Cystic Fibrosis Clinical Trial
Official title:
A Randomized, Double-Blind, Placebo-Controlled, Multi-Center, Crossover Study to Evaluate the Effectiveness and Safety of PANCRECARB® MS-16 (Pancrelipase) in Reducing Steatorrhea in Children and Adults With Cystic Fibrosis
The primary objective of this study is to determine if PANCRECARB® MS-16 (pancrelipase) is safe and effective in reducing steatorrhea (as measured by 72-hour stool fat determinations) in children and adults with cystic fibrosis and pancreatic insufficiency.
Pancreatic insufficiency (PI) is a common pathologic condition that occurs in approximately
90% of patients with cystic fibrosis (CF). Pancreatic insufficiency is characterized by both
pancreatic enzyme and bicarbonate insufficiencies. Consequently, maldigestion occurs and a
variety of essential nutrients are lost through the stools, especially fat and fat soluble
vitamins. As a result, patients often experience growth failure and malnutrition. Effective
correction of maldigestion is critical to the survival and well-being of these patients.
Several strengths of PANCRECARB® (pancrelipase) (i.e., MS4, MS8, MS16) have been available
and used by patients with CF for more than a decade. The digestive enzymes in PANCRECARB®
(pancrelipase) act locally in the gastrointestinal tract. The active enzymes hydrolyze fats
into glycerol and fatty acids, proteins into peptides and amino acids, and starches into
dextrins and maltose. PANCRECARB® (pancrelipase) has the potential to promote increased
lipase activity with efficient fat digestion. Efficient fat digestion is important in CF
because it may lead to improved nutritional and pulmonary status and ultimately to improved
quality of life and enhanced survival.
PANCRECARB® MS-8 (pancrelipase) has been compared to enteric-coated pancreatic enzymes
without bicarbonate for its efficacy in reducing steatorrhea in patients with CF.
Differences in fat excretion, when subjects received PANCRECARB® MS-8 (pancrelipase) versus
enteric-coated enzymes without bicarbonate, were compared using linear modeling. Mean fat
excretion decreased significantly in subjects who received PANCRECARB® MS-8 (pancrelipase)
compared to enteric-coated enzymes without bicarbonate.
This study has been designed in accordance with FDA 2006 guideline on exocrine pancreatic
insufficiency drug products. Assuming that the results of this study demonstrate that
therapy with PANCRECARB® MS-16 (pancrelipase) results in clinically and statistically
significant improvement in fat absorption relative to placebo in subjects with CF and
pancreatic insufficiency, the study results will be part of a submission for marketing
approval of PANCRECARB® (pancrelipase).
The study consists of two treatment periods with 72-hour stool collections separated by a
washout period. Study subjects will be required to consume a diet high in fat content.
;
Allocation: Randomized, Endpoint Classification: Safety/Efficacy Study, Intervention Model: Crossover Assignment, Masking: Double Blind (Subject, Caregiver, Investigator, Outcomes Assessor), Primary Purpose: Treatment
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