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

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

PERTseverance: Efficacy of PERT for PEI in Unresectable Pancreatic Cancer. (clinicaltrials.gov) - P4 | N=100 | Recruiting | Sponsor: Hospital Clinico Universitario de Santiago | Not yet recruiting ➔ Recruiting | Trial completion date: Jun 2025 ➔ Dec 2026 | Trial primary completion date: Dec 2024 ➔ Jun 2026

Enrollment open • Trial completion date • Trial primary completion date • Oncology • Pancreatic Cancer • Solid Tumor

STUDY OF THE EFFECT OF THE PANCREATIC ENZYME REPLACEMENT THERAPY EN311 ON TWO ANIMAL MODELS OF PANCREATIC INSUFFICIENCY IN VIVO (ESPGHAN 2025) - "Moreover, at a concentration ten times lower than CREON®, EN311 is twice as effective in promoting intestinal lipid absorption in PDL rats. Conclusions EN311 formulation restores the pancreatic function in mice and is 18 times more effective than CREON® at an equivalent dose for the treatment of induced pancreatic insufficiency in rats."

Preclinical • Cystic Fibrosis • Fibrosis • Gastroenterology • Gastrointestinal Disorder • Genetic Disorders • Immunology • Pulmonary Disease • Respiratory Diseases

Pancrelipase as Adjunctive Therapy in Severe SCOT Deficiency: A Case of a Novel OXCT1 Gene Deletion. (PubMed, JIMD Rep) - "This case highlights the therapeutic potential of combining pancreatic enzyme replacement with cornstarch in infants under 12 months of age, given their limited pancreatic amylase activity. It underscores a potential management strategy for infants with severe forms of inherited metabolic disorders, such as SCOT deficiency and glycogen storage disease type I, where cornstarch is a cornerstone of therapy."

Journal • Metabolic Disorders • OXCT1

PANCRELIPASE IMPROVES THE HEALTH-RELATED QUALITY OF LIFE IN PATIENTS WITH EXOCRINE PANCREATIC INSUFFICIENCY AND CHRONIC PANCREATITIS: RESULTS OF THE CISCP STUDY (DDW 2025) - P | "We demonstrate significant improvements in HrQoL during treatment with pancrelipase based on PEI-Q impact scores. Fatigue and anxiety baseline T scores of this CP population with EPI were consistent with mildly worse disease relative to the US general population (50 ±10). Following 1 and 3 months of pancrelipase treatment, anxiety and fatigue T scores were similar to the US general population indicating a meaningful improvement."

Clinical • HEOR • CNS Disorders • Depression • Fatigue • Mood Disorders • Pancreatitis • Psychiatry

CLINICALLY MEANINGFUL SYMPTOM IMPROVEMENTS WITH PANCRELIPASE IN PATIENTS WITH EXOCRINE PANCREATIC INSUFFICIENCY AND CHRONIC PANCREATITIS UTILIZING THE PANCREATIC EXOCRINE INSUFFICINECY QUESTIONNAIRE (DDW 2025) - "We demonstrate significant and clinically meaningful improvements in EPI symptoms utilizing the validated PEI-Q in a real-world population of patients with chronic pancreatitis and EPI who were treated with pancrelipase. Improvements in EPI symptoms and stool consistency were sustained through the 3-month observation period. These results suggest the PEI-Q may represent a useful tool in the clinical management of EPI in patients with chronic pancreatitis and warrants further study."

Clinical • Cystic Fibrosis • Diabetes • Genetic Disorders • Immunology • Pain • Pancreatitis • Respiratory Diseases

Post-surgical biliary pancreatitis and GAD positive diabetes: a rare case of Type 3c DM with Autoimmune features (ESPE-ESE 2025) - "Pain control due to opioid intolerance (hallucinations on morphine and nausea with oxycodone) required PCA fentanyl 20 mcg bolus, paracetamol, and diclofenac supplement...The patient was managed with basal-bolus insulin (Lantus 28 units nightly, Novorapid 8-14 units per meal ) and sliding scale correction for blood glucose 10 mmol/L. The patient was discharged with a management plan of Creon 250,000 units and Humalog 12-20 units with a meal. Tresiba long-acting double strength 84 units at night... This is an atypical instance of type 3c diabetes accompanied by post-surgical pancreatitis, biliary blockage, and a rapid onset of GAD-positive diabetes. Acute pancreatitis has been known to elevate GAD-antibody levels, which can result in insulin-dependent diabetes. The presented case is rare as GAD antibody levels are typically lower in autoimmune diabetes (less than 100 U/ML)."

Clinical • Addiction (Opioid and Alcohol) • CNS Disorders • Diabetes • Fatigue • Gastroenterology • Hepatology • Immunology • Insomnia • Metabolic Disorders • Pain • Pancreatitis • Pulmonary Disease • Respiratory Diseases • Sleep Disorder • Type 1 Diabetes Mellitus

An optogenetic mouse model of hindlimb spasticity after spinal cord injury. (PubMed, Exp Neurol) - "Incidences of prolonged involuntary muscle contraction in response to the stimulus (fictive spasms) were also detected through EMG and visual observation during the testing period, supporting the presence of spasticity. As such, the optogenetic mouse model developed for this study appears to elicit spasticity-associated behaviours in SCI mice reliably and may be valuable for studying SCI-related limb spasticity mechanisms and therapeutic."

