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. 1987 Jul;42(7):533–537. doi: 10.1136/thx.42.7.533

Enteric coated microspheres of pancreatin in the treatment of cystic fibrosis: comparison with a standard enteric coated preparation.

R J Stead 1, I Skypala 1, M E Hodson 1, J C Batten 1
PMCID: PMC460823  PMID: 3326213

Abstract

In an open, randomised crossover study enteric coated microspheres of pancreatin were compared with a standard preparation of enteric coated pancreatin over two consecutive 28 day treatment periods in 23 adults with steatorrhoea due to cystic fibrosis. Lipase intake was equal to the patients' previous requirements and was the same during the two months. Patients performed 72 hour faecal collections at the end of each month and completed diary cards daily throughout. Comparison of the month of treatment with enteric coated microspheres with the month of standard enteric coated tablets showed a significant increase in body weight on microsphere capsules (p less than 0.02). There was also a reduced frequency of bowel actions (p less than 0.001) and abdominal pain (p less than 0.05), and improvement in stool character (p less than 0.001) on microsphere capsules. Faecal fat excretion was reduced by 44% with the microsphere capsules (p less than 0.01), and 86% of patients showed an increased coefficient of fat absorption (mean increase 13%, 95% confidence limits 6.5-19.1%; p less than 0.001). Eighty one per cent of patients preferred microsphere capsules of the two treatments. Thus enteric coated microsphere capsules are more effective in treating steatorrhoea in cystic fibrosis than standard enteric coated tablets.

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Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Chase H. P., Long M. A., Lavin M. H. Cystic fibrosis and malnutrition. J Pediatr. 1979 Sep;95(3):337–347. doi: 10.1016/s0022-3476(79)80504-1. [DOI] [PubMed] [Google Scholar]
  2. Cox K. L., Isenberg J. N., Ament M. E. Gastric acid hypersecretion in cystic fibrosis. J Pediatr Gastroenterol Nutr. 1982;1(4):559–565. doi: 10.1097/00005176-198212000-00019. [DOI] [PubMed] [Google Scholar]
  3. DiMagno E. P., Malagelada J. R., Go V. L., Moertel C. G. Fate of orally ingested enzymes in pancreatic insufficiency. Comparison of two dosage schedules. N Engl J Med. 1977 Jun 9;296(23):1318–1322. doi: 10.1056/NEJM197706092962304. [DOI] [PubMed] [Google Scholar]
  4. Gow R., Bradbear R., Francis P., Shepherd R. Comparative study of varying regimens to improve steatorrhoea and creatorrhoea in cystic fibrosis: Effectiveness of an enteric-coated preparation with and without antacids and cimetidine. Lancet. 1981 Nov 14;2(8255):1071–1074. doi: 10.1016/s0140-6736(81)91276-9. [DOI] [PubMed] [Google Scholar]
  5. Graham D. Y. Enzyme replacement therapy of exocrine pancreatic insufficiency in man. Relations between in vitro enzyme activities and in vivo potency in commercial pancreatic extracts. N Engl J Med. 1977 Jun 9;296(23):1314–1317. doi: 10.1056/NEJM197706092962303. [DOI] [PubMed] [Google Scholar]
  6. Hills M., Armitage P. The two-period cross-over clinical trial. Br J Clin Pharmacol. 1979 Jul;8(1):7–20. doi: 10.1111/j.1365-2125.1979.tb05903.x. [DOI] [PMC free article] [PubMed] [Google Scholar]
  7. Kraemer R., Rüdeberg A., Hadorn B., Rossi E. Relative underweight in cystic fibrosis and its prognostic value. Acta Paediatr Scand. 1978 Jan;67(1):33–37. doi: 10.1111/j.1651-2227.1978.tb16273.x. [DOI] [PubMed] [Google Scholar]
  8. Lapey A., Kattwinkel J., Di Sant'Agnese P. A., Laster L. Steatorrhea and azotorrhea and their relation to growth and nutrition in adolescents and young adults with cystic fibrosis. J Pediatr. 1974 Mar;84(3):328–334. doi: 10.1016/s0022-3476(74)80712-2. [DOI] [PubMed] [Google Scholar]
  9. Mischler E. H., Parrell S., Farrell P. M., Odell G. B. Comparison of effectiveness of pancreatic enzyme preparations in cystic fibrosis. Am J Dis Child. 1982 Dec;136(12):1060–1063. doi: 10.1001/archpedi.1982.03970480026006. [DOI] [PubMed] [Google Scholar]
  10. Mitchell E. A., Quested C., Marks R. E., Pinnock R. E., Elliott R. B. Comparative trial of viokase, pancreatin and Pancrease pancrelipase (enteric coated beads) in the treatment of malabsorption in cystic fibrosis. Aust Paediatr J. 1982 Jun;18(2):114–117. doi: 10.1111/j.1440-1754.1982.tb02002.x. [DOI] [PubMed] [Google Scholar]
  11. Niessen K. H., König J., Molitor M., Neef B. Studies on the quality of pancreatic preparations: enzyme content, prospective bioavailability, bile acid pattern, and contamination with purines. Eur J Pediatr. 1983 Oct;141(1):23–29. doi: 10.1007/BF00445663. [DOI] [PubMed] [Google Scholar]
  12. Regan P. T., Malagelada J. R., DiMagno E. P., Glanzman S. L., Go V. L. Comparative effects of antacids, cimetidine and enteric coating on the therapeutic response to oral enzymes in severe pancreatic insufficiency. N Engl J Med. 1977 Oct 20;297(16):854–858. doi: 10.1056/NEJM197710202971603. [DOI] [PubMed] [Google Scholar]
  13. Schneider M. U., Knoll-Ruzicka M. L., Domschke S., Heptner G., Domschke W. Pancreatic enzyme replacement therapy: comparative effects of conventional and enteric-coated microspheric pancreatin and acid-stable fungal enzyme preparations on steatorrhoea in chronic pancreatitis. Hepatogastroenterology. 1985 Apr;32(2):97–102. [PubMed] [Google Scholar]
  14. Shepherd R., Cooksley W. G., Cooke W. D. Improved growth and clinical, nutritional, and respiratory changes in response to nutritional therapy in cystic fibrosis. J Pediatr. 1980 Sep;97(3):351–357. doi: 10.1016/s0022-3476(80)80180-6. [DOI] [PubMed] [Google Scholar]
  15. Zentler-Munro P. L., Fine D. R., Batten J. C., Northfield T. C. Effect of cimetidine on enzyme inactivation, bile acid precipitation, and lipid solubilisation in pancreatic steatorrhoea due to cystic fibrosis. Gut. 1985 Sep;26(9):892–901. doi: 10.1136/gut.26.9.892. [DOI] [PMC free article] [PubMed] [Google Scholar]
  16. di Sant'agnese P. A., Davis P. B. Cystic fibrosis in adults. 75 cases and a review of 232 cases in the literature. Am J Med. 1979 Jan;66(1):121–132. doi: 10.1016/0002-9343(79)90491-1. [DOI] [PubMed] [Google Scholar]

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