Clinical Edge Journal Scan

Key clinical point: Treatment with a combination of venetoclax (VEN) and hypomethylating agents (HMA) may be an option for younger AML patients, but myelosuppression was a concern, and 43.7% of treated patients were hospitalized for a treatment-related adverse event.

Major finding: In the 26 newly-diagnosed AML patients, the complete remission rate was 53.8%, but only 38.5% in the 39 relapsed/refractory patients; however, 70% remained dependent on red blood cell transfusion and 58.6% remained dependent on platelet transfusion during and after treatment.

Study details: The data come from 65 patients with acute myeloid leukemia and 7 patients with myelodysplastic syndrome who were treated with a combination of VEN and HMA.

Disclosures: The study’s corresponding author was supported by the National Institutes of Health and the National Cancer Institute. Lead author Dr. Feld had no financial conflicts to disclose. 

Source: Feld J et al. Hemasphere. 2021 Mar 9. doi: 10.1097/HS9.0000000000000549.

Key clinical point: Treatment with a combination of venetoclax (VEN) and hypomethylating agents (HMA) may be an option for younger AML patients, but myelosuppression was a concern, and 43.7% of treated patients were hospitalized for a treatment-related adverse event.

Major finding: In the 26 newly-diagnosed AML patients, the complete remission rate was 53.8%, but only 38.5% in the 39 relapsed/refractory patients; however, 70% remained dependent on red blood cell transfusion and 58.6% remained dependent on platelet transfusion during and after treatment.

Study details: The data come from 65 patients with acute myeloid leukemia and 7 patients with myelodysplastic syndrome who were treated with a combination of VEN and HMA.

Disclosures: The study’s corresponding author was supported by the National Institutes of Health and the National Cancer Institute. Lead author Dr. Feld had no financial conflicts to disclose. 

Source: Feld J et al. Hemasphere. 2021 Mar 9. doi: 10.1097/HS9.0000000000000549.

Key clinical point: Treatment with a combination of venetoclax (VEN) and hypomethylating agents (HMA) may be an option for younger AML patients, but myelosuppression was a concern, and 43.7% of treated patients were hospitalized for a treatment-related adverse event.

Major finding: In the 26 newly-diagnosed AML patients, the complete remission rate was 53.8%, but only 38.5% in the 39 relapsed/refractory patients; however, 70% remained dependent on red blood cell transfusion and 58.6% remained dependent on platelet transfusion during and after treatment.

Study details: The data come from 65 patients with acute myeloid leukemia and 7 patients with myelodysplastic syndrome who were treated with a combination of VEN and HMA.

Disclosures: The study’s corresponding author was supported by the National Institutes of Health and the National Cancer Institute. Lead author Dr. Feld had no financial conflicts to disclose. 

Source: Feld J et al. Hemasphere. 2021 Mar 9. doi: 10.1097/HS9.0000000000000549.

Key clinical point: Mutations promoting loss of function in the histone methyltransferase EZH2 are relatively rare but may promote chemoresistance to the treatment agent cytarabine in patients with acute myeloid leukemia.

Major finding: In cell lines and in patient samples, AML patients, loss of function of EZH2 fostered resistance to cytarabine; the EZH2 mutation was present in 4% of AML patients at diagnosis; low expression of EZH2 mRNA was correlated with poor overall survival and relapse-free survival.

Study details: The data come from a combination of patient samples, in vivo and in vitro patient-derived xenografts, and haematopeoietic cell lines, and included 25 patients with an EZH2 mutation at the time of diagnosis.

Disclosures: The study was supported by Projekt DEAL. The researchers had no financial conflicts to disclose. 

Source: Kempf JM et al. Sci Rep. 2021 Mar 12. doi: 10.1038/s41598-021-84708-6.

Key clinical point: Mutations promoting loss of function in the histone methyltransferase EZH2 are relatively rare but may promote chemoresistance to the treatment agent cytarabine in patients with acute myeloid leukemia.

Major finding: In cell lines and in patient samples, AML patients, loss of function of EZH2 fostered resistance to cytarabine; the EZH2 mutation was present in 4% of AML patients at diagnosis; low expression of EZH2 mRNA was correlated with poor overall survival and relapse-free survival.

Study details: The data come from a combination of patient samples, in vivo and in vitro patient-derived xenografts, and haematopeoietic cell lines, and included 25 patients with an EZH2 mutation at the time of diagnosis.

Disclosures: The study was supported by Projekt DEAL. The researchers had no financial conflicts to disclose. 

