Creon (pancrelipase delayed-release) / AbbVie, Eisai - LARVOL DELTA

Visiting recognition: a palimpsest model of personhood at the threshold of death. (PubMed, Med Humanit) - "Effective care at life's threshold requires institutional support for temporal recognition. Dementia care, advance planning and genomic counselling should hold memorial, relational and anticipatory dimensions simultaneously, with recognition understood as ongoing relational work rather than one-time acknowledgement."

Journal • Alzheimer's Disease • CNS Disorders • Dementia • APOE

Towards resolving questions about PERT efficacy (NACFC 2026) - P2 | "We designed a Phase 2 trial to determine the efficacy of ANG003 compared to standard-of-care porcine pancrelipase (pPERT) and to evaluate various methods for determining efficacy... There is an opportunity to improve care for people with exocrine pancreatic insufficiency by studying and comparing PERT efficacy outcomes using both traditional and newer methods. Understanding this essential treatment should be based on the best scientific knowledge available."

Clinical • Gastrointestinal Disorder

Histopathologic and computed tomography findings in CF pigs with meconium ileus, including animals treated with pancreatic enzymes (NACFC 2026) - "CF meconium contains glycoproteins, including Muc2. Intestinal mucins present multiple O -glycan subtypes, with intestinal cells of the epithelial surface and crypts displaying distinct glycosylation patterns. CT scans of CF pigs revealed dilation occurs in the proximal small intestines and poor contrast-filling occurs during enema treatment, presumably from obstructive meconium."

Cystic Fibrosis • Gastrointestinal Disorder • Genetic Disorders • Immunology • Respiratory Diseases • MUC2 • MUC5AC

Pneumatosis Intestinalis: A Rare Complication of PEG (ACG 2026) - "A) Initial KUB Post-PEG B) Subsequent Noncontrast CT Abdomen & Pelvis C) Repeat CT Abdomen & Pelvis With Contrast Administered Through the PEG Tube. Figure: Figure 2: Pneumatosis Intestinalis Intraoperatively."

Cardiovascular • Gastroesophageal Reflux Disease • Ischemic stroke

Atypical presentation of necrotising pancreatitis in early adolescence. (PubMed, BMJ Case Rep) - "He has subsequently developed acute recurrent pancreatitis.No underlying cause for his presentation has been identified, and he is being considered for total pancreatectomy.This case highlights the importance of maintaining a broad differential diagnosis in the assessment of abdominal pain in paediatric patients. Prompt diagnosis and timely interventions are essential to reduce the risk of potentially significant consequences in NP."

Journal • Acute Kidney Injury • Diabetes • Metabolic Disorders • Nephrology • Pain • Pancreatitis • Pediatrics • Renal Disease

Impact of the pancreatic enzyme replacement therapy (PERT) shortage on prescribing in England: Analysis of national data. (PubMed, Br J Clin Pharmacol) - "Although prescribing remained highest for Creon 25 000, the shortage was associated with a shift towards Creon 10 000 and an increase in alternative products, particularly Nutrizym."

Journal • Oncology • Solid Tumor

Clinical plausibility of eggshell membrane proteins for osteoarthritis: a study of solubility, digestibility, and immune response. (PubMed, Mol Cell Biochem) - "We examined the role of disulfide-crosslinked proteins in insolubility using dithiothreitol (DTT) and evaluated digestibility of proteins by SDS-PAGE after treatment with pepsin, pancrelipase (Creon®), or sequential digestion...In PBMC assays, Biova® increased IL-6 after lipopolysaccharide stimulation, showed a non-significant TNFα reduction, and had no effect on IL-17 A or granzyme B. Together, commercial ESM supplements are largely insoluble, resistant to digestion, and show no meaningful anti-inflammatory activity in human immune cells. These findings challenge the plausibility of orally administered ESM as a therapeutic intervention for osteoarthritis."

Journal • Immunology • Osteoarthritis • Pain • Rheumatology • GZMB • IL17A • IL6 • TNFA

PERT-AP: Pancreatic Enzyme Replacement Therapy for Acute Pancreatitis-Associated Exocrine Pancreatic Insufficiency (clinicaltrials.gov) - P4 | N=30 | Recruiting | Sponsor: Ohio State University | N=60 ➔ 30 | Trial completion date: Jul 2027 ➔ Dec 2027 | Trial primary completion date: Dec 2026 ➔ Sep 2027

Enrollment change • Trial completion date • Trial primary completion date • Pancreatitis

Pancrelipase Improves Symptoms of Exocrine Pancreatic Insufficiency and Health-Related Quality of Life in a Real-World Population of Patients with Chronic Pancreatitis. (PubMed, Dig Dis Sci) - P | "Pancrelipase improved patient-reported EPI symptoms and HRQoL based on the PEI-Q, which may be a useful tool for monitoring PERT treatment in patients with chronic pancreatitis and EPI."

