{A figure is presented}An Enteric-Coated High-Buffered Pancrelipase Reduces Steatorrhea in Patients with Cystic Fibrosis: A Prospective, Randomized Study

Mary Sue Brady, Jennifer L. Garson, Susan K. Krug, Ajay Kaul, Karyl A. Rickard, Helena Hoen Caffrey, Naomi Fineberg, William F. Balistreri, John Stevens

Research output: Contribution to journalArticle

30 Citations (Scopus)

Abstract

Objective: Enteric-coated (EC) high-buffered (2.5 mEq [2.5 mmol] bicarbonate per capsule) pancrelipase microsphere enzymes were compared to EC-nonbuffered pancreatic enzymes for efficacy in reducing steatorrhea in patients with cystic fibrosis. Design: Prospective, randomized, controlled trial using a crossover design with each subject as his/her own control. Subjects/Setting: Eighteen subjects with cystic fibrosis, who had pancreatic insufficiency and required large enzyme doses, were studied over two consecutive 7-day treatment periods. Intervention: Each 7-day period consisted of 3 days at home followed by 4 days in a general clinical research center for careful control of diets, enzyme lipase doses (given at approximately 50% of the subject's usual lipase dose), and carmine red-labeled stool collections for 72-hour fecal fat balance studies. Main Outcome Measure: Fecal fat excretion. Statistical Analyses Performed: Differences in fat excretion, when each subject received EC-high-buffered pancrelipase vs EC-nonbuffered enzymes, were compared using linear modeling. Results: Mean fat excretion decreased significantly in each subject during periods when given EC-high-buffered pancrelipase compared with periods when given EC-nonbuffered enzymes (fat excretion 18.2% vs 24.9% or fat absorption 81.8% vs 75.1%, respectively; P=0.01). Thirteen of 18 subjects (72%) excreted less fat when receiving EC-high-buffered pancrelipase whereas 10 (56%) decreased fat excretion by more than 5%, and five subjects did not respond. Conclusions: EC-high-buffered pancrelipase decreased fat excretion, symbolizing improved fat absorption, when compared with EC-nonbuffered pancreatic enzymes given at equivalent, reduced (approximately 50% of usual) lipase doses in nourished subjects with cystic fibrosis and mild pulmonary disease.

Original languageEnglish
Pages (from-to)1181-1186
Number of pages6
JournalJournal of the American Dietetic Association
Volume106
Issue number8
DOIs
StatePublished - Aug 2006
Externally publishedYes

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Pancrelipase
steatorrhea
Steatorrhea
cystic fibrosis
Cystic Fibrosis
Fats
Prospective Studies
lipids
excretion
Enzymes
enzymes
Lipase
dosage
Carmine
Exocrine Pancreatic Insufficiency
balance studies
Bicarbonates
Microspheres
bicarbonates
Cross-Over Studies

ASJC Scopus subject areas

  • Food Science
  • Medicine(all)

Cite this

{A figure is presented}An Enteric-Coated High-Buffered Pancrelipase Reduces Steatorrhea in Patients with Cystic Fibrosis : A Prospective, Randomized Study. / Brady, Mary Sue; Garson, Jennifer L.; Krug, Susan K.; Kaul, Ajay; Rickard, Karyl A.; Caffrey, Helena Hoen; Fineberg, Naomi; Balistreri, William F.; Stevens, John.

In: Journal of the American Dietetic Association, Vol. 106, No. 8, 08.2006, p. 1181-1186.

Research output: Contribution to journalArticle

Brady, Mary Sue ; Garson, Jennifer L. ; Krug, Susan K. ; Kaul, Ajay ; Rickard, Karyl A. ; Caffrey, Helena Hoen ; Fineberg, Naomi ; Balistreri, William F. ; Stevens, John. / {A figure is presented}An Enteric-Coated High-Buffered Pancrelipase Reduces Steatorrhea in Patients with Cystic Fibrosis : A Prospective, Randomized Study. In: Journal of the American Dietetic Association. 2006 ; Vol. 106, No. 8. pp. 1181-1186.
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title = "{A figure is presented}An Enteric-Coated High-Buffered Pancrelipase Reduces Steatorrhea in Patients with Cystic Fibrosis: A Prospective, Randomized Study",
abstract = "Objective: Enteric-coated (EC) high-buffered (2.5 mEq [2.5 mmol] bicarbonate per capsule) pancrelipase microsphere enzymes were compared to EC-nonbuffered pancreatic enzymes for efficacy in reducing steatorrhea in patients with cystic fibrosis. Design: Prospective, randomized, controlled trial using a crossover design with each subject as his/her own control. Subjects/Setting: Eighteen subjects with cystic fibrosis, who had pancreatic insufficiency and required large enzyme doses, were studied over two consecutive 7-day treatment periods. Intervention: Each 7-day period consisted of 3 days at home followed by 4 days in a general clinical research center for careful control of diets, enzyme lipase doses (given at approximately 50{\%} of the subject's usual lipase dose), and carmine red-labeled stool collections for 72-hour fecal fat balance studies. Main Outcome Measure: Fecal fat excretion. Statistical Analyses Performed: Differences in fat excretion, when each subject received EC-high-buffered pancrelipase vs EC-nonbuffered enzymes, were compared using linear modeling. Results: Mean fat excretion decreased significantly in each subject during periods when given EC-high-buffered pancrelipase compared with periods when given EC-nonbuffered enzymes (fat excretion 18.2{\%} vs 24.9{\%} or fat absorption 81.8{\%} vs 75.1{\%}, respectively; P=0.01). Thirteen of 18 subjects (72{\%}) excreted less fat when receiving EC-high-buffered pancrelipase whereas 10 (56{\%}) decreased fat excretion by more than 5{\%}, and five subjects did not respond. Conclusions: EC-high-buffered pancrelipase decreased fat excretion, symbolizing improved fat absorption, when compared with EC-nonbuffered pancreatic enzymes given at equivalent, reduced (approximately 50{\%} of usual) lipase doses in nourished subjects with cystic fibrosis and mild pulmonary disease.",
author = "Brady, {Mary Sue} and Garson, {Jennifer L.} and Krug, {Susan K.} and Ajay Kaul and Rickard, {Karyl A.} and Caffrey, {Helena Hoen} and Naomi Fineberg and Balistreri, {William F.} and John Stevens",
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AU - Garson, Jennifer L.

