The Effects of High Dose Pancreatic Enzyme Replacement Therapy After Pancreatoduodenectomy

Phase 4

Completed

• Conditions: Pancreaticoduodenectomy
• Interventions: Drug: Norzyme® 40000 IU; Drug: Placebo

• Registration Number: NCT02127021
• Lead Sponsor: Seoul National University Hospital

Brief Summary

Up to now, the studies concerning nutritional assessment after pancreatic resection were rare. The low-dose pancreatic enzyme treatment after pancreatectomy showed no significant benefit in terms of nutritional status. This study is a multicenter randomized phase IV study by using high-dose Norzyme® (40,000 IU) to evaluate quality of life and nutritional status after pancreaticoduodenectomy.

Detailed Description

There are not enough studies evaluating nutritional parameters in patients with pancreatic resection. After pancreatic surgery, there are several ways to improve patient condition in terms of quality of life including nutrition.

In the investigators previous study, pancreatic enzyme supplement through the administration of Norzyme® 25000 IU containing lipase 25000 IU, amylase 22500 IU, and protease 1250 IU after various type of pancreatectomy to improve quality of life and nutritional status failed to prove its effectiveness. After administration of low-dose Norzyme® (25000 IU), some patients showed weight gain, but statistically significant conclusions were not obtained mainly because of various types of pancreatectomy and low supplementary dosage of pancreatic enzyme.

Therefore, the investigators design this study to find out the effect of high-dose Norzyme® (40000 IU) on weight gain, quality of life, stool habit change, and nutritional status in patients with pancreaticoduodenectomy. The investigators will evaluate the effectiveness and adequacy of high-dose pancreatic supplementary treatment through a randomized, placebo-using, single-blinded, and multicenter study.

Study Timeline

• Study Start: 2014-04
• Study First Submitted: 2014-04-03
• Study First Submitted QC: 2014-04-28
• Study First Posted: 2014-04-30
• Primary Completion: 2017-09-07
• Status Verified: 2017-12
• Study Completion: 2017-12-31
• Last Update Submitted: 2019-01-03
• Last Update Posted: 2019-01-07

Recruitment & Eligibility

• Status: COMPLETED
• Sex: All
• Target Recruitment: 304

Inclusion Criteria

• Age between 18 and 75 years
• ECOG performance status : 0,1,2
• Patients who underwent pancreaticoduodenectomy or pylorus preserving pancreaticoduodenectomy
• stool elastase ≤200, preoperatively and postoperatively
• Patients consented to this study

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Exclusion Criteria

• Patients with comorbidities such as liver cirrhosis, chronic renal failure, heart failure, and inflammatory bowel disease which can affect the assessment of quality of life or nutritional status
• Patients underwent major abdominal organ surgery such as gastrectomy and colon resection which can affect the assessment of quality of life or nutritional status
• Patients with locoregional recurrence or distant metastasis
• Patients which were not able to progress diet and medication within 10 days after surgery
• Patients with pork allergy

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Study & Design

• Study Type: INTERVENTIONAL
• Study Design: PARALLEL

Arm && Interventions

Group	Intervention	Description
Norzyme® 40000 IU	Norzyme® 40000 IU	Single capsule of Norzyme® 40000 IU will be prescribed three times a day while taking a meal meal.
Placebo	Placebo	Single capsule of placebo drug with the same appearance of Norzyme® 40000 IU will be prescribed three times a day while taking a meal meal. The formulation and the form of placebo is same with the Norzyme® 40000 IU. Placebo contains microcrystalline cellulose as the main component, titanium oxide, colloidal silica, yellow iron oxide, brown iron oxide, black iron oxide, magnesium stearate, triethyl citrate, talc, and simethicone emulsion in very small amount

Primary Outcome Measures

Name	Time	Method
Change from Baseline in body weight at 3 months after medication	3 months after medication	Body weight will be measured 3 times during the entire study period, once preoperatively and two times postoperatively. After surgery, weight will be measured before medication and at the 3 months after medication.These serial weight measurements will be analyzed to figure out changes in body weight over time.

Secondary Outcome Measures

Name	Time	Method
Change from Baseline in Nutritional Status at 3 months after medication	3 months after medication	To assess the nutritional status of the patient underwent pancreaticoduodenectomy by testing fasting blood glucose, C-peptide, Insulin, Hb A1c, serum protein, serum albumin, serum pre-albumin, and transferrin
Change from baseline in stool habit at 3 months after medication	3 months after medication	To check change from baseline in stool habit at 3 months after medication

Trial Locations

Locations (6)

Kangnam Severance Hospital; 🇰🇷 Seoul, Korea, Republic of

Dongguk University Ilsan Medical Center; 🇰🇷 Goyang, Kyeonggi, Korea, Republic of

Seoul National University Bundang Hospital; 🇰🇷 Seongnam, Bundang-gu, Korea, Republic of

Center for Liver Cancer, National Cancer Center; 🇰🇷 Goyang, Gyeonggi, Korea, Republic of

Chung-Ang University Hospital; 🇰🇷 Seoul, Korea, Republic of

Department of Surgery, Seoul National University College of Medicine; 🇰🇷 Seoul, Korea, Republic of