Journal • Preclinical • CNS Disorders • Movement Disorders • Orthopedics

To explore the effect of early whole course immune nutrition supplementation in patients with previously untreated advanced pancreatic cancer:a prospective, single-arm, single-center clinical study (ChiCTR) - P=N/A | N=30 | Recruiting | Sponsor: The Affiliated Drum Tower Hospital to Medical School of Nanjing University; The Affiliated Drum Tower Hospital to Medical School of Nanjing University

New trial • Hepatology • Oncology • Pancreatic Cancer • Solid Tumor

The Regulatory Role of Pancreatic Enzymes in the Maintenance of Small Intestinal Structure and Enterocyte Turnover with Special Reference to Alpha Amylase. (PubMed, Int J Mol Sci) - "The aim of this study was to elucidate the impact of porcine pancreatic enzymes (Creon® pancrelipase) in comparison to microbial-derived alpha amylase (MD amylase) on the small intestine wall structure, mucosal glycogen accumulation, and enterocyte turnover...However, supplementation of exogenous microbial amylase alone also affected gut morphology in a similar way to that of the complex host pancreatic enzymes offered orally. These data indicate that in addition to their role in digestion of nutrients in EPI, intraluminal pancreatic enzymes, especially amylase, contribute to gut health through maintenance of the intestinal wall architecture and physiological enterocyte turnover."

Journal

Pancrelipase Delayed-Release Capsules Improve Stool Frequency and Consistency in Patients with Exocrine Pancreatic Insufficiency Due to Chronic Pancreatitis or Pancreatic Surgery: Post-hoc Analysis of Patient-Reported Daily Symptoms in a Double-Blind Randomized Trial. (PubMed, Pancreas) - No abstract available

Journal • Retrospective data • Surgery • Pancreatitis

CMV Infection Presenting as Colitis and Pancreatic Insufficiency in an Immunocompetent Patient (ACG 2024) - "Biopsies indicated atypical cells with coarse cytoplasmic granulation consistent with cytomegalovirus (CMV) infection, for which the patient was prescribed valganciclovir...There have been a few documented cases of CMV infections causing hepatitis and pancreatitis. To date, there are no reported cases in the literature of an immunocompetent person with a CMV infection experiencing both colitis and exocrine pancreatic insufficiency."

Clinical • Cytomegalovirus Infection • Gastroenterology • Gastrointestinal Disorder • Hepatology • Human Immunodeficiency Virus • Immunology • Infectious Disease • Inflammation • Inflammatory Bowel Disease • Musculoskeletal Pain • Pain • Pancreatitis • Solid Organ Transplantation • ELANE

When Gallstones Turn Autoimmune (ACG 2024) - "He was started on prednisone 40mg daily with normalization of liver function tests within 4 weeks of steroid initiation...B-cell therapy such as Rituximab is currently being studied as an alternative treatment. While AIC is associated with autoimmune pancreatitis (AIP) in 90% of cases, 10% of cases are isolated, while up to 39% of AIP cases have demonstrated concomitant AIC. While no cause has yet been determined, an association between AIC, various autoimmune diseases, and allergies has been shown in recent studies."

Biliary Cancer • Cholangiocarcinoma • Dermatology • Diabetes • Gastroenterology • Gastrointestinal Cancer • Gastrointestinal Disorder • Hepatology • Immunology • Metabolic Disorders • Oncology • Pain • Pancreatitis • Pruritus • Rare Diseases • Solid Tumor • Type 2 Diabetes Mellitus

A Case of Kearns-Sayer Syndrome Presenting with Hypoglycaemia and Adrenal Insufficiency (ESPE 2024) - "Hydrocortisone and fludrocortisone replacement was commenced...Persistent raised lactate levels should prompt further investigation despite a normal initial "metabolic screen". Understanding adrenal insufficiency within the broader context of rare metabolic conditions like Kearns-Sayre Syndrome is crucial for accurate diagnosis and effective management."

Clinical • Endocrine Disorders • Genetic Disorders • Hepatology • Hypoglycemia • Liver Failure • Metabolic Disorders • Nephrology • Pediatrics • Renal Disease

Mitigating Financial Toxicity of Pancreatic Enzyme Replacement Therapy in Medicare Part D (ACG 2024) - "Total MPD PERT spending was $1.67 billion; Creon spending was $1.31 billion (78%). Alternative supply at Amazon and GoodRx price-point was constitutively unfavorable, mean relative cost 1.34 and 1.38 respectively. Zenpep was also unfavorable at VHA price-point; although others yielded potential cost savings."

Medicare • Reimbursement • US reimbursement • Gastroenterology • Pancreatitis