Pancreatic enzyme replacement therapy in patients with exocrine pancreatic insufficiency due to chronic pancreatitis: a 1-year disease management study on symptom control and quality of life.
OBJECTIVE
Exocrine pancreatic insufficiency (EPI) is frequent in patients with chronic pancreatitis (CP). This 1-year, prospective, multicenter, observational, disease management study aimed to assess symptom improvement and quality of life in patients with CP with EPI who were receiving pancreatic enzyme replacement.


METHODS
Patients with CP and chronic EPI were either assigned to cohort 1 that consisted of patients already taking pancreatin (Kreon; Abbott Arzneimittel GmbH, Hannover, Germany) or cohort 2 that consisted of patients with newly diagnosed EPI without prior pancreatic enzyme treatment. Symptoms were documented, and quality of life was assessed using the gastrointestinal quality of life index (GIQLI) at baseline, 6 months, and 1 year.


RESULTS
A total of 294 patients were evaluated (cohort 1, n = 206; cohort 2, n = 88). The proportion of patients experiencing gastrointestinal symptoms and recurrent pain after 1 year was significantly reduced in both cohorts (P < 0.001). The alleviation of symptoms was reflected in GIQLI score improvements at 1 year in both cohorts (P < 0.001), independent of CP severity and etiology. Improvements in GIQLI score were more pronounced in cohort 2 (P < 0.001).


CONCLUSIONS
Pancreatin demonstrated symptom relief and improvement in quality of life in patients with CP-related EPI in this disease management study.
From the *Department of Surgery, Klinikum Rechts der Isar, Technische Universität München, Munich; †Department of Internal Medicine, Israelitisches Krankenhaus, Hamburg; ‡Department of Surgery, St Josef-Hospital, Ruhr-University Bochum, Bochum, Germany; §Department of Surgical Gastroenterology, Karolinska Institutet, Stockholm, Sweden; ∥Institut für Empirische Gesundheitsökonomie, Burscheid; ¶Leibniz University, Hannover; #Hamburg University of Applied Sciences, Hamburg, Germany; **Abbott Products Operations AG, Allschwil, Switzerland; ††School of Public Health, University Bielefeld, Bielefeld; ‡‡Abbott Arzneimittel GmbH, Hannover; and §§Abbott Products, Hannover, Germany.
Jan G
JG
D'Haese
Güralp O
GO
Ceyhan
Ihsan Ekin
IE
Demir
Peter
P
Layer
Waldemar
W
Uhl
Matthias
M
Löhr
Reinhard
R
Rychlik
Konstantinos
K
Pirilis
York
Y
Zöllner
Birgit
B
Gradl
Douglas
D
Foerster
Julia
J
Möbius
Friederike
F
Henniges
Helmut
H
Friess
D000368:Aged; D003967:Diarrhea / Q000503:physiopathology / Q000517:prevention & control; D056947:Enzyme Replacement Therapy / Q000379:methods*; D010188:Exocrine Pancreatic Insufficiency / Q000188:drug therapy* / Q000209:etiology; D005260:Female; D041981:Gastrointestinal Tract / Q000187:drug effects / Q000503:physiopathology; D006801:Humans; D008297:Male; D008875:Middle Aged; D010146:Pain / Q000503:physiopathology / Q000517:prevention & control; D010194:Pancreatin / Q000627:therapeutic use*; D050500:Pancreatitis, Chronic / Q000150:complications*; D011446:Prospective Studies; D011788:Quality of Life; D013997:Time Factors; D016896:Treatment Outcome; D015431:Weight Loss / Q000187:drug effects / Q000502:physiology
D010194:Pancreatin