Year 2017 / Volume 109 / Number 10
Original
Pancreatic enzyme replacement therapy in cystic fibrosis: dose, variability and coefficient of fat absorption

684-689

DOI: 10.17235/reed.2017.4951/2017

Joaquim Calvo-Lerma, Sandra Martínez-Barona, Etna Masip, Victoria Fornés, Carmen Ribes-Koninckx,

Abstract
Objectives: Pancreatic enzyme replacement therapy (PERT) remains a backbone in the nutritional treatment of cystic fibrosis. Currently, there is a lack of an evidence-based tool that allows dose adjustment. To date, no studies have found an association between PERT dose and fat absorption. Therefore, the aim of the study was to assess the influence of both the PERT dose and the variability in this dose on the coefficient of fat absorption (CFA). Methods: This is a retrospective longitudinal study of 16 pediatric patients (192 food records) with three consecutive visits to the hospital over a twelve-month period. Dietary fat intake and PERT were assessed via a four-day food record and fat content in stools was determined by means of a three-day stool sample collection. A beta regression model was built to explain the association between the CFA and the interaction between the PERT dose (lipase units [LU]/g dietary fat) and the variability in the PERT dose (standard deviation [SD]). Results: The coefficient of fat absorption increased with the PERT dose when the variability in the dose was low. In contrast, even at the highest PERT dose values, the CFA decreased when the variability was high. The confidence interval suggested an association, although the analysis was not statistically significant. Conclusion: The variability in the PERT dose adjustment should be taken into consideration when performing studies on PERT efficiency. A clinical goal should be the maintenance of a constant PERT dose rather than trying to obtain an optimal value.
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Calvo-Lerma J, Martínez-Barona S, Masip E, Fornés V, Ribes-Koninckx C. Pancreatic enzyme replacement therapy in cystic fibrosis: dose, variability and coefficient of fat absorption . 4951/2017


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Publication history

Received: 13/03/2017

Accepted: 06/05/2017

Online First: 27/07/2017

Published: 29/09/2017

Article revision time: 45 days

Article Online First time: 136 days

Article editing time: 200 days


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