Cochrane · systematic review · CD008227
Pancreatic enzyme replacement therapy for people with cystic fibrosis
Somaraju, URR, Solis-Moya, A · Cochrane Database of Systematic Reviews · 2020 · Cochrane Library
Cystic Fibrosis and Genetic DisordersAMSTAR 2: not assessed
SoF tableOnly the outcomes this review put in its Summary of Findings table are listed (the Cochrane Handbook caps them at about seven per comparison). Its other analyses are not shown here.
Questions
56
current version
GRADE rated
27
No studies
29
Included studies
NR
No studies 29 · 51.8%Ungraded 0 · 0%Very low 16 · 28.6%Low 9 · 16.1%Moderate 2 · 3.6%High 0 · 0%
Ungraded means an effect was reported without a GRADE rating; it is not a gap. No studies means the review found nothing to answer the question. The six categories are a display order, not a score.
Questions and results
Summary of findings: ECM compared with NECT plus cimetidine
Population: adults with cystic fibrosis
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Change in weight (kg) Summary of findings: ECM vs NECT plus cimetidine | MD 0.4 | 1 study · 12 participants | Very low Downgraded: risk of bias, imprecision |
Change in height Summary of findings: ECM vs NECT plus cimetidine | no estimate extracted | NR | No studies |
Change in BMI Summary of findings: ECM vs NECT plus cimetidine | no estimate extracted | NR | No studies |
Frequency in bowel symptoms: abdominal pain (% of days affected) Summary of findings: ECM vs NECT plus cimetidine | no estimate extracted | 1 study · 12 participants | Very low Downgraded: risk of bias, imprecision |
CFA: change in FFE (g/day) Summary of findings: ECM vs NECT plus cimetidine | no estimate extracted | 1 study · 12 participants | Low Downgraded: risk of bias, imprecision |
Adverse events Summary of findings: ECM vs NECT plus cimetidine | no estimate extracted | NR | No studies |
Pulmonary exacerbations Summary of findings: ECM vs NECT plus cimetidine | no estimate extracted | NR | No studies |
Summary of findings: ECM compared with ECT
Population: children and adults with cystic fibrosis
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Change in weight (kg) Summary of findings: ECM vs ECT | MD 0.32 | 2 studies · 41 participants | Very low Downgraded: risk of bias, imprecision |
Change in height Summary of findings: ECM vs ECT | no estimate extracted | NR | No studies |
Change in BMI Summary of findings: ECM vs ECT | no estimate extracted | NR | No studies |
Frequency of bowel symptoms: abdominal pain (% of days affected) Summary of findings: ECM vs ECT | no estimate extracted | 2 studies · 41 participants | Very low Downgraded: risk of bias, imprecision |
CFA: change in FFE (g/day) Summary of findings: ECM vs ECT | no estimate extracted | 2 studies · 41 participants | Low Downgraded: risk of bias, imprecision |
Adverse events Summary of findings: ECM vs ECT | no estimate extracted | NR | No studies |
Pulmonary exacerbations Summary of findings: ECM vs ECT | no estimate extracted | NR | No studies |
Summary of findings: ECM compared with ECMM
Population: children with cystic fibrosis and proven pancreatic insufficiency
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Change in weight Summary of findings: ECM vs ECMM | no estimate extracted | NR | No studies |
Change in height Summary of findings: ECM vs ECMM | no estimate extracted | NR | No studies |
Change in BMI Summary of findings: ECM vs ECMM | no estimate extracted | NR | No studies |
Frequency of bowel symptoms Summary of findings: ECM vs ECMM | no estimate extracted | 1 study · 54 participants | Very low Downgraded: risk of bias, imprecision, indirectness |
CFA: change in FFE (g/day) Summary of findings: ECM vs ECMM | no estimate extracted | 1 study · 22 participants | Very low Downgraded: risk of bias, imprecision, indirectness |
Adverse events Summary of findings: ECM vs ECMM | no estimate extracted | NR | No studies |
Pulmonary exacerbations Summary of findings: ECM vs ECMM | no estimate extracted | NR | No studies |
Summary of findings: ECM (Creon®) compared with a different ECM
Population: children and adults with cystic fibrosis
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Change in weight (kg) Summary of findings: ECM (Creon®) vs a different ECM | MD 0 | 1 study · 83 participants | Moderate Downgraded: risk of bias, imprecision |
Change in height Summary of findings: ECM (Creon®) vs a different ECM | no estimate extracted | NR | No studies |
Change in BMI Summary of findings: ECM (Creon®) vs a different ECM | no estimate extracted | NR | No studies |
Frequency of bowel symptoms: proportion of days with abdominal pain Summary of findings: ECM (Creon®) vs a different ECM | MD 0 | 1 study · 83 participants | Low Downgraded: risk of bias, imprecision |
CFA: CFA (%) Summary of findings: ECM (Creon®) vs a different ECM | MD 1.35 | 2 studies · 110 participants | Moderate Downgraded: risk of bias, imprecision |
