Exocrine Pancreatic Insufficiency

Key clinical point: Patients who experience malabsorption with sorafenib treatment may develop exocrine pancreatic insufficiency (EPI); supplementation with pancreatic enzymes may benefit these patients.

Major finding: Two patients had moderate and 6 patients had severe pancreatic insufficiency. Six patients who developed EPI received pancreatic enzymes and recovered from the malabsorption symptoms within 1 month. The fecal elastase values recovered in 5 of 6 patients who received pancreatic enzymes.

Study details: A prospective study of 21 patients with hepatocellular carcinoma treated with sorafenib who developed malabsorption.

Disclosures: No study sponsor was identified. The authors received speaker fees and grants outside the study work.

Citation: Díaz-González A et al. J Clin Gastroenterol. 2021 Mar 1. doi: 10.1097/MCG.0000000000001366.

Key clinical point: Patients who experience malabsorption with sorafenib treatment may develop exocrine pancreatic insufficiency (EPI); supplementation with pancreatic enzymes may benefit these patients.

Major finding: Two patients had moderate and 6 patients had severe pancreatic insufficiency. Six patients who developed EPI received pancreatic enzymes and recovered from the malabsorption symptoms within 1 month. The fecal elastase values recovered in 5 of 6 patients who received pancreatic enzymes.

Study details: A prospective study of 21 patients with hepatocellular carcinoma treated with sorafenib who developed malabsorption.

Disclosures: No study sponsor was identified. The authors received speaker fees and grants outside the study work.

Citation: Díaz-González A et al. J Clin Gastroenterol. 2021 Mar 1. doi: 10.1097/MCG.0000000000001366.

Key clinical point: Patients who experience malabsorption with sorafenib treatment may develop exocrine pancreatic insufficiency (EPI); supplementation with pancreatic enzymes may benefit these patients.

Major finding: Two patients had moderate and 6 patients had severe pancreatic insufficiency. Six patients who developed EPI received pancreatic enzymes and recovered from the malabsorption symptoms within 1 month. The fecal elastase values recovered in 5 of 6 patients who received pancreatic enzymes.

Study details: A prospective study of 21 patients with hepatocellular carcinoma treated with sorafenib who developed malabsorption.

Disclosures: No study sponsor was identified. The authors received speaker fees and grants outside the study work.

Citation: Díaz-González A et al. J Clin Gastroenterol. 2021 Mar 1. doi: 10.1097/MCG.0000000000001366.

Key clinical point: Exocrine pancreatic insufficiency is a feature of type 1 diabetes (T1D). Lower levels of fecal elastase-1 and amylase are reported in patients with T1D vs. healthy individuals.

Major finding: Compared with healthy individuals, fecal elastase-1 levels were significantly lower in participants with new-onset and long-standing T1D (P = .0070 and .0010, respectively). Pancreatic amylase levels were significantly lower in patients with long-standing T1D vs. healthy individuals (P = .0001). The markers of impaired exocrine function tests (fecal elastase-1, serum pancreatic amylase, and lipase) correlated with the reduction of fasting and urinary C-peptide (all P less than .001).

Study details: A single-center, cross-sectional study of pancreatic exocrine function in adult patients with new-onset T1D (n = 12) or long-standing T1D (n = 19) and healthy individuals (n = 25).

Disclosures: This study was supported by a grant received by Battaglia M from the Italian Diabetes Society (SID) Research Foundation SID.

Citation: Dozio N et al. BMJ Open Diab Res Care. 2021 Feb. doi: 10.1136/bmjdrc-2019-001158.

Key clinical point: Exocrine pancreatic insufficiency is a feature of type 1 diabetes (T1D). Lower levels of fecal elastase-1 and amylase are reported in patients with T1D vs. healthy individuals.

Major finding: Compared with healthy individuals, fecal elastase-1 levels were significantly lower in participants with new-onset and long-standing T1D (P = .0070 and .0010, respectively). Pancreatic amylase levels were significantly lower in patients with long-standing T1D vs. healthy individuals (P = .0001). The markers of impaired exocrine function tests (fecal elastase-1, serum pancreatic amylase, and lipase) correlated with the reduction of fasting and urinary C-peptide (all P less than .001).