AU - Krug, Susan K.

AU - Kaul, Ajay

AU - Rickard, Karyl A.

AU - Caffrey, Helena Hoen

AU - Fineberg, Naomi

AU - Balistreri, William F.

AU - Stevens, John

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N2 - Objective: Enteric-coated (EC) high-buffered (2.5 mEq [2.5 mmol] bicarbonate per capsule) pancrelipase microsphere enzymes were compared to EC-nonbuffered pancreatic enzymes for efficacy in reducing steatorrhea in patients with cystic fibrosis. Design: Prospective, randomized, controlled trial using a crossover design with each subject as his/her own control. Subjects/Setting: Eighteen subjects with cystic fibrosis, who had pancreatic insufficiency and required large enzyme doses, were studied over two consecutive 7-day treatment periods. Intervention: Each 7-day period consisted of 3 days at home followed by 4 days in a general clinical research center for careful control of diets, enzyme lipase doses (given at approximately 50% of the subject's usual lipase dose), and carmine red-labeled stool collections for 72-hour fecal fat balance studies. Main Outcome Measure: Fecal fat excretion. Statistical Analyses Performed: Differences in fat excretion, when each subject received EC-high-buffered pancrelipase vs EC-nonbuffered enzymes, were compared using linear modeling. Results: Mean fat excretion decreased significantly in each subject during periods when given EC-high-buffered pancrelipase compared with periods when given EC-nonbuffered enzymes (fat excretion 18.2% vs 24.9% or fat absorption 81.8% vs 75.1%, respectively; P=0.01). Thirteen of 18 subjects (72%) excreted less fat when receiving EC-high-buffered pancrelipase whereas 10 (56%) decreased fat excretion by more than 5%, and five subjects did not respond. Conclusions: EC-high-buffered pancrelipase decreased fat excretion, symbolizing improved fat absorption, when compared with EC-nonbuffered pancreatic enzymes given at equivalent, reduced (approximately 50% of usual) lipase doses in nourished subjects with cystic fibrosis and mild pulmonary disease.

AB - Objective: Enteric-coated (EC) high-buffered (2.5 mEq [2.5 mmol] bicarbonate per capsule) pancrelipase microsphere enzymes were compared to EC-nonbuffered pancreatic enzymes for efficacy in reducing steatorrhea in patients with cystic fibrosis. Design: Prospective, randomized, controlled trial using a crossover design with each subject as his/her own control. Subjects/Setting: Eighteen subjects with cystic fibrosis, who had pancreatic insufficiency and required large enzyme doses, were studied over two consecutive 7-day treatment periods. Intervention: Each 7-day period consisted of 3 days at home followed by 4 days in a general clinical research center for careful control of diets, enzyme lipase doses (given at approximately 50% of the subject's usual lipase dose), and carmine red-labeled stool collections for 72-hour fecal fat balance studies. Main Outcome Measure: Fecal fat excretion. Statistical Analyses Performed: Differences in fat excretion, when each subject received EC-high-buffered pancrelipase vs EC-nonbuffered enzymes, were compared using linear modeling. Results: Mean fat excretion decreased significantly in each subject during periods when given EC-high-buffered pancrelipase compared with periods when given EC-nonbuffered enzymes (fat excretion 18.2% vs 24.9% or fat absorption 81.8% vs 75.1%, respectively; P=0.01). Thirteen of 18 subjects (72%) excreted less fat when receiving EC-high-buffered pancrelipase whereas 10 (56%) decreased fat excretion by more than 5%, and five subjects did not respond. Conclusions: EC-high-buffered pancrelipase decreased fat excretion, symbolizing improved fat absorption, when compared with EC-nonbuffered pancreatic enzymes given at equivalent, reduced (approximately 50% of usual) lipase doses in nourished subjects with cystic fibrosis and mild pulmonary disease.

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