Adverse events Summary of findings: ECM (Creon®) vs a different ECM | no estimate extracted | 1 study · 83 participants | Low Downgraded: risk of bias, imprecision |
Pulmonary exacerbations Summary of findings: ECM (Creon®) vs a different ECM | no estimate extracted | NR | No studies |
Summary of findings: ECM compared with TPE
Population: children with cystic fibrosis
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Change in weight (kg) Summary of findings: ECM vs TPE | no estimate extracted | 1 study · 17 participants | Very low Downgraded: risk of bias, imprecision, indirectness |
Change in height Summary of findings: ECM vs TPE | no estimate extracted | NR | No studies |
Change in BMI Summary of findings: ECM vs TPE | no estimate extracted | NR | No studies |
Frequency of bowel symptoms Summary of findings: ECM vs TPE | no estimate extracted | NR | No studies |
CFA: change in FFE (g/day) Summary of findings: ECM vs TPE | no estimate extracted | 1 study · 17 participants | Very low Downgraded: risk of bias, imprecision, indirectness |
Adverse events Summary of findings: ECM vs TPE | no estimate extracted | NR | No studies |
Pulmonary exacerbations Summary of findings: ECM vs TPE | no estimate extracted | NR | No studies |
Summary of findings: ECM compared with other enteric‐coated preparations
Population: children with cystic fibrosis
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Change in weight (kg) Summary of findings: ECM vs other enteric‐coated preparations | no estimate extracted | 2 studies · 56 participants | Very low Downgraded: risk of bias, imprecision, indirectness |
Change in height Summary of findings: ECM vs other enteric‐coated preparations | no estimate extracted | 1 study · 45 participants | Very low Downgraded: risk of bias, imprecision, indirectness |
Change in BMI Summary of findings: ECM vs other enteric‐coated preparations | no estimate extracted | NR | No studies |
Frequency of bowel symptoms: stool frequency Summary of findings: ECM vs other enteric‐coated preparations | no estimate extracted | 2 studies · 56 participants | Very low Downgraded: risk of bias, imprecision, indirectness |
CFA: fat absorption Summary of findings: ECM vs other enteric‐coated preparations | no estimate extracted | 2 studies · 56 participants | Very low Downgraded: risk of bias, imprecision, indirectness |
Adverse events Summary of findings: ECM vs other enteric‐coated preparations | no estimate extracted | NR | No studies |
Pulmonary exacerbations Summary of findings: ECM vs other enteric‐coated preparations | no estimate extracted | NR | No studies |
Summary of findings: low‐dose compared with high‐dose PERT
Population: children and adults with cystic fibrosis
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Change in weight (kg) Summary of findings: low‐dose vs high‐dose PERT | no estimate extracted | 1 study · 17 participants | Very low Downgraded: risk of bias, imprecision, indirectness |
Change in height Summary of findings: low‐dose vs high‐dose PERT | no estimate extracted | NR | No studies |
Change in BMI Summary of findings: low‐dose vs high‐dose PERT | no estimate extracted | NR | No studies |
Frequency of bowel symptoms: stool frequency Summary of findings: low‐dose vs high‐dose PERT | no estimate extracted | 1 study · 17 participants | Very low Downgraded: risk of bias, imprecision, indirectness |
CFA: FFE (g/day) Summary of findings: low‐dose vs high‐dose PERT | no estimate extracted | 1 study · 17 participants | Very low Downgraded: risk of bias, imprecision, indirectness |
Adverse events Summary of findings: low‐dose vs high‐dose PERT | no estimate extracted | 2 studies · 146 participants | Very low Downgraded: risk of bias, imprecision, indirectness |
Pulmonary exacerbations Summary of findings: low‐dose vs high‐dose PERT | no estimate extracted | NR | No studies |
Summary of findings: liprotamase compared with porcine PERT
Population: children aged 7 years or over and adults with cystic fibrosis
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Change in weight (kg) Summary of findings: liprotamase vs porcine PERT | no estimate extracted | 1 study · 128 participants | Low Downgraded: risk of bias |
Change in height Summary of findings: liprotamase vs porcine PERT | no estimate extracted | NR | No studies |
Change in BMI Summary of findings: liprotamase vs porcine PERT | no estimate extracted | NR | No studies |
Frequency of bowel symptoms: abdominal pain Summary of findings: liprotamase vs porcine PERT | no estimate extracted | 1 study · 128 participants | Low Downgraded: risk of bias |
CFA: change from baseline (%) Summary of findings: liprotamase vs porcine PERT | no estimate extracted | 1 study · 128 participants | Low Downgraded: risk of bias |
Adverse events Summary of findings: liprotamase vs porcine PERT | no estimate extracted | 1 study · 128 participants | Low Downgraded: risk of bias |
Pulmonary exacerbations: number of exacerbations Summary of findings: liprotamase vs porcine PERT | OR 0.56 [0.13, 2.45] | 1 study · 128 participants | Low Downgraded: risk of bias |