Source: Kempf JM et al. Sci Rep. 2021 Mar 12. doi: 10.1038/s41598-021-84708-6.

Key clinical point: Mutations promoting loss of function in the histone methyltransferase EZH2 are relatively rare but may promote chemoresistance to the treatment agent cytarabine in patients with acute myeloid leukemia.

Major finding: In cell lines and in patient samples, AML patients, loss of function of EZH2 fostered resistance to cytarabine; the EZH2 mutation was present in 4% of AML patients at diagnosis; low expression of EZH2 mRNA was correlated with poor overall survival and relapse-free survival.

Study details: The data come from a combination of patient samples, in vivo and in vitro patient-derived xenografts, and haematopeoietic cell lines, and included 25 patients with an EZH2 mutation at the time of diagnosis.

Disclosures: The study was supported by Projekt DEAL. The researchers had no financial conflicts to disclose. 

Source: Kempf JM et al. Sci Rep. 2021 Mar 12. doi: 10.1038/s41598-021-84708-6.

Key clinical point: Gene set variation analysis (GSVA) showed that the PI3K-Akt-mTOR pathway was positively related to FLT3-ITD mutation.

Major finding: In patients with acute myeloid leukemia, expression of RPS6KA1 and AP2M1 were predictors of chemoresistance and overall survival.

Study details: The data come from four genetic data sets: GSE6891, GSE10358, GSE15434, and GSE61804 of patients with acute myeloid leukemia. 

Disclosures: The study was supported by the Young & Middle-aged Medical Key Talents Training Project of Wuhan. The researchers had no financial conflicts to disclose. 

Source: Yu D-H et al. Front Cell Dev Biol. 2021 Feb 26. doi: 10.3389/fcell.2021.641629.

Key clinical point: Gene set variation analysis (GSVA) showed that the PI3K-Akt-mTOR pathway was positively related to FLT3-ITD mutation.

Major finding: In patients with acute myeloid leukemia, expression of RPS6KA1 and AP2M1 were predictors of chemoresistance and overall survival.

Study details: The data come from four genetic data sets: GSE6891, GSE10358, GSE15434, and GSE61804 of patients with acute myeloid leukemia. 

Disclosures: The study was supported by the Young & Middle-aged Medical Key Talents Training Project of Wuhan. The researchers had no financial conflicts to disclose. 

Source: Yu D-H et al. Front Cell Dev Biol. 2021 Feb 26. doi: 10.3389/fcell.2021.641629.

Key clinical point: Gene set variation analysis (GSVA) showed that the PI3K-Akt-mTOR pathway was positively related to FLT3-ITD mutation.

Major finding: In patients with acute myeloid leukemia, expression of RPS6KA1 and AP2M1 were predictors of chemoresistance and overall survival.

Study details: The data come from four genetic data sets: GSE6891, GSE10358, GSE15434, and GSE61804 of patients with acute myeloid leukemia. 

Disclosures: The study was supported by the Young & Middle-aged Medical Key Talents Training Project of Wuhan. The researchers had no financial conflicts to disclose. 

Source: Yu D-H et al. Front Cell Dev Biol. 2021 Feb 26. doi: 10.3389/fcell.2021.641629.

Key clinical point: For AML patients unable to undergo intensive chemotherapy, glasdegib and venetoclax were similarly effective, each in combination with low-dose cytarabine.

Major finding: Overall response rates were higher in the venetoclax study compared to the glasdegib study (48% vs. 24%), but overall survival was similar (hazard ratio 0.75 vs. HR 0.46).

Study details: The data come an indirect comparison of studies of each treatment: the BRIGHT AML 1003 GLAS+LDAC trial, and the VIALE-C VEN+LDAC trial.

Disclosures: The study was sponsored by Pfizer. Several researchers are Pfizer employees and lead author Dr. Tremblay served as a paid consultant to Pfizer during the study.

Source: Tremblay G et al. J Comp Eff Res. 2021 Mar 18. doi: 10.2217/cer-2020-0280.

Key clinical point: For AML patients unable to undergo intensive chemotherapy, glasdegib and venetoclax were similarly effective, each in combination with low-dose cytarabine.

Major finding: Overall response rates were higher in the venetoclax study compared to the glasdegib study (48% vs. 24%), but overall survival was similar (hazard ratio 0.75 vs. HR 0.46).

Study details: The data come an indirect comparison of studies of each treatment: the BRIGHT AML 1003 GLAS+LDAC trial, and the VIALE-C VEN+LDAC trial.