Study details: A single-center, cross-sectional study of pancreatic exocrine function in adult patients with new-onset T1D (n = 12) or long-standing T1D (n = 19) and healthy individuals (n = 25).

Disclosures: This study was supported by a grant received by Battaglia M from the Italian Diabetes Society (SID) Research Foundation SID.

Citation: Dozio N et al. BMJ Open Diab Res Care. 2021 Feb. doi: 10.1136/bmjdrc-2019-001158.

Key clinical point: Exocrine pancreatic insufficiency is a feature of type 1 diabetes (T1D). Lower levels of fecal elastase-1 and amylase are reported in patients with T1D vs. healthy individuals.

Major finding: Compared with healthy individuals, fecal elastase-1 levels were significantly lower in participants with new-onset and long-standing T1D (P = .0070 and .0010, respectively). Pancreatic amylase levels were significantly lower in patients with long-standing T1D vs. healthy individuals (P = .0001). The markers of impaired exocrine function tests (fecal elastase-1, serum pancreatic amylase, and lipase) correlated with the reduction of fasting and urinary C-peptide (all P less than .001).

Study details: A single-center, cross-sectional study of pancreatic exocrine function in adult patients with new-onset T1D (n = 12) or long-standing T1D (n = 19) and healthy individuals (n = 25).

Disclosures: This study was supported by a grant received by Battaglia M from the Italian Diabetes Society (SID) Research Foundation SID.

Citation: Dozio N et al. BMJ Open Diab Res Care. 2021 Feb. doi: 10.1136/bmjdrc-2019-001158.

Key clinical point: Exocrine pancreatic insufficiency (EPI) is common in patients with gastroenteropancreatic neuroendocrine neoplasia (NEN) receiving somatostatin analogs. Pancreatic enzyme replacement therapy (PERT) is justified in patients experiencing EPI symptoms.

Major findings: Studies have reported an EPI prevalence of 20% to 38% in patients with NEN receiving somatostatin analogs. Its symptoms overlap with clinical features of tumor and common side effects of somatostatin analogs. EPI can be diagnosed with noninvasive fecal elastase-1 test and is easy to treat using PERT. However, there is a general lack of awareness about EPI and PERT. A multidisciplinary team of gastroenterologists and nutritionists can increase the odds of providing the best care.

Study details: An editorial on EPI in patients with NEN receiving somatostatin analogs.

Disclosures: No specific funding was identified for this editorial. Panzuto F received speaker honoraria from Mylan Italia.

Source: Panzuto F et al. Expert Opin Drug Saf. 2021 Feb 2. doi: 10.1080/14740338.2021.1881478.

Key clinical point: Exocrine pancreatic insufficiency (EPI) is common in patients with gastroenteropancreatic neuroendocrine neoplasia (NEN) receiving somatostatin analogs. Pancreatic enzyme replacement therapy (PERT) is justified in patients experiencing EPI symptoms.

Major findings: Studies have reported an EPI prevalence of 20% to 38% in patients with NEN receiving somatostatin analogs. Its symptoms overlap with clinical features of tumor and common side effects of somatostatin analogs. EPI can be diagnosed with noninvasive fecal elastase-1 test and is easy to treat using PERT. However, there is a general lack of awareness about EPI and PERT. A multidisciplinary team of gastroenterologists and nutritionists can increase the odds of providing the best care.

Study details: An editorial on EPI in patients with NEN receiving somatostatin analogs.

Disclosures: No specific funding was identified for this editorial. Panzuto F received speaker honoraria from Mylan Italia.

Source: Panzuto F et al. Expert Opin Drug Saf. 2021 Feb 2. doi: 10.1080/14740338.2021.1881478.

Key clinical point: Exocrine pancreatic insufficiency (EPI) is common in patients with gastroenteropancreatic neuroendocrine neoplasia (NEN) receiving somatostatin analogs. Pancreatic enzyme replacement therapy (PERT) is justified in patients experiencing EPI symptoms.

Major findings: Studies have reported an EPI prevalence of 20% to 38% in patients with NEN receiving somatostatin analogs. Its symptoms overlap with clinical features of tumor and common side effects of somatostatin analogs. EPI can be diagnosed with noninvasive fecal elastase-1 test and is easy to treat using PERT. However, there is a general lack of awareness about EPI and PERT. A multidisciplinary team of gastroenterologists and nutritionists can increase the odds of providing the best care.

Study details: An editorial on EPI in patients with NEN receiving somatostatin analogs.

Disclosures: No specific funding was identified for this editorial. Panzuto F received speaker honoraria from Mylan Italia.

Source: Panzuto F et al. Expert Opin Drug Saf. 2021 Feb 2. doi: 10.1080/14740338.2021.1881478.

Key clinical point: Pancrelipase improves stool consistency and frequency and coefficient of fat absorption (CFA) in patients with chronic pancreatitis with moderate to severe exocrine pancreatic insufficiency (EPI).

Major finding: Higher number of patients reported decreased stool frequency at week 1 with pancrelipase vs. placebo (72% vs. 38%; P less than .001). Mean change in CFA from baseline was significantly greater with pancrelipase vs. placebo (24.7% vs. 6.4%; P less than .001). Improvements in stool consistency (P = .03) and frequency (P less than .001) correlated with CFA improvement. Symptom improvements persisted over 52 weeks of treatment.

Study details: A pooled study of 2 randomized double-blind trials including patients with chronic pancreatitis and EPI, who received either pancrelipase (n = 59) or placebo (n = 57). Thirty-four patients received open-label pancrelipase treatment for 51 weeks in another trial.

Disclosures: The editorial support for this study was funded by AbbVie. The authors reported no conflicts of interest.

Source: Barkin JA et al. Pancreas. 2021 Feb 1. doi: 10.1097/MPA.0000000000001733.

Key clinical point: Pancrelipase improves stool consistency and frequency and coefficient of fat absorption (CFA) in patients with chronic pancreatitis with moderate to severe exocrine pancreatic insufficiency (EPI).

Major finding: Higher number of patients reported decreased stool frequency at week 1 with pancrelipase vs. placebo (72% vs. 38%; P less than .001). Mean change in CFA from baseline was significantly greater with pancrelipase vs. placebo (24.7% vs. 6.4%; P less than .001). Improvements in stool consistency (P = .03) and frequency (P less than .001) correlated with CFA improvement. Symptom improvements persisted over 52 weeks of treatment.

Study details: A pooled study of 2 randomized double-blind trials including patients with chronic pancreatitis and EPI, who received either pancrelipase (n = 59) or placebo (n = 57). Thirty-four patients received open-label pancrelipase treatment for 51 weeks in another trial.

Disclosures: The editorial support for this study was funded by AbbVie. The authors reported no conflicts of interest.

Source: Barkin JA et al. Pancreas. 2021 Feb 1. doi: 10.1097/MPA.0000000000001733.

Key clinical point: Pancrelipase improves stool consistency and frequency and coefficient of fat absorption (CFA) in patients with chronic pancreatitis with moderate to severe exocrine pancreatic insufficiency (EPI).

Major finding: Higher number of patients reported decreased stool frequency at week 1 with pancrelipase vs. placebo (72% vs. 38%; P less than .001). Mean change in CFA from baseline was significantly greater with pancrelipase vs. placebo (24.7% vs. 6.4%; P less than .001). Improvements in stool consistency (P = .03) and frequency (P less than .001) correlated with CFA improvement. Symptom improvements persisted over 52 weeks of treatment.

Study details: A pooled study of 2 randomized double-blind trials including patients with chronic pancreatitis and EPI, who received either pancrelipase (n = 59) or placebo (n = 57). Thirty-four patients received open-label pancrelipase treatment for 51 weeks in another trial.

Disclosures: The editorial support for this study was funded by AbbVie. The authors reported no conflicts of interest.

Source: Barkin JA et al. Pancreas. 2021 Feb 1. doi: 10.1097/MPA.0000000000001733.