STATED VERSUS ACTUAL LIPASE ACTIVITY IN PANCREATIC-ENZYME SUPPLEMENTS- IMPLICATIONS FOR CLINICAL USE

We have carried out an independent investigation of the lipase activit y of several pancreatin preparations, including high-lipase preparatio ns of pancreatin that have recently become available. Six preparations from three pharmaceutical companies, Cilag, Duphar, and Merck, were a nalyzed during the recommended shelf life of the preparation and inclu ded a standard and a high-lipase preparation from each manufacturer. A ll preparations studied showed lipase activity in excess of that which was stated on the packets, and in some cases it was more than twofold . This has important implications for patients and prescribers since c hanges in apparent enzyme requirements may reflect differences in the potency of batches with time. As it is impossible to evaluate capsule requirements with each new batch prescribed, the presence or relief of symptoms of malabsorption will probably continue to be the way in whi ch most patients monitor their enzyme supplementation on a regular bas is. We believe that clinicians need to be aware of the extent of possi ble intrinsic variation between individual prescriptions before attemp ting to define possible dose/symptom relationships.