Disclosures: The study was sponsored by Pfizer. Several researchers are Pfizer employees and lead author Dr. Tremblay served as a paid consultant to Pfizer during the study.

Source: Tremblay G et al. J Comp Eff Res. 2021 Mar 18. doi: 10.2217/cer-2020-0280.

Key clinical point: For AML patients unable to undergo intensive chemotherapy, glasdegib and venetoclax were similarly effective, each in combination with low-dose cytarabine.

Major finding: Overall response rates were higher in the venetoclax study compared to the glasdegib study (48% vs. 24%), but overall survival was similar (hazard ratio 0.75 vs. HR 0.46).

Study details: The data come an indirect comparison of studies of each treatment: the BRIGHT AML 1003 GLAS+LDAC trial, and the VIALE-C VEN+LDAC trial.

Disclosures: The study was sponsored by Pfizer. Several researchers are Pfizer employees and lead author Dr. Tremblay served as a paid consultant to Pfizer during the study.

Source: Tremblay G et al. J Comp Eff Res. 2021 Mar 18. doi: 10.2217/cer-2020-0280.

Key clinical point: Venetoclax combination therapy was safe and effective in older adults with acute myeloid leukemia who had not been previously treated.

Major finding: A total of 12 patients achieved complete remission, and another 4 patients achieved complete remission with incomplete blood recovery, with a median response duration of 8.9 months; however, response duration dropped to 4.6 months for patients with adverse cytogenetic risk.

Study details: The data come from 19 consecutive patients with a median age of 77 years and previously untreated AML who received venetoclax combination therapy at a single center; 12 of these received a starting dose of 400 mg daily, 4 received 200 mg, and 3 patients received 100 mg.

Disclosures: The study was supported by the Ligue Nationale Contre le Cancer, and the association Laurette Fugain. The researchers had no financial conflicts to disclose. 

Source: Vazquez R et al. Blood Cancer J. 2021 Mar 19. doi: 10.1038/s41408-021-00448-w.

Key clinical point: Venetoclax combination therapy was safe and effective in older adults with acute myeloid leukemia who had not been previously treated.

Major finding: A total of 12 patients achieved complete remission, and another 4 patients achieved complete remission with incomplete blood recovery, with a median response duration of 8.9 months; however, response duration dropped to 4.6 months for patients with adverse cytogenetic risk.

Study details: The data come from 19 consecutive patients with a median age of 77 years and previously untreated AML who received venetoclax combination therapy at a single center; 12 of these received a starting dose of 400 mg daily, 4 received 200 mg, and 3 patients received 100 mg.

Disclosures: The study was supported by the Ligue Nationale Contre le Cancer, and the association Laurette Fugain. The researchers had no financial conflicts to disclose. 

Source: Vazquez R et al. Blood Cancer J. 2021 Mar 19. doi: 10.1038/s41408-021-00448-w.

Key clinical point: Venetoclax combination therapy was safe and effective in older adults with acute myeloid leukemia who had not been previously treated.

Major finding: A total of 12 patients achieved complete remission, and another 4 patients achieved complete remission with incomplete blood recovery, with a median response duration of 8.9 months; however, response duration dropped to 4.6 months for patients with adverse cytogenetic risk.

Study details: The data come from 19 consecutive patients with a median age of 77 years and previously untreated AML who received venetoclax combination therapy at a single center; 12 of these received a starting dose of 400 mg daily, 4 received 200 mg, and 3 patients received 100 mg.

Disclosures: The study was supported by the Ligue Nationale Contre le Cancer, and the association Laurette Fugain. The researchers had no financial conflicts to disclose. 

Source: Vazquez R et al. Blood Cancer J. 2021 Mar 19. doi: 10.1038/s41408-021-00448-w.

Key clinical point: Green tea extract was safely tolerated and associated with improved immune modulation regardless of tumor burden in older acute myeloid leukemia patients on low-dose chemotherapy.

Major finding: After 30 days, older adults with acute myeloid leukemia who consumed green tea extract showed an increase in total and CD8⁺ T cells, perforin⁺/granzyme B⁺ natural killer cells, monocytes, and classical monocytes. 

Study details: The data come from 10 patients aged 60 years and older with acute myeloid leukemia with myelodysplasia-related changes (AML-MRC) who received two capsules of green tea extract for a 1,000-mg daily dose for at least 6 months.

