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The Effects of Oral Pancreatic Enzymes (Creon 10 Capsule) on Steatorrhea: A Multicenter, Placebo-controlled, Parallel Group Trial in Subjects With Chronic Pancreatitis

Safdi, Michael MD*; Bekal, Pradeep K. MD*; Martin, Stephen MD*; Saeed, Zahid A. MD*; Burton, Frank MD; Toskes, Phillip P. MD

doi: 10.1097/01.mpa.0000226884.32957.5e
Original Articles

Objectives: Creon 10 Minimicrospheres is an enteric-coated, delayed-release pancrelipase preparation designed to deliver active pancreatic enzymes to the small intestine. The primary objective of this study was to compare the effect of Creon 10 with placebo in the control of steatorrhea in chronic pancreatitis patients. Secondary objectives included evaluation of stool parameters and global improvement of symptoms scales.

Methods: The study was a randomized, double-blind, placebo-controlled, 2-week trial. After a placebo run-in ("washout") phase, the effect on coefficient of fat absorption (%), daily fat excretion before and after treatment, and stool frequency and consistency were assessed.

Results: In Creon 10-treated subjects, the change in mean coefficient of fat absorption (%) from run-in to double-blind phase was significantly higher compared with placebo-treated subjects (+36.7 vs. +12.1, P = 0.0185). Stool consistency improved significantly more with Creon 10 than with placebo (P = 0.0102) resulting in more subjects with formed stool; stool frequency decreased significantly more with Creon 10 than with placebo (P = 0.0015) from 10.8 during placebo run-in to 5.2 stools per day during double-blind treatment; and daily mean fat excretion in stool decreased significantly more (−56.5 vs. −11.4 g/d, P = 0.0181) in Creon 10-treated subjects compared with placebo-treated subjects. Global disease symptom scores showed greater improvement for both physicians and subjects in the Creon 10 group relative to those receiving placebo. Between treatment difference reached statistical significance for Creon 10 (P = 0.0435) for physician score and showed a trend (P = 0.0634) favoring Creon for subject score.

Conclusions: This randomized, placebo-controlled trial found that Creon 10 treatment controlled steatorrhea, as reflected in reduced fat excretion, decreased stool frequency and improved stool consistency. Creon 10 treatment was safe and well tolerated.

From the *Greater Cincinnati Gastroenterology Associates, Cincinnati, OH; †St Louis University Health and Sciences Center, St Louis, MO; and ‡University of Florida, Gainesville, FL.

Received for publication April 4, 2005; accepted March 13, 2006.

The preparation of this manuscript was supported by a grant from Solvay Pharmaceuticals, Inc, Marietta, GA.

Reprints: Michael Safdi, MD, Greater Cincinnati Gastroenterology Associates, 2925 Vernon Place, Suite 100, Cincinnati, OH 45219 (e-mail:

© 2006 Lippincott Williams & Wilkins, Inc.