Original Articles

Pancreatic Enzyme Replacement Therapy in Patients With Exocrine Pancreatic Insufficiency Due to Chronic Pancreatitis

A 1-Year Disease Management Study on Symptom Control and Quality of Life

D’Haese, Jan G. MD^*; Ceyhan, Güralp O. MD^*; Demir, Ihsan Ekin MD^*; Layer, Peter MD^†; Uhl, Waldemar MD^‡; Löhr, Matthias MD^§; Rychlik, Reinhard PhD^∥; Pirilis, Konstantinos MD^¶; Zöllner, York PhD^#; Gradl, Birgit MSc^**; Foerster, Douglas MSc^**††; Möbius, Julia PhD^‡‡; Henniges, Friederike PhD^§§; Friess, Helmut MD^*

Author Information

From the *Department of Surgery, Klinikum Rechts der Isar, Technische Universität München, Munich; †Department of Internal Medicine, Israelitisches Krankenhaus, Hamburg; ‡Department of Surgery, St Josef-Hospital, Ruhr-University Bochum, Bochum, Germany; §Department of Surgical Gastroenterology, Karolinska Institutet, Stockholm, Sweden; ∥Institut für Empirische Gesundheitsökonomie, Burscheid; ¶Leibniz University, Hannover; #Hamburg University of Applied Sciences, Hamburg, Germany; **Abbott Products Operations AG, Allschwil, Switzerland; ††School of Public Health, University Bielefeld, Bielefeld; ‡‡Abbott Arzneimittel GmbH, Hannover; and §§Abbott Products, Hannover, Germany.

Received for publication August 19, 2013; accepted February 5, 2014.

Reprints: Helmut Friess, MD, Department of Surgery, Klinikum rechts der Isar, Technische Universität München, Ismaninger Str 22, 81675 Munich, Germany (e-mail: [email protected]).

Funding statement: This study was supported by Abbott Arzneimittel GmbH, formerly Solvay Arzneimittel GmbH, in Hannover, Germany.

The authors declare no conflict of interest.

Pancreas 43(6):p 834-841, August 2014. | DOI: 10.1097/MPA.0000000000000131

Abstract

Objective

Exocrine pancreatic insufficiency (EPI) is frequent in patients with chronic pancreatitis (CP). This 1-year, prospective, multicenter, observational, disease management study aimed to assess symptom improvement and quality of life in patients with CP with EPI who were receiving pancreatic enzyme replacement.

Methods

Patients with CP and chronic EPI were either assigned to cohort 1 that consisted of patients already taking pancreatin (Kreon; Abbott Arzneimittel GmbH, Hannover, Germany) or cohort 2 that consisted of patients with newly diagnosed EPI without prior pancreatic enzyme treatment. Symptoms were documented, and quality of life was assessed using the gastrointestinal quality of life index (GIQLI) at baseline, 6 months, and 1 year.

Results

A total of 294 patients were evaluated (cohort 1, n = 206; cohort 2, n = 88). The proportion of patients experiencing gastrointestinal symptoms and recurrent pain after 1 year was significantly reduced in both cohorts (P < 0.001). The alleviation of symptoms was reflected in GIQLI score improvements at 1 year in both cohorts (P < 0.001), independent of CP severity and etiology. Improvements in GIQLI score were more pronounced in cohort 2 (P < 0.001).

Conclusions

Pancreatin demonstrated symptom relief and improvement in quality of life in patients with CP-related EPI in this disease management study.

Article Keywords

Keywords
disease management research, exocrine pancreatic insufficiency, gastrointestinal quality of life index, Kreon/Creon, pancreatic enzyme replacement

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Pancreatic Enzyme Replacement Therapy in Patients With Exocrine Pancreatic Insufficiency Due to Chronic Pancreatitis

A 1-Year Disease Management Study on Symptom Control and Quality of Life