From the Guidelines
Creon is indicated for patients with exocrine pancreatic insufficiency (EPI) due to conditions such as cystic fibrosis, chronic pancreatitis, pancreatic cancer, pancreatic surgery, or other conditions that affect pancreatic function, as evidenced by the most recent guidelines 1.
Indications for Use
The indications for Creon, a pancreatic enzyme replacement therapy, are based on the diagnosis of exocrine pancreatic insufficiency (EPI), which can result from various conditions. These conditions include:
- Cystic fibrosis
- Chronic pancreatitis
- Pancreatic cancer
- Pancreatic surgery
- Other conditions that affect pancreatic function
Diagnosis of EPI
The diagnosis of EPI is crucial for the initiation of Creon therapy. According to the guidelines, EPI should be suspected in patients with high-risk clinical conditions, such as chronic pancreatitis, relapsing acute pancreatitis, pancreatic ductal adenocarcinoma, cystic fibrosis, and previous pancreatic surgery 1. The diagnosis can be confirmed through tests such as the fecal elastase test, which is the most appropriate initial test 1.
Treatment with Creon
Once EPI is diagnosed, treatment with Creon is required to prevent complications related to fat malabsorption and malnutrition, which can have a negative impact on quality of life 1. The medication contains a mixture of digestive enzymes (lipase, protease, and amylase) that help break down fats, proteins, and carbohydrates in food. Dosing is typically individualized based on weight, clinical symptoms, and fat content of the diet, but generally ranges from 500-2,500 lipase units/kg/meal for adults, with half that dose for snacks 1.
Administration and Monitoring
Creon should be taken with meals or snacks, with capsules swallowed whole or opened and sprinkled on soft, non-hot food that doesn't require chewing. Patients should be monitored for response through symptom improvement, weight gain, and nutritional status 1. Routine supplementation and monitoring of fat-soluble vitamin levels are also appropriate, and dietary modifications may include a low-moderate fat diet with frequent smaller meals and avoiding very-low-fat diets 1.
From the Research
Indications for Use of Creon
The indications for use of Creon, a pancreatic enzyme replacement therapy, are as follows:
- Exocrine pancreatic insufficiency (EPI) due to cystic fibrosis (CF) 2, 3, 4
- EPI due to chronic pancreatitis (CP) 5, 3, 6
- EPI due to pancreatic surgery (PS) 5, 3, 6
Patient Populations
Creon is indicated for use in various patient populations, including:
- Adults and children ≥12 years with EPI due to CF 2
- Patients ≥18 years with EPI due to CP or PS 5, 6
- Young children with CF (aged 1 month to 6 years) 3
Clinical Benefits
The use of Creon has been shown to provide several clinical benefits, including: