Study design (if review, criteria of inclusion for studies)
Systematic review of RCTs
Participants
Patients with exocrine pancreatic insufficiency.
Interventions
Pancreatic enzyme supplements
Outcome measures
Coefficient of fat absorption, diarrhoea and adverse events.
Main results
A total of 12 manuscripts met inclusion criteria. Most studies (10/12) compared pancreatic enzyme supplements that used different delivery systems, while using similar quantities of enzymes. These studies found no consistent difference in fat malabsorption or gastrointestinal symptoms between different active treatments. Two small placebo-controlled trials (n = 65 patients) demonstrate that pancreatic enzyme supplements are superior to placebo for fat absorption. Data are inadequate to determine if pancreatic enzyme supplements lead to weight gain or improvement in diarrhoea.
Authors' conclusions
Based on data from randomized cross-over trials, pancreatic enzyme supplements appear to improve fat malabsorption. No specific branded product or specific delivery system is superior for treatment of fat malabsorption in patients with exocrine pancreatic insufficiency.