Properties of different pancreatin preparations used in pancreatic exocrine insufficiency

@article{Lhr2009PropertiesOD,
  title={Properties of different pancreatin preparations used in pancreatic exocrine insufficiency},
  author={Johannes Matthias L{\"o}hr and Frank Hummel and Konstantinos T Pirilis and Gregor Steinkamp and Andrea K{\"o}rner and Friederike Henniges},
  journal={European Journal of Gastroenterology \& Hepatology},
  year={2009},
  volume={21},
  pages={1024-1031}
}
Background Pancreatic enzyme preparations are a life-saving substitution for a pivotal physiological function of the entire organism that is impaired in chronic pancreatitis, cystic fibrosis and other diseases with exocrine pancreatic insufficiency. Pancreatic enzyme preparations, generically called pancreatin, are not alike. Rather, they present a broad variety of pancreatin composition. Aim The properties of a set of commercially available pancreatin preparations were investigated in light of… 

Differences in In Vitro Properties of Pancreatin Preparations for Pancreatic Exocrine Insufficiency as Marketed in Russia and CIS

Pancreatic enzyme-replacement therapy (PERT), provided as pancreatin to patients with pancreatic exocrine insufficiency, is considered an essential substitute for the pivotal physiological function the pancreas fulfills in digestion, but preparations available in Russia and CIS demonstrate product- to-product and batch-to-batch variability regarding the measured properties of lipase activity, dissolution, and particle size.

Novel ciliate lipases for enzyme replacement during exocrine pancreatic insufficiency

Three novel ciliate lipases derived from Tetrahymena thermophila are cloned and analyzed and are promising candidates for an improved enzyme replacement therapy for exocrine pancreatic insufficiency.

In vitro Comparison of Pancreatic Enzyme Preparations Available in the Indian Market

Differences exist between pancreatic enzyme preparations in terms of physical properties, dissolution, and release behavior that can affect their clinical efficacy, and the present study suggests that these preparations should not be used interchangeably.

Pancreatic enzyme replacement therapy for pancreatic exocrine insufficiency in the 21(st) century.

Approaches for improving the results of enzyme therapy are described including changing to, or adding, a different product, adding non-enteric coated enzymes, use of antisecretory drugs and/or antacids, and changing the timing of enzyme administration.

Pancreatic enzyme therapy.

There is still no simple test that can be used to diagnose pancreatic exocrine insufficiency with certainty, and the treatment is symptomatic; its goals are to lessen steatorrhea and reverse weight loss.

Diagnosis and treatment of pancreatic exocrine insufficiency

Methods evaluating digestion, such as fecal fat quantification and the 13 C-mixed triglycerides test, are the most accurate tests for pancreatic exocrine insufficiency, but the probability of the diagnosis can also be estimated based on symptoms, signs of malnutrition in blood tests, fecal elastase 1 levels and signs of morphologically severe chronic pancreatitis on imaging.

Diagnosis and treatment of pancreatic exocrine insufficiency.

Methods evaluating digestion, such as fecal fat quantification and the (13)C-mixed triglycerides test, are the most accurate tests for pancreatic exocrine insufficiency, but the probability of the diagnosis can also be estimated based on symptoms, signs of malnutrition in blood tests, fecal elastase 1 levels and signs of morphologically severe chronic pancreatitis on imaging.

Role of Acid Suppression in Exocrine Pancreatic Insufficiency: A Therapeutic Principle

The addition of PPIs to PEPs in patients with EPI results in a higher duodenal pH and thus a reduced inactivation of the residual enzyme secretion of patients, an earlier dissolution of PEP's from enteric coating, and a prevention of bile salt precipitation.

Response to: properties of different pancreatin preparations used in pancreatic exocrine insufficiency, Löhr JM et al. Eur J Gastroenterol Hepatol 2009; 21(9):1024-1031.

  • P. Lederer
  • Medicine, Biology
    European journal of gastroenterology & hepatology
  • 2010
Comparing the particle sizes of 10 different pancreatin preparations indicated that approximately 90% of Kreon microspheres (Solvay Pharmaceuticals, Hannover, Germany) have a diameter less than 1.7 mm promote suboptimal digestion in patients with pancreatic insufficiency (PI).

Chronic pancreatitis and pancreatic cancer; the clinical aspects and treatment of pancreatic exocrine insufficiency

Clinical aspects of exocrine pancreatic insufficiency in chronic pancreatitis and pancreatic cancer were explored and an attempt was made to gain insight in the current practice of enzyme supplementation, in particular the prevalence of under-treatment and its consequences.
...

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