Disclosures: The study was supported by Conselho Nacional de Desenvolvimento Científico e Tecnológico, the Fundação de Amparo à Pesquisa do Estado de São Paulo, and the Coordenação de Aperfeiçoamento de Pessoal de Nível Superior. The researchers had no financial conflicts to disclose. 

Source: Calgarotto AK et al. Integr Cancer Ther. 2021 Mar 23. doi:10.1177/15347354211002647.

Key clinical point: Green tea extract was safely tolerated and associated with improved immune modulation regardless of tumor burden in older acute myeloid leukemia patients on low-dose chemotherapy.

Major finding: After 30 days, older adults with acute myeloid leukemia who consumed green tea extract showed an increase in total and CD8⁺ T cells, perforin⁺/granzyme B⁺ natural killer cells, monocytes, and classical monocytes. 

Study details: The data come from 10 patients aged 60 years and older with acute myeloid leukemia with myelodysplasia-related changes (AML-MRC) who received two capsules of green tea extract for a 1,000-mg daily dose for at least 6 months.

Disclosures: The study was supported by Conselho Nacional de Desenvolvimento Científico e Tecnológico, the Fundação de Amparo à Pesquisa do Estado de São Paulo, and the Coordenação de Aperfeiçoamento de Pessoal de Nível Superior. The researchers had no financial conflicts to disclose. 

Source: Calgarotto AK et al. Integr Cancer Ther. 2021 Mar 23. doi:10.1177/15347354211002647.

Key clinical point: Green tea extract was safely tolerated and associated with improved immune modulation regardless of tumor burden in older acute myeloid leukemia patients on low-dose chemotherapy.

Major finding: After 30 days, older adults with acute myeloid leukemia who consumed green tea extract showed an increase in total and CD8⁺ T cells, perforin⁺/granzyme B⁺ natural killer cells, monocytes, and classical monocytes. 

Study details: The data come from 10 patients aged 60 years and older with acute myeloid leukemia with myelodysplasia-related changes (AML-MRC) who received two capsules of green tea extract for a 1,000-mg daily dose for at least 6 months.

Disclosures: The study was supported by Conselho Nacional de Desenvolvimento Científico e Tecnológico, the Fundação de Amparo à Pesquisa do Estado de São Paulo, and the Coordenação de Aperfeiçoamento de Pessoal de Nível Superior. The researchers had no financial conflicts to disclose. 

Source: Calgarotto AK et al. Integr Cancer Ther. 2021 Mar 23. doi:10.1177/15347354211002647.

Key clinical point: Treatment regimen was a key factor in survival rates among adults with acute myeloid leukemia, and patients with high responsiveness of tumor cells in vitro showed stronger response to chemotherapy.

Major finding: Patients with high sensitivity to daunorubicin showed a good response to anthracycline‐based therapy; by contrast, patients who received daunorubicin during induction chemotherapy as part of standard clinical care, but who did not sensitivity to it, responded poorly to treatment,

Study details: The data come from a retrospective analysis of survival rates in 127 adults with acute myeloid leukemia.

Disclosures: The study was funded by the Russian Science Foundation and the Russian State Budget Project of ICBFM SB RAS. The researchers had no financial conflicts to disclose. 

Source: Kolesnikova MA et al. Cancer Rep. 2021 Mar 6. doi: 10.1002/cnr2.1362.

Key clinical point: Treatment regimen was a key factor in survival rates among adults with acute myeloid leukemia, and patients with high responsiveness of tumor cells in vitro showed stronger response to chemotherapy.

Major finding: Patients with high sensitivity to daunorubicin showed a good response to anthracycline‐based therapy; by contrast, patients who received daunorubicin during induction chemotherapy as part of standard clinical care, but who did not sensitivity to it, responded poorly to treatment,

Study details: The data come from a retrospective analysis of survival rates in 127 adults with acute myeloid leukemia.

Disclosures: The study was funded by the Russian Science Foundation and the Russian State Budget Project of ICBFM SB RAS. The researchers had no financial conflicts to disclose. 

Source: Kolesnikova MA et al. Cancer Rep. 2021 Mar 6. doi: 10.1002/cnr2.1362.

Key clinical point: Treatment regimen was a key factor in survival rates among adults with acute myeloid leukemia, and patients with high responsiveness of tumor cells in vitro showed stronger response to chemotherapy.

Major finding: Patients with high sensitivity to daunorubicin showed a good response to anthracycline‐based therapy; by contrast, patients who received daunorubicin during induction chemotherapy as part of standard clinical care, but who did not sensitivity to it, responded poorly to treatment,

Study details: The data come from a retrospective analysis of survival rates in 127 adults with acute myeloid leukemia.

