Konstan Michael W, Accurso Frank J, Nasr Samya Z, Ahrens Richard C, Graff Gavin R
Rainbow Babies & Children's Hospital & Case Western Reserve University School of Medicine, Cleveland, OH, USA.
Children's Hospital Colorado & University of Colorado Denver, Denver, CO, USA.
Clin Investig (Lond). 2013 Aug 1;3(8):723-729. doi: 10.4155/cli.13.62.
Pancreatic enzyme replacement therapy (PERT) is used to treat exocrine pancreatic insufficiency in cystic fibrosis.
RESULTS/METHODS: Efficacy and safety of a unique enteric-coated (EC) bicarbonate-buffered PERT product (PERTZYE/PANCRECARB; Digestive Care, Inc., Bethlehem, PA, USA) was studied in a randomized, double-blind, placebo-controlled cross-over design. Subjects were stabilized on EC-bicarbonate-buffered PERT and a high-fat diet. During two treatment periods, subjects were randomized to EC-bicarbonate-buffered PERT or placebo, followed by a 72-h stool collection employing an ingested stool dye marker. Mean coefficient of fat absorption with EC-bicarbonate-buffered PERT was 82.5% compared with 46.3% with the placebo (absolute difference 36.2%; p < 0.001), a 78.2% improvement for active over placebo. Similar improvements in nitrogen absorption were observed. Overall stool frequency and stool weight decreased (p < 0.001). No safety concerns were identified.
EC-bicarbonate-buffered PERT is effective in treating cystic fibrosis-associated exocrine pancreatic insufficiency.
胰酶替代疗法(PERT)用于治疗囊性纤维化患者的外分泌性胰腺功能不全。
结果/方法:采用随机、双盲、安慰剂对照交叉设计,对一种独特的肠溶包衣(EC)碳酸氢盐缓冲的PERT产品(PERTZYE/PANCRECARB;美国宾夕法尼亚州伯利恒市消化护理公司)的疗效和安全性进行了研究。受试者接受EC碳酸氢盐缓冲的PERT和高脂饮食治疗,病情稳定。在两个治疗期内,受试者被随机分为接受EC碳酸氢盐缓冲的PERT或安慰剂治疗,随后使用摄入的粪便染料标记物进行72小时粪便收集。与安慰剂组的46.3%相比,EC碳酸氢盐缓冲的PERT组的脂肪吸收平均系数为82.5%(绝对差异36.2%;p<0.001),活性药物组相对于安慰剂组有78.2%的改善。观察到氮吸收也有类似改善。总体粪便频率和粪便重量下降(p<0.001)。未发现安全问题。
EC碳酸氢盐缓冲的PERT对治疗囊性纤维化相关的外分泌性胰腺功能不全有效。