HEOR • Journal • Real-world evidence • Pancreatitis

Phase 2 Study to Assess the Safety and Efficacy of ANG003 (clinicaltrials.gov) - P2 | N=113 | Recruiting | Sponsor: Anagram Therapeutics, Inc. | Not yet recruiting ➔ Recruiting

Enrollment open • Cystic Fibrosis • Genetic Disorders • Immunology • Pulmonary Disease • Respiratory Diseases

Phase 2 Study to Assess the Safety and Efficacy of ANG003 (clinicaltrials.gov) - P2 | N=113 | Not yet recruiting | Sponsor: Anagram Therapeutics, Inc.

New P2 trial • Cystic Fibrosis • Genetic Disorders • Immunology • Pulmonary Disease • Respiratory Diseases

Dependency of Glucose Homeostasis on Pancreatic Enzymes with Special Reference to Amylase; Study on Healthy and Exocrine Pancreatic Insufficient Pigs. (PubMed, Biomolecules) - "In summary, glucose homeostasis mechanisms in EPI pigs were downregulated compared to healthy animals. Creon supplementation during EPI significantly increased postprandial glucose level, while amylase treatment had the opposite effect, which could be explained by its metabolic actions."

Journal

Subtype-specific roles of nigrostriatal dopaminergic neurons in motor and associative learning. (PubMed, Ageing Neurodegener Dis) - "Both Calb1 + and Aldh1a1 + nigrostriatal DANs are key regulators of movement and motor learning, with Calb1 + neurons additionally modulating reward-based associative learning. These findings highlight the functional heterogeneity of nigrostriatal DAN subtypes and identify potential therapeutic targets for addressing motor and non-motor deficits in Parkinson's disease."

Journal • CNS Disorders • Movement Disorders • Parkinson's Disease • ALDH1A1 • CALB1

Prescribing Patterns and Perceptions of Pancreatic Enzyme Replacement Therapy among Healthcare Providers: A Prospective United States Healthcare Providers Survey. (PubMed, Adv Ther) - "HCPs consider multiple factors when prescribing PERT for patients with EPI. HCP perceptions varied across PERT products, and Creon was favorably perceived more often compared to the other therapeutic options. Various factors may contribute to barriers to treatment and should be addressed to improve access."

Journal

Hormonal Therapy for Carcinoid Syndrome: A Potential Trigger for Exocrine Pancreatic Insufficiency (ACG 2025) - "A small-to-moderate left pleural effusion was also noted. While not formally described in the radiology report, imaging review revealed pancreatic atrophy and calcifications suggestive of chronic pancreatitis."

Addiction (Opioid and Alcohol) • Anemia • Carcinoid Syndrome • Endocrine Cancer • Endocrine Disorders • Genito-urinary Cancer • Hepatocellular Cancer • Neuroendocrine Carcinoma • Neuroendocrine Tumor • Pancreatic Cancer • Pancreatitis • Prostate Cancer • Respiratory Diseases • Solid Tumor • CHGA

Changes in Medicaid claims for chronic medications for cystic fibrosis (NACFC 2025) - "Background: Several published reports have described changes in chronic medications for cystic fibrosis (CF) after the initiation of elexacaftortezacaftor-ivacaftor (ETI)...Prescriptions for inhaled tobramycin were difficult to differentiate from prescriptions for IV tobramycin, so we have not yet included tobramycin in our analysis... Prescriptions for dornase alfa and inhaled aztreonam decreased after the introduction of ETI, but to a greater extent than recorded in the CFFPR (approximately 15% and 25%, respectively). These results support the use of claims data to complement CFFPR analyses and prospective studies to understand changes in chronic CF medications use after ETI. Our analysis is limited by the inability to examine only people with CF, to determine if people with CF took the medications that were prescribed, or whether changes in medications occurred via shared decision-making with the CF care team."

Medicaid • Reimbursement • US reimbursement • Cystic Fibrosis • Genetic Disorders • Immunology • Respiratory Diseases

Pancrelipase Treatment of Exocrine Pancreatic Insufficiency Due to Chronic Pancreatitis: Rationale and Methodology of a Real-World, Prospective, Observational Study. (PubMed, Pancreas) - No abstract available

Journal • Observational data • Real-world evidence • Pancreatitis

Subtype-Specific Roles of Nigrostriatal Dopaminergic Neurons in Motor and Associative Learning. (PubMed, bioRxiv) - "These findings establish Calb1 + and Aldh1a1 + nigrostriatal DANs as key regulators of movement and motor learning, with Calb1 + neurons additionally modulating reward-based associative learning. This study advances our understanding of the functional heterogeneity of nigrostriatal DAN subtypes and identifies potential therapeutic targets for addressing motor and non-motor deficits in Parkinson's disease."