Disclosures: The study was funded by the Russian Science Foundation and the Russian State Budget Project of ICBFM SB RAS. The researchers had no financial conflicts to disclose. 

Source: Kolesnikova MA et al. Cancer Rep. 2021 Mar 6. doi: 10.1002/cnr2.1362.

Key clinical point: No significant differences were seen between urban and rural acute myeloid leukemia patients with regard to overall survival or progression to hematopoietic cell transplantation.

Major finding:  Overall survival at one year was 47.9% between the groups (45% for rural and 49% for urban). In addition, the proportions of patients with cytogenetic risk factors and who went on to hematopoietic cell transplantation (HCT) were not significantly different between the two groups.

Study details: The data come from a retrospective study of 163 acute myeloid leukemia patients diagnosed at a single center between September 2015 and December 2019, 42% of whom lived in a rural area at the time of diagnosis.

Disclosures: The study received no outside funding. Lead author Dr. Isaac had no financial conflicts to disclose. 

Source: Isaac KM et al. Cancer Rep 2021 Mar 9. doi: 10.1002/cnr2.1354.

Key clinical point: No significant differences were seen between urban and rural acute myeloid leukemia patients with regard to overall survival or progression to hematopoietic cell transplantation.

Major finding:  Overall survival at one year was 47.9% between the groups (45% for rural and 49% for urban). In addition, the proportions of patients with cytogenetic risk factors and who went on to hematopoietic cell transplantation (HCT) were not significantly different between the two groups.

Study details: The data come from a retrospective study of 163 acute myeloid leukemia patients diagnosed at a single center between September 2015 and December 2019, 42% of whom lived in a rural area at the time of diagnosis.

Disclosures: The study received no outside funding. Lead author Dr. Isaac had no financial conflicts to disclose. 

Source: Isaac KM et al. Cancer Rep 2021 Mar 9. doi: 10.1002/cnr2.1354.

Key clinical point: No significant differences were seen between urban and rural acute myeloid leukemia patients with regard to overall survival or progression to hematopoietic cell transplantation.

Major finding:  Overall survival at one year was 47.9% between the groups (45% for rural and 49% for urban). In addition, the proportions of patients with cytogenetic risk factors and who went on to hematopoietic cell transplantation (HCT) were not significantly different between the two groups.

Study details: The data come from a retrospective study of 163 acute myeloid leukemia patients diagnosed at a single center between September 2015 and December 2019, 42% of whom lived in a rural area at the time of diagnosis.

Disclosures: The study received no outside funding. Lead author Dr. Isaac had no financial conflicts to disclose. 

Source: Isaac KM et al. Cancer Rep 2021 Mar 9. doi: 10.1002/cnr2.1354.

The following two studies are related to additional at-risk patient populations for exocrine pancreatic insufficiency. In a single-center cross-sectional study out of Italy, researchers demonstrated that EPI is a feature of type 1 diabetes—compared with healthy individuals, fecal elastase-1 levels were significantly lower in participants with new-onset and long-standing T1D (P = .0070 and .0010, respectively). Notably the study showed correlation between progressive exocrine and endocrine function throughout the natural history of disease. Certainly, further research is needed to clarify the pathogenesis and role of EPI in type 1 diabetes.

Lastly the final selection comes from AIIMS in India, where they assessed endocrine and exocrine function in patients following pancreatic trauma. Notably, of the 20 patients studied with trauma, 11 of them (55%) had evidence of pancreatic exocrine insufficiency by fecal elastase measurement. 4 patients had severe pancreatic insufficiency, 3 of which had partial pancreatectomy (with mean pancreatic volume of 48.65cm3 following surgery). Classic teaching is that EPI develops when exocrine function is impaired by ~90%, however in the resection groups, they have demonstrated severe EPI in patients with roughly 50% retained pancreatic volume.   

The following two studies are related to additional at-risk patient populations for exocrine pancreatic insufficiency. In a single-center cross-sectional study out of Italy, researchers demonstrated that EPI is a feature of type 1 diabetes—compared with healthy individuals, fecal elastase-1 levels were significantly lower in participants with new-onset and long-standing T1D (P = .0070 and .0010, respectively). Notably the study showed correlation between progressive exocrine and endocrine function throughout the natural history of disease. Certainly, further research is needed to clarify the pathogenesis and role of EPI in type 1 diabetes.

