Delayed release pancrelipase for treatment of pancreatic exocrine insufficiency associated with chronic pancreatitis

Devi Mukkai Krishnamurty, Atoosa Rabiee, Sanjay B. Jagannath, Dana K. Andersen

Research output: Contribution to journalReview article

12 Scopus citations

Abstract

Pancreatic enzyme supplements (PES) are used in chronic pancreatitis (CP) for correction of pancreatic exocrine insufficiency (PEI) as well as pain and malnutrition. The use of porcine pancreatic enzymes for the correction of exocrine insufficiency is governed by the pathophysiology of the disease as well as pharmacologic properties of PES. Variability in bioequivalence of PES has been noted on in vitro and in vivo testing and has been attributed to the differences in enteric coating and the degree of micro-encapsulation. As a step towards standardizing pancreatic enzyme preparations, the Food and Drug Administration now requires the manufacturers of PES to obtain approval of marketed formulations by April 2010. In patients with treatment failure, apart from evaluating drug and dietary interactions and compliance, physicians should keep in mind that patients may benefit from switching to a different formulation. The choice of PES (enteric coated versus non-enteric coated) and the need for acid suppression should be individualized. There is no current standard test for evaluating adequacy of therapy in CP patients and studies have shown that optimization of therapy based on symptoms may be inadequate. Goals of therapy based on overall patient presentation and specific laboratory tests rather than mere correction of steatorrhea are needed.

Original languageEnglish (US)
Pages (from-to)507-520
Number of pages14
JournalTherapeutics and Clinical Risk Management
Volume5
Issue number1
StatePublished - Dec 1 2009

Keywords

  • Chronic pancreatitis
  • Pancreatic enzyme supplement
  • Pancreatic exocrine insufficiency

ASJC Scopus subject areas

  • Safety Research
  • Pharmacology, Toxicology and Pharmaceutics(all)
  • Pharmacology (medical)
  • Chemical Health and Safety

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