Why CREON for EPI

MELISSA: Setting expectations and explaining the function of the pancreas to patients can really help patients understand what EPI is and why they need to treat it.

DR. RANNEY: When I diagnose a patient with EPI, I simply explain that their pancreas is not secreting enough enzymes to help them digest their food. To fix this problem, we'll be giving them pancreatic enzymes in a capsule to break down and digest that food.

DR. RANNEY: With CREON, most patients will be taking two 36,000 unit capsules with a meal and one with a snack. For patients or practitioners who think that this sounds like a high dose, I'd like to explain that a normal pancreas actually secretes around 720,000 lipase units with each meal. And so we're only actually using one tenth of that dose. You know, this is usually a pretty quick conversation with patients. They really understand the idea of needing enzymes to digest their food, and if the function of their pancreas is lacking, they quickly grasp that taking a PERT like CREON can be to their benefit.

MELISSA: The way I like to explain it is, I say the enzymes are going to act like little scissors to cut up the fats that you eat, and they're going to help you digest the food, and so that you can absorb the nutrients. I keep it simple, straightforward, short, and it really helps them understand and feel like there's a clear way to manage their EPI.

DR. RANNEY: I think once you've had this conversation, your patients are more likely to be compliant with CREON because they understand exactly why they're taking it. Do you typically educate all your patients on normal pancreatic output?

MELISSA: Absolutely. I think every case is different, and since every patient will have a different level of understanding about their condition, I find that discussing pancreatic lipase output is generally a good way to help patients learn about how and why we dose CREON the way that we do. And to your point, if they understand why they're taking the CREON, they'll have a higher likelihood of staying on CREON as prescribed.

DