EPI is a manageable condition1-3

Once you have made a diagnosis of EPI, a comprehensive management plan should include pancreatic enzyme replacement therapy (PERT) along with certain lifestyle modifications. PERT is the standard of care for EPI.

Comprehensive EPI management plan1-3

Once an EPI diagnosis has been made, there are a number of things to consider regarding a management plan.

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PERT

  • PERTs are the basis of therapy for treatment of EPI
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Lifestyle Modifications

  • Eating a well-balanced diet
  • Avoiding or limiting alcohol intake
  • Smoking cessation
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Vitamin Supplements

  • Consider vitamin supplementation, including fat-soluble vitamins A, D, E, and K

PERT is the standard of care for EPI2

PERTs help break down fats, proteins, and carbohydrates so they can be absorbed within the intestines and into the bloodstream.4

PERTs2:

  • REPLACE pancreatic enzymes in patients with EPI
  • CONTAIN lipase, amylase, and protease

Tell your EPI patients to take PERT with meals and snacks.1

When dosing PERTs, consider weight, diet, and symptoms5

According to Cystic Fibrosis Foundation guidelines, enzyme dosing should begin at 500 lipase units/kg/meal for patients ≥4 years of age.

Example of weight-based dosing of PERT5*
Patient weight Minimum dose
110 lb (49.9 kg) 24,950 lipase units/meal
160 lb (72.6 kg) 36,300 lipase units/meal
200 lb (90.7 kg) 45,350 lipase units/meal

*Always follow the prescribing information of the product you are prescribing for exact dosing information.

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46%

of adult PERT patients are started on a dose meant for a PATIENT WEIGHING <100 lb6†

†n=sample of 489,890 PERT patients observed between July 2015 and June 2017; only non-CF patients aged 20+ included; prescribed lipase units per day based on each patient’s average script size over the 2-year study period.

Source: SHS data July 2015-June 2017.

Individualize and titrate PERT dosage based on5,7:

  • Clinical symptoms
  • Fat content of the diet

Schedule a follow-up visit a few weeks after treatment initiation to discuss symptoms with your patients and assess the need for titration.

References: 1. Domínguez-Muñoz JE. Pancreatic enzyme therapy for pancreatic exocrine insufficiency. Curr Gastroenterol Rep. 2007;9(2):116-122. 2. Fieker A, Philpott J, Armand M. Enzyme replacement therapy for pancreatic insufficiency: present and future. Clin Exp Gastroenterol. 2011;4:55-73. 3. Lindkvist B. Diagnosis and treatment of pancreatic exocrine insufficiency. World J Gastroenterol. 2013;19(42):7258-7266. 4. US Food and Drug Administration. Guidance for Industry Exocrine Pancreatic Insufficiency Drug Products – Submitting NDAs. April 2006. https://www.fda.gov/downloads/Drugs/GuidanceComplianceRegulatoryInformation/Guidances/ucm071651.pdf. Accessed October 31, 2018. 5. Cystic Fibrosis Foundation. Use of Pancreatic Enzyme Supplements for Patients with Cystic Fibrosis in the Context of Fibrosing Colonopathy. Paper presented at the: Consensus Conference; March 23, 1995. Accessed August 20, 2018. 6. Data on file. AbbVie Inc. Source: SHS data (2015-2017), 2017. 7. Windsor JA. Pancreatic enzyme replacement therapy in chronic pancreatitis: a long way to go. Gut. 2017;66(8):1354-1355.