What is Pancreatic exocrine insufficiency (PEI) ?

Pancreatic exocrine insufficiency (PEI) is inadequate intraluminal pancreatic enzyme activity, due to insufficient enzyme production, insufficient enzyme activation, or early enzyme degradation leading to maldigestion and malabsorption of nutrients.4
    PEI is commonly associated with

Chronic pancreatitis

Acute necrotizing pancreatitis

Surgical procedures such as pancreatectomy, gastrectomy, or gastrointestinal bypass surgery

Ductal obstruction of the pancreas, cystic fibrosis, pancreatic and periampullary cancer

Symptoms of PEI

Abdominal pain

Flatulence

Weight loss

Bloating

Steatorrhea (fatty stools)

Is there any Treatment available? Yes

Pancreatic Enzyme Replacement Therapy (PERT) replaces the enzymes that pancreas make and help to treat Pancreatic exocrine insufficiency.

But

Mechanism of Action

Creon contains lipase, amylase and protease enzymes and offers USFDA compliant lipase activity5,6

RIGHT ENZYME | RIGHT TIME | RIGHT PLACE

RIGHT ENZYME

Adequate lipase, amylase, and protease5. Additional advantage of Phopholipase A2 and Cholesterolesterase

RIGHT TIME

Gastric acid protection ensures smooth transition to duodenum without dilution in stomach5

RIGHT PLACE

Rapid Enzyme release at right pH for maximum lipase availability5

Phospholipase A2

Hydrolyzes

Phospholipids

Cholesterol Esterase

Hydrolyzes

Cholesteryl Esters

UPTO 2X HIGHER LIPASE ACTIVITY WITH UNIQUE CREON® MINIMICROSPHERE TECHNOLOGY5

BRAND % LIPASE ACTIVITY
CREON® 25000 111%
AGNA 25000 77%
ENZAR HS 93%
PANLIPASE 25000 55%

Rapid Enzyme release at right pH in duodenum5

Available Dosage

pancreatin IP 150mg
Pancreatin IP 150mg
pancreatin IP 300mg
Pancreatin IP 300mg
pancreatin IP 400mg
Pancreatin IP 400mg
pancreatin IP 150mg
Pancreatin IP 150mg
(each dispensed dose)

How Efficient is Creon?

LEADERSHIP7

WORLD's
NO.1

PANCREATIC ENZYME REPLACEMENT THERAPY

LEGACY8

120


YEARS OF
CLINICAL USAGE

RELIABILITY9

~5


MILLION PATIENT
YEARS

REACH10

>90


COUNTRIES

Benefits of Creon Therapy

Diabetic patients
Diabetic patients

For Diabetic patients11

  • Reduces Flatuence
  • Reduces Abdominal pain
  • Reduces Fatty stools
  • Reduces HbA1c level
pancreatitis patients and GI surgery
pancreatitis patients and GI surgery

For Chronic pancreatitis patients12 and GI surgery patients

  • 5-10 kg weight gain
  • 50% reduction in stool frequency
  • 34% improvement in fat absorption (Vit A,D,E,K)
  • Long term safety and tolerability
acute pancreatitis
acute pancreatitis

For acute pancreatitis11

  • Improved Pancreatic exocrine function
  • Improved Body weight
  • Improved Flatulence
  • Improved Quality of life

References

(1) Shivaprasad, C., Pulikkal, A. A., & Kumar, K. M. (2015). Pancreatic exocrine insufficiency in type 1 and type 2 diabetics of Indian origin. Pancreatology : official journal of the International Association of Pancreatology (IAP) ... [et al.], 15(6), 616–619. https://doi.org/10.1016/j.pan.2015.09.018
(2) Hollemans, R. A., Hallensleben, N. D. L., Mager, D. J., Kelder, J. C., Besselink, M. G., Bruno, M. J., Verdonk, R. C., van Santvoort, H. C., & Dutch Pancreatitis Study Group (2018). Pancreatic exocrine insufficiency following acute pancreatitis: Systematic review and study level meta-analysis. Pancreatology : official journal of the International Association of Pancreatology (IAP) ... [et al.], 18(3), 253–262. https://doi.org/10.1016/j.pan.2018.02.009
(3) Chaudhary A, Domínguez-Muñoz JE, Layer P, Lerch MM. Pancreatic Exocrine Insufficiency as a Complication of Gastrointestinal Surgery and the Impact of Pancreatic Enzyme Replacement Therapy. Dig Dis. 2020;38(1):53-68. doi: 10.1159/000501675. Epub 2019 Aug 16. PMID: 31422398; PMCID: PMC6979421.
(4) Shrikhande SV, Prasad VGM, Domínguez-Muñoz JE, Weigl KE, Sarda KD. In vitro Comparison of Pancreatic Enzyme Preparations Available in the Indian Market. Drug Des Devel Ther. 2021 Sep 7;15:3835-3843. doi: 10.2147/DDDT.S319949. PMID: 34522087; PMCID: PMC8434830.
(5) Shrikhande SV, et al. Drug Design, Development and Therapy. 2021;15:3835
(6) Kuhn RJ, et al. The Journal of Pediatric Pharmacology and Therapeutics. 2007;12(2):115-28.
(7) Internal Calculations based on Quintiles IMS database, Quintiles IMS Analytics Link MATO9 2016.
(8) Creon International Scientific Brochure
(9) SolvayPharmaceuticals. NDA 20-725 for Creon' (Pancrelipase Delayed-release Capsules) Briefing Document for December 2, 2008 Antiviral Drugs Advisory Committee. Available from-https://www fda gov/ohrms/dockets/ac/08/transcripts/2008-4402tI-Partl pdf. Accessed on 25 Oct.2017
(10) Creon Global sales aid GLCRE150051
(11) Mohan V, Poongothai S, Pitchumoni CS. Oral pancreatic enzyme therapy in the control of diabetes mellitus in tropical calculous pancreatitis. Int J Pancreatol. 1998 Aug;24(1):19-22. doi: 10.1007/BF02787526. PMID: 9746885
(12) Ramesh H, Reddy N, Bhatia S, Rajkumar JS, Bapaye A, Kini D, Kalla M, Thorat V. A 51-week, open-label clinical trial in India to assess the efficacy and safety of pancreatin 40000 enteric-coated minimicrospheres in patients with pancreatic exocrine insufficiency due to chronic pancreatitis. Pancreatology. 2013 Mar 1;13(2):133-9.

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