| Systematic review: efficacy and safety of pancreatic enzyme supplements for exocrine pancreatic insufficiency. | |
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MedLine Citation:
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PMID: 19804466 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: Pancreatic enzyme supplements are standard therapy for fat malabsorption in patients with exocrine pancreatic insufficiency. The FDA determined that published data are insufficient to support the efficacy and safety of these agents. AIM: To determine if pancreatic enzyme supplements are: (i) superior to placebo for treating fat malabsorption and (ii) superior to other supplements based on randomized cross-over trials. METHODS: A computer-assisted search of MEDLINE and EMBASE was performed to identify relevant studies. Data extraction on study design, improvement in coefficient of fat absorption, diarrhoea and adverse events using prespecified forms. RESULTS: A total of 12 manuscripts met inclusion criteria. Most studies (10/12) compared pancreatic enzyme supplements that used different delivery systems, while using similar quantities of enzymes. These studies found no consistent difference in fat malabsorption or gastrointestinal symptoms between different active treatments. Two small placebo-controlled trials (n = 65 patients) demonstrate that pancreatic enzyme supplements are superior to placebo for fat absorption. Data are inadequate to determine if pancreatic enzyme supplements lead to weight gain or improvement in diarrhoea. CONCLUSIONS: Based on data from randomized cross-over trials, pancreatic enzyme supplements appear to improve fat malabsorption. No specific branded product or specific delivery system is superior for treatment of fat malabsorption in patients with exocrine pancreatic insufficiency. |
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Authors:
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J R Taylor; T B Gardner; A K Waljee; M J Dimagno; P S Schoenfeld |
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Publication Detail:
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Type: Journal Article; Research Support, Non-U.S. Gov't; Review |
Journal Detail:
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Title: Alimentary pharmacology & therapeutics Volume: 31 ISSN: 1365-2036 ISO Abbreviation: Aliment. Pharmacol. Ther. Publication Date: 2010 Jan |
Date Detail:
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Created Date: 2009-12-16 Completed Date: 2010-05-12 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 8707234 Medline TA: Aliment Pharmacol Ther Country: England |
Other Details:
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Languages: eng Pagination: 57-72 Citation Subset: IM |
Affiliation:
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Division of Gastroenterology, University of Michigan Medical Center, Ann Arbor, MI 48105, USA. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Cross-Over Studies Cystic Fibrosis / complications, drug therapy*, enzymology Diarrhea / drug therapy*, enzymology Enzymes / therapeutic use* Exocrine Pancreatic Insufficiency / drug therapy*, enzymology, etiology Humans Placebos / therapeutic use Randomized Controlled Trials as Topic |
| Chemical | |
Reg. No./Substance:
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0/Enzymes; 0/Placebos |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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