Lastly the final selection comes from AIIMS in India, where they assessed endocrine and exocrine function in patients following pancreatic trauma. Notably, of the 20 patients studied with trauma, 11 of them (55%) had evidence of pancreatic exocrine insufficiency by fecal elastase measurement. 4 patients had severe pancreatic insufficiency, 3 of which had partial pancreatectomy (with mean pancreatic volume of 48.65cm3 following surgery). Classic teaching is that EPI develops when exocrine function is impaired by ~90%, however in the resection groups, they have demonstrated severe EPI in patients with roughly 50% retained pancreatic volume.   

The following two studies are related to additional at-risk patient populations for exocrine pancreatic insufficiency. In a single-center cross-sectional study out of Italy, researchers demonstrated that EPI is a feature of type 1 diabetes—compared with healthy individuals, fecal elastase-1 levels were significantly lower in participants with new-onset and long-standing T1D (P = .0070 and .0010, respectively). Notably the study showed correlation between progressive exocrine and endocrine function throughout the natural history of disease. Certainly, further research is needed to clarify the pathogenesis and role of EPI in type 1 diabetes.

Lastly the final selection comes from AIIMS in India, where they assessed endocrine and exocrine function in patients following pancreatic trauma. Notably, of the 20 patients studied with trauma, 11 of them (55%) had evidence of pancreatic exocrine insufficiency by fecal elastase measurement. 4 patients had severe pancreatic insufficiency, 3 of which had partial pancreatectomy (with mean pancreatic volume of 48.65cm3 following surgery). Classic teaching is that EPI develops when exocrine function is impaired by ~90%, however in the resection groups, they have demonstrated severe EPI in patients with roughly 50% retained pancreatic volume.   

Key clinical point: The sphere size is not an essential parameter for selecting effective pancreatin preparations for patients with exocrine pancreatic insufficiency (EPI).

Major finding: One study reported faster emptying of 2 mm pellets than a pancake meal in patients with pancreatic disease. Another study reported parallel emptying of liver pate and 1.5 mm pellets (range, 1.0-1.5 mm). One study reported no clear pattern in stomach emptying for pancreatin pellets of less than 1.2 mm. Emptying of pancreatin preparations with a particle size of up to 7 mm is also documented in the postprandial phase in healthy individuals.

Study details: Meta-analysis of 26 studies that evaluated gastric emptying of indigestible particles of different sizes in healthy volunteers or patients with EPI under fed conditions.

Disclosures: This meta-analysis was supported by Nordmark. The authors received consulting fees outside of this work.

Citation: Peterson K-U. J Gastrointestin Liver Dis. 2021 Mar 12. doi: 10.15403/jgld-2985.

Key clinical point: The sphere size is not an essential parameter for selecting effective pancreatin preparations for patients with exocrine pancreatic insufficiency (EPI).

Major finding: One study reported faster emptying of 2 mm pellets than a pancake meal in patients with pancreatic disease. Another study reported parallel emptying of liver pate and 1.5 mm pellets (range, 1.0-1.5 mm). One study reported no clear pattern in stomach emptying for pancreatin pellets of less than 1.2 mm. Emptying of pancreatin preparations with a particle size of up to 7 mm is also documented in the postprandial phase in healthy individuals.

Study details: Meta-analysis of 26 studies that evaluated gastric emptying of indigestible particles of different sizes in healthy volunteers or patients with EPI under fed conditions.

Disclosures: This meta-analysis was supported by Nordmark. The authors received consulting fees outside of this work.

Citation: Peterson K-U. J Gastrointestin Liver Dis. 2021 Mar 12. doi: 10.15403/jgld-2985.

Key clinical point: The sphere size is not an essential parameter for selecting effective pancreatin preparations for patients with exocrine pancreatic insufficiency (EPI).

Major finding: One study reported faster emptying of 2 mm pellets than a pancake meal in patients with pancreatic disease. Another study reported parallel emptying of liver pate and 1.5 mm pellets (range, 1.0-1.5 mm). One study reported no clear pattern in stomach emptying for pancreatin pellets of less than 1.2 mm. Emptying of pancreatin preparations with a particle size of up to 7 mm is also documented in the postprandial phase in healthy individuals.

Study details: Meta-analysis of 26 studies that evaluated gastric emptying of indigestible particles of different sizes in healthy volunteers or patients with EPI under fed conditions.

Disclosures: This meta-analysis was supported by Nordmark. The authors received consulting fees outside of this work.

Citation: Peterson K-U. J Gastrointestin Liver Dis. 2021 Mar 12. doi: 10.15403/jgld-2985.