Pancreatic enzyme replacement therapy for people with cystic fibrosis

Usha Rani Somaraju; Arturo Solis‐Moya

doi:10.1002/14651858.CD008227.pub2

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Figure 1

Forest plot of comparison: 2 ECM versus ECT, outcome: 2.2 Stool frequency [number/day].

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Figure 2

Forest plot of comparison: 2 ECM versus ECT, outcome: 2.3 Abdominal pain [% days].

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Figure 3

Forest plot of comparison: 2 ECM versus ECT, outcome: 2.4 FFE [g/day].

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Analysis 1.1

Comparison 1 ECM versus NECT + adjuvant cimetidine, Outcome 1 Change in weight.

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Analysis 1.2

Comparison 1 ECM versus NECT + adjuvant cimetidine, Outcome 2 Stool frequency.

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Analysis 1.3

Comparison 1 ECM versus NECT + adjuvant cimetidine, Outcome 3 Abdominal pain.

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Analysis 1.4

Comparison 1 ECM versus NECT + adjuvant cimetidine, Outcome 4 FFE.

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Analysis 2.1

Comparison 2 ECM versus ECT, Outcome 1 Change in weight.

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Analysis 2.2

Comparison 2 ECM versus ECT, Outcome 2 Stool frequency.

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Analysis 2.3

Comparison 2 ECM versus ECT, Outcome 3 Abdominal pain.

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Analysis 2.4

Comparison 2 ECM versus ECT, Outcome 4 FFE.

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Analysis 3.1

Comparison 3 ECM versus ECMM, Outcome 1 FFE.

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Analysis 4.1

Comparison 4 Creon® versus Pancrease®, Outcome 1 Co‐efficient of fat absorption.

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Analysis 5.1

Comparison 5 ECM versus TPE, Outcome 1 FFE.

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Table 1. Glossary of terms

Term/abbreviation	Definition
BMI	body mass index
CF	cystic fibrosis
CFA	coefficient of fat absorption
chyme	the semi‐fluid mass of partly digested food expelled by the stomach into the duodenum
DIOS	distal intestinal obstruction syndrome
ECM	enteric coated microspheres
FFE	faecal fat excretion
hyperuricaemia	an excess of uric acid in the blood
hyperuricosuria	the presence of excessive amounts of uric acid in the urine
Ileocecum	the combined ileum (end of the small intestine) and cecum (start of the large intestine)
NECM	non‐enteric coated microspheres
PERT	pancreatic enzyme replacement therapy
PI	pancreatic insufficiency
porcine	relating to or suggesting swine (pigs)
RCT	randomised controlled trial
steatorrhoea	loss of fat in the stools

Table 1. Glossary of terms

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Comparison 1. ECM versus NECT + adjuvant cimetidine

Outcome or subgroup title	No. of studies	No. of participants	Statistical method	Effect size
1 Change in weight Show forest plot	1		Mean Difference (IV, Fixed, 95% CI)	Totals not selected

1.1 At 1 month	1		Mean Difference (IV, Fixed, 95% CI)	0.0 [0.0, 0.0]
2 Stool frequency Show forest plot	1		Mean Difference (IV, Fixed, 95% CI)	Totals not selected

2.1 At 1 month	1		Mean Difference (IV, Fixed, 95% CI)	0.0 [0.0, 0.0]
3 Abdominal pain Show forest plot	1		Mean Difference (IV, Fixed, 95% CI)	Totals not selected

3.1 At 1 month	1		Mean Difference (IV, Fixed, 95% CI)	0.0 [0.0, 0.0]
4 FFE Show forest plot	1		Mean Difference (IV, Fixed, 95% CI)	Totals not selected

4.1 At 1 month	1		Mean Difference (IV, Fixed, 95% CI)	0.0 [0.0, 0.0]

Comparison 1. ECM versus NECT + adjuvant cimetidine

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Comparison 2. ECM versus ECT

Outcome or subgroup title	No. of studies	No. of participants	Statistical method	Effect size
1 Change in weight Show forest plot	2		Mean Difference (IV, Fixed, 95% CI)	Subtotals only

1.1 At 1 month	2	82	Mean Difference (IV, Fixed, 95% CI)	0.32 [‐0.03, 0.67]
2 Stool frequency Show forest plot	2		Mean Difference (IV, Fixed, 95% CI)	Subtotals only

2.1 At 1 month	2	82	Mean Difference (IV, Fixed, 95% CI)	‐0.58 [‐0.85, ‐0.30]
3 Abdominal pain Show forest plot	2		Mean Difference (IV, Fixed, 95% CI)	Subtotals only

3.1 At 1 month	2	82	Mean Difference (IV, Fixed, 95% CI)	‐7.96 [‐12.97, ‐2.94]
4 FFE Show forest plot	2		Mean Difference (IV, Fixed, 95% CI)	Subtotals only

4.1 At 1 month	2	66	Mean Difference (IV, Fixed, 95% CI)	‐11.79 [‐17.42, ‐6.15]

Comparison 2. ECM versus ECT

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Comparison 3. ECM versus ECMM

Outcome or subgroup title	No. of studies	No. of participants	Statistical method	Effect size
1 FFE Show forest plot	1		Mean Difference (IV, Fixed, 95% CI)	Totals not selected

1.1 At 1 month	1		Mean Difference (IV, Fixed, 95% CI)	0.0 [0.0, 0.0]

Comparison 3. ECM versus ECMM

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Comparison 4. Creon® versus Pancrease®

Outcome or subgroup title	No. of studies	No. of participants	Statistical method	Effect size
1 Co‐efficient of fat absorption Show forest plot	1		Mean Difference (IV, Fixed, 95% CI)	Totals not selected

1.1 At 1 month	1		Mean Difference (IV, Fixed, 95% CI)	0.0 [0.0, 0.0]

Comparison 4. Creon® versus Pancrease®

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Comparison 5. ECM versus TPE

Outcome or subgroup title	No. of studies	No. of participants	Statistical method	Effect size
1 FFE Show forest plot	1		Mean Difference (IV, Fixed, 95% CI)	Totals not selected

1.1 At 1 month	1		Mean Difference (IV, Fixed, 95% CI)	0.0 [0.0, 0.0]

Comparison 5. ECM versus TPE

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