname: Vasileva
authors.forename: Y
authors.initials: Y
authors.lastname: Shen
authors.forename: S
authors.initials: S
authors.lastname: Sander-Struckmeier
authors.forename: S
authors.initials: S
authors.lastname: Caras
authors.forename: D C
authors.initials: DC
authors.lastname: Whitcomb
mesh_terms: D000328:Adult; D002214:Capsules; D003692:Delayed-Action Preparations; D004311:Double-Blind Method; D010188:Exocrine Pancreatic Insufficiency / Q000188:drug therapy*; D005260:Female; D005765:Gastrointestinal Agents / Q000008:administration & dosage*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010179:Pancreas / Q000601:surgery*; D050500:Pancreatitis, Chronic / Q000188:drug therapy*; D020799:Pancrelipase / Q000008:administration & dosage*; D013997:Time Factors; D016896:Treatment Outcome; D015430:Weight Gain
chemical_list: D002214:Capsules; D003692:Delayed-Action Preparations; D005765:Gastrointestinal Agents; D020799:Pancrelipase