Preliminary report of the ¹³C-mixed triglyceride breath test to assess timing of pancreatic enzyme replacement therapy in children with cystic fibrosis

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• 作者：Natalie van der Haak^a ; ^{natalie.vanderhaak@sa.gov.au" class="auth_mail" title="E-mail the corresponding author} ; Julia Boase^a ; Geoffrey Davidson^b ; Ross Butler^b ; ¹ ; Michelle Miller^c ; Billingsley Kaambwa^d ; Stamatiki Kritas^b ; ²
• 关键词：Cystic fibrosis ; Pancreatic enzyme replacement therapy ; Lipase activity ; Gastric emptying
• 刊名：Journal of Cystic Fibrosis
• 出版年：2016
• 出版时间：September 2016
• 年：2016
• 卷：15
• 期：5
• 页码：669-674
• 全文大小：303 K

文摘

Despite guidelines suggesting pancreatic enzyme replacement therapy (PERT) should be taken before or during a meal, it is currently unknown whether this has benefits over administration after a meal in individuals with cystic fibrosis (CF).

Methods

18 children with pancreatic insufficient CF were randomised to two ¹³C-mixed triglyceride (¹³C-MTG) breath tests to assess lipase activity with PERT administered 10 min before and 10 min after a meal. Results were expressed as percentage cumulative dose recovered (PCDR) of ¹³CO₂ and were compared with established values in healthy subjects. Gastric half emptying time (T½) was also assessed by a ¹³C-octanoate breath test.

Results

There was no difference in mean PCDR of ¹³CO₂ between taking PERT before versus after the meal (p = 0.68). Eleven subjects had a greater PCDR when PERT was taken before and 7 when PERT was taken after the meal. 6/8 subjects (75%) with a lower than normal PCDR at one time point normalised PCDR when PERT timing was changed. When PERT was taken after the meal, PCDR was higher in normal vs. fast T½ (p = 0.04).

Conclusions

Changing PERT timing can result in normalised lipase activity. Gastric emptying rate may influence optimal timing of PERT.

Clinical Trial Registration Number — This study was undertaken prior to the registration process being a commonly required practice.