Pancreatic Enzyme Replacement Therapy: Not Only in Chronic Pancreatitis.

Mario Capasso, Ludovica Venezia, Filippo Antonini, Luca Barresi, Germana De Nucci, Marco Valvano

Journal: Journal of gastrointestinal and liver diseases : JGLD 2025;34(3):390-399

PMID: 41004814

Abstract

The therapeutic application of Pancrelipase spans several key gastroenterological conditions, ranging from chronic pancreatitis to genetic disorders such as cystic fibrosis. Consequently, pancreatic enzyme replacement therapy (PERT) is applicable in a variety of clinical settings, managing pancreatic insufficiency. Beyond chronic pancreatitis, PERT has also shown effectiveness in addressing malabsorption associated with pancreatic surgery, gastrointestinal malignancies, and various dysmetabolic conditions. This review aims to provide a comprehensive overview of the therapeutic applications of PERT and its clinical role in managing both surgical and non-surgical conditions, beyond chronic pancreatitis. PERT has proven crucial in improving patient outcomes, addressing gastrointestinal symptoms, and supporting long-term health in patients with pancreatic insufficiency. While more research, particularly from randomized controlled trials, is required to optimize dosing strategies and establish standardized PERT protocols, clinicians should consider tailoring PERT to individual patient needs based on the available evidence across various clinical scenarios.

Address: Gastroenterology and Digestive Endoscopy Department, ASST Crema Maggiore Hospital, Crema, Italy. [email protected].; Gastroenterology Unit, Department of Oncological and Specialty Medicine, Azienda Ospedaliero-Universitaria 'Maggiore Della Carità', Novara, Italy. [email protected].; Gastroenterology and Interventional Endoscopy Unit, Mazzoni Hospital, Ascoli Piceno, Italy. [email protected].; Pancreas Unit, IRCCS-ISMETT (Mediterranean Institute for Transplantation and Advanced Specialized Therapies), Palermo. [email protected].; Gastroenterology and Endoscopy Unit, ASST Rhodense, Garbagnate Milanese, Italy. [email protected].; Gastroenterology Unit, Ente Ospedaliero Galliera, Genova; Gastroenterology Unit, Division of Gastroenterology, Hepatology, and Nutrition, Department of Life, Health and Environmental Sciences, University of L'Aquila, L'Aquila, Italy. [email protected].
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