Contribution of pancreatic enzyme replacement therapy to survival and quality of life in patients with pancreatic exocrine insufficiency.

Publisher: Baishideng Publishing Group Country of Publication: United States NLM ID: 100883448 Publication Model: Print Cited Medium: Internet ISSN: 2219-2840 (Electronic) Linking ISSN: 10079327 NLM ISO Abbreviation: World J Gastroenterol Subsets: MEDLINE

Publication: 2014- : Pleasanton, CA : Baishideng Publishing Group
Original Publication: Beijing : WJG Press, c1998-

Quality of Life*; Enzyme Replacement Therapy/*methods ; Evidence-Based Medicine/*methods ; Exocrine Pancreatic Insufficiency/*therapy ; Malnutrition/*drug therapy; Exocrine Pancreatic Insufficiency/complications ; Exocrine Pancreatic Insufficiency/mortality ; Humans ; Malnutrition/etiology ; Malnutrition/mortality ; Pancreas/pathology ; Time Factors ; Treatment Outcome

The objective of this study was to analyze the current evidence for the use of pancreatic enzyme replacement therapy (PERT) in affecting survival and quality of life in patients with pancreatic exocrine insufficiency (PEI). Systematic searches of the literature were performed using the PubMed database. Articles were selected for inclusion if they reported findings from trials assessing the effects of PERT on quality of life, survival, malabsorption, growth parameters (such as height, body weight and body mass index), or gastrointestinal symptoms (such as abdominal pain, stool consistency and flatulence). PERT improved PEI-related malabsorption and weight maintenance in patients with cystic fibrosis, chronic pancreatitis, pancreatic cancer, and post-surgical states. In patients with chronic pancreatitis, PERT improved PEI-related symptoms and quality of life measures. Several small retrospective studies have also suggested that PERT may have a positive impact on survival, but long-term studies assessing this effect were not identified. PERT is effective for treating malnutrition and supporting weight maintenance, and it is associated with improved quality of life and possibly with enhanced survival in patients with PEI. However, there is evidence that not all patients with PEI receive adequate PERT. Future work should aim to assess the long-term effects of PERT on the survival of patients with PEI.
Competing Interests: Conflict-of-interest statement: Layer P has participated in consulting and speaking activities for Abbott Laboratories Ltd, Allergan plc, Almirall, Dr. Falk Pharma GmbH, Nordmark Arzneimittel GmbH & Co. KG and Shire. Kashirskaya N has participated in consulting and speaking activities for Abbott Laboratories Ltd, Chiesi Pharmaceuticals B.V., Pharmaxis Ltd, PRO.MED.CS Praha a.s., Nordmark Arzneimittel GmbH & Co. KG. Gubergrits N has no relevant conflicts of interest to be declared.

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Keywords: Chronic pancreatitis; Cystic fibrosis; Malabsorption; Pancreatic cancer; Pancreatic enzyme replacement therapy; Pancreatic exocrine insufficiency; Post-surgical states; Quality of life; Survival

Date Created: 20190608 Date Completed: 20191213 Latest Revision: 20200225

20231215

PMC6543241

10.3748/wjg.v25.i20.2430

31171887