Enteric-coated pancreatic enzyme with bicarbonate is equal to standard enteric-coated enzyme in treating malabsorption in cystic fibrosis

Journal of Pediatric Gastroenterology and Nutrition

Volumn 42, Issue 3, 2006, Pages 256-261

  Kalnins, Daina ^a   Ellis, Lynda ^a   Corey, Mary ^a,b   Pencharz, Paul B ^a,b   Stewart, Cynthia ^f   Tullis, Elizabeth ^c,d   Durie, Peter R N ^a,b,e  

^a HOSPITAL FOR SICK CHILDREN RESEARCH INSTITUTE   (Canada)

^b UNIVERSITY OF TORONTO   (Canada)

^c UNIVERSITY OF TORONTO   (Canada)

^d ST MICHAEL'S HOSPITAL   (Canada)

^e HOSPITAL FOR SICK CHILDREN   (Canada)

^f NONE

Author keywords

Bicarbonate; Cystic fibrosis; Malabsorption; Oral pancreatic enzymes

Indexed keywords

BICARBONATE; NITROGEN; PANCREAS ENZYME; TRIACYLGLYCEROL LIPASE;

ABSORPTION; ARTICLE; CHILD; CLINICAL ARTICLE; CLINICAL TRIAL; CONTROLLED CLINICAL TRIAL; CONTROLLED STUDY; CROSSOVER PROCEDURE; CYSTIC FIBROSIS; DISEASE SEVERITY; DOUBLE BLIND PROCEDURE; ENTERIC COATED TABLET; ENZYME ACTIVITY; FECES; FECES ANALYSIS; FEMALE; HUMAN; IN VITRO STUDY; INFORMATION PROCESSING; MALABSORPTION; NUTRIENT; PANCREAS INSUFFICIENCY; PRIORITY JOURNAL; RANDOMIZED CONTROLLED TRIAL;

ADOLESCENT; ADULT; BICARBONATES; CHILD; CROSS-OVER STUDIES; CYSTIC FIBROSIS; DOUBLE-BLIND METHOD; EXOCRINE PANCREATIC INSUFFICIENCY; FECES; FEMALE; GASTROINTESTINAL AGENTS; HUMANS; LIPID METABOLISM; MALABSORPTION SYNDROMES; MALE; NITROGEN; PANCRELIPASE; TABLETS, ENTERIC-COATED; TREATMENT OUTCOME;

EID: 33645319738     PISSN: 02772116     EISSN: None     Source Type: Journal    
DOI: 10.1097/01.mpg.0000189356.93784.01     Document Type: Article

References (24)

