welcome to oneFAPvoice
- a positively charged Familial Adenomatous Polyposis community.- join today!
- login
Efficacy of pancreatic enzyme replacement therapy in chronic pancreatitis: systematic review and meta-analysis
source: Gut
year: 2017
authors: Cameron G, Donaldson K, Jones G, Lancaster J, Lucas A, Manby K, McLaren T, Rodgers C, Rodgers J, Swindlehurst W, Symon N, Warrington D, Whitby M.
summary/abstract:Objective The benefits of pancreatic enzyme replacement therapy (PERT) in chronic pancreatitis (CP) are inadequately defined. We have undertaken a systematic review and meta-analysis of randomised controlled trials of PERT to determine the efficacy of PERT in exocrine pancreatic insufficiency (EPI) from CP.
Design Major databases were searched from 1966 to 2015 inclusive. The primary outcome was coefficient of fat absorption (CFA). Effects of PERT versus baseline and versus placebo, and of different doses, formulations and schedules were determined.
Results A total of 17 studies (511 patients with CP) were included and assessed qualitatively (Jadad score). Quantitative data were synthesised from 14 studies. PERT improved CFA compared with baseline (83.7±6.0 vs 63.1±15.0, p<0.00001; I2=89%) and placebo (83.2±5.5 vs 67.4±7.0, p=0.0001; I2=86%). PERT improved coefficient of nitrogen absorption, reduced faecal fat excretion, faecal nitrogen excretion, faecal weight and abdominal pain, without significant adverse events. Follow-up studies demonstrated that PERT increased serum nutritional parameters, improved GI symptoms and quality of life without significant adverse events. High-dose or enteric-coated enzymes showed a trend to greater effectiveness than low-dose or non-coated comparisons, respectively. Subgroup, sensitive and meta-regression analyses revealed that sample size, CP diagnostic criteria, study design and enzyme dose contributed to heterogeneity; data on health inequalities were lacking.
DOI: 10.1136/gutjnl-2016-312529
read more full text source
expertly curated content related to this topic
-
Summer’s Complaint: My family’s courageous, century-long struggle with a rare genetic cancer syndromeFamilial Adenomatous Polyposis, or FAP, ...
-
Enhanced Recovery Protocol for Colectomy Patients Reduced Hospital StayMultihospital collaboration and implemen...
-
APC Mutations are Associated with Increased Bone Mineral Density in Patients with Familial Adenomatous PolyposisThe canonical Wnt pathway plays a key re...
-
An F.A.P.: Introducing My Desmoid Debaclehttps://www.youtube.com/watch?v=nZn1Pa5V...
-
daniel shockley’s storyShockley wants to spread the information...
-
A Unique Variant of Afferent Limb Syndrome After Ileal Pouch-Anal Anastomosis: A Case Series and Review of the Liter...BACKGROUND: Afferent limb syndrome is a...