Journal • CNS Disorders • Movement Disorders • Parkinson's Disease • ALDH1A1 • CALB1

Mendelian Randomization Uncovers Potential Repurposable Medications for Neuropsychiatric Disorders. (PubMed, Curr Neuropharmacol) - "MR-based drug repurposing is a promising approach for the treatment of neuropsychiatric disorders. Further validation is necessary to effectively integrate these medications into clinical practice."

Journal • Alzheimer's Disease • Cardiovascular • CNS Disorders • Dementia • Epilepsy • Hematological Disorders • Mental Retardation • Mood Disorders • Multiple Sclerosis • Psychiatry • Subarachnoid Hemorrhage

Capsules, confidence and cystic fibrosis: reflections on setting up a pill school (ECFS 2025) - "Overall, 37% (3/8) 2-3 year olds and 17% (2/12) patients 4 years transitioned to tablets or capsules after the training, with 4 patients progressing to Creon gastro-resistant capsules, and 3 patients to Kaftrio tablets as a consequence... Although the number of young children who were successfully established on tablets and capsules is modest, the training was well received by parents and children. KidzMedz provides novel structured guidance on how to swallow solid dosage forms. This is the first UK study providing pill swallowing training to patients <4 years old."

Cystic Fibrosis • Genetic Disorders • Immunology • Pediatrics • Respiratory Diseases

Current dietetic practices in managing pancreatic enzyme replacement therapy across the United Kingdom (ECFS 2025) - "Our objective was to survey current practice of PERT management in children with CF (cwCF) to better understand opportunities and challenges since the introduction of Elexacaftor/Tezacaftor/Ivacaftor (ETI). We conducted an online, anonymous survey between July-September 2024 amongst dietitians registered with The Health and Care Professions Council who are involved in the management of cwCF... There is heterogeneity in the practice of PERT management across UK CF dietitians. Evidence and guidelines are needed to support dietitians and patients in managing PERT safely in the highly effective modulator era."

Mood Disorders • Psychiatry • ELANE

A case of improved compliance with pancreatic enzyme replacement therapy in a paediatric patient, resulting in insulin therapy cessation (ECFS 2025) - "More focus in CF Diabetes reviews and at initial diagnosis of CF Diabetes on PERT in relation to managing glucose levels may be helpful in reducing insulin requirements and managing post meal blood glucose rises."

Clinical • Compliance • Diabetes • Fatigue • Hypoglycemia • Metabolic Disorders • Mood Disorders • Pediatrics • Psychiatry

Management of Pancreatic Enzyme Replacement Therapy (PERT) Shortages in a large UK Adult Cystic Fibrosis (CF) Centre: an imPERaTive approach (ECFS 2025) - "The responsive management of PERT shortages, to ensure sustained patient supplies is associated with a substantial increase in hospital drug costs and staffing time."

Clinical • Cystic Fibrosis • Genetic Disorders • Immunology • Respiratory Diseases

Regulation of glucose homeostasis by meal macronutrients and exogenous enzymes; studies on healthy and exocrine pancreatic insufficient pigs (ECFS 2025) - "We compared porcine pancrelipase (Creon), a mixture of lipase, protease, amylase and other biologically active components which is enterically coated), to pure ANG003 amylase. Eighteen pigs kept on a hight fat diet (HFD; 20%) were randomly divided to ANG003 amylase and Creon groups... In conclusion, glucose homeostasis mechanisms in EPI pigs are downregulated when compared to healthy animals. Creon appears to lower glucose utilization as compared to ANG003 microbial amylase. Both the adaptation to mixed dietary components and the type of enzymatic supplementation can positively or negatively influence glucose homeostasis."

Clinical • Diabetes • Metabolic Disorders

A comparative study of a novel microbially derived pancreatic enzymes mixture (ANG003) and porcine pancrelipase (Creon) effects on coefficient of fat absorption in exocrine pancreatic insufficient pig (ECFS 2025) - "In conclusion, ANG003, a novel broad-spectrum microbially-derived enzyme replacement, immediately allows high values of CFA over 80 % consistent with healthy pigs. Creon exhibited a lag time to achieve the same values as ANG003. No significant differences in CFA were observed between Creon and ANG003 group in the last 24-hour collection."

Preclinical