1. Durie P, Kalnins D, Ellis L. Uses and abuses of enzyme therapy in cystic fibrosis. J R Soc Med 1998;91(Suppl 34):2-13.
2. Kopelman H, Corey M, Gaskin K, et al. Impaired chloride secretion, as well as bicarbonate secretion, underlies the fluid secretory defect in the cystic fibrosis pancreas. Gastroenterology 1988;95:349-55.
3. Kraisinger M, Hochhaus G, Stecenko A, Bowser E, Hendeles L. Clinical pharmacology of pancreatic enzymes in patients with cystic fibrosis and in vitro performance of microencapsulated formulations. J Clin Pharmacol 1994;34:158-66.
4. Thomson M, Clague A, Cleghorn GJ, Shepherd RW. Comparative in vitro and in vivo studies of enteric-coated pancrelipase preparations for pancreatic insufficiency. J Pediatr Gastroenterol Nutr 1993;17:407-13.
5. Heizer WD, Cleaveland CR, Iber FL. Gastric inactivation of pancreatic supplements. Bull Johns Hopkins Hosp 1965;116: 261-70.
6. Guarner L, Rodriguez R, Guarner F, Malagelada JR. Fate of oral enzymes in pancreatic insufficiency. Gut 1993;34:708-12.
7. Butt AM, Ip W, Ellis L, et al. The fate of exogenous enzymes in patients with cystic fibrosis and pancreatic insufficiency [Abstract]. J Pediatr Gastroenterol Nutr 2001;33:391.
8. Youngberg CA, Berardi RR, Howatt WF, et al. Comparison of gastrointestinal pH in cystic fibrosis and healthy subjects. Dig Dis Sci 1987;32:472-80.
9. Delchier JC, Vidon N, Saint-Marc Girardin MF, et al. Fate of orally ingested enzymes in pancreatic insufficiency: comparison of two pancreatic enzyme preparations. Aliment Pharmacol Ther 1991;5:365-78.
10. Graham DY. Pancreatic enzyme replacement: the effect of antacids or cimetidine. Dig Dis Sci 1982;27:485-90.
11. Durie PR, Bell L, Linton W, Corey ML, Forstner GG. Effect of cimetidine and sodium bicarbonate on pancreatic replacement therapy in cystic fibrosis. Gut 1980;21:778-86.
12. Dutta SK, Hubbard VS, Appler M. Critical examination of therapeutic efficacy of a pH-sensitive enteric-coated pancreatic enzyme preparation in treatment of exocrine pancreatic insufficiency secondary to cystic fibrosis. Dig Dis Sci 1988;33:1237-44.
13. Borowitz DS, Grand RJ, Durie PR. Use of pancreatic enzyme supplements for patients with cystic fibrosis in the context of fibrosing colonopathy. Consensus Committee. J Pediatr 1995;127:681-4.
14. van de Kamer JH, ten Bokkel Huinink H, Weyers HA. Rapid method for the determination of fat in feces. J Biol Chem 1949;177:347-55.
15. Munro HN, Crim MC. The Proteins and Amino Acids. In: Shils ME, Olson JA, Shike M, eds. Modern Nutrition in Health and Disease, 8th ed. Philadelphia: Lea and Febiger; 1994, 1-35.
16. ASTM (American Society for Testing Material) sfbc. Moline IL: Parr Instrument Company, 1979.
17. Kuczmarski RJ, Ogden CL, Grummer-Strawn LM, et al. CDC growth charts: United States. Adv Data 2000:1-27.
18. Brady MS, Stevens J, Rickard K, Fineberg N. Effectiveness of a new enteric coated (EC) pancreatic enzyme with bicarbonate (Pancrecarb) in reducing steatorrhea in patients with cystic fibrosis (CF): A prospective randomized study [Abstract]. Pediatr Pulmonol 1998;17[Suppl]:354.
19. Francisco MP, Wagner MH, Sherman JM, et al. Ranitidine and omeprazole as adjuvant therapy to pancrelipase to improve fat absorption in patients with cystic fibrosis. J Pediatr Gastroenterol Nutr 2002;35:79-83.
20. Heijerman HG, Lamers CB, Bakker W. Omeprazole enhances the efficacy of pancreatin (pancrease) in cystic fibrosis. Ann Intern Med 1991;114:200-1.
21. Laiho KM, Gavin J, Murphy JL, Connett GJ, Wootton SA. Maldigestion and malabsorption of 13C labelled tripalmitin in gastrostomy-fed patients with cystic fibrosis. Clin Nutr 2004;23:347-53.
22. Kalnins D, Corey M, Ellis L, Durie PR, Pencharz PB. Combining unprotected pancreatic enzymes with pH-sensitive enteric-coated microspheres does not improve nutrient digestion in patients with cystic fibrosis. J Pediatr 2005;146:489-93.
23. Kalivianakis M, Minich DM, Bijleveld CM, et al. Fat malabsorption in cystic fibrosis patients receiving enzyme replacement therapy is due to impaired intestinal uptake of long-chain fatty acids. Am J Clin Nutr 1999;69:127-34.
24. Baker SS, Borowitz D, Duffy L, et al. Pancreatic enzyme therapy and clinical outcomes in patients with cystic fibrosis. J Pediatr 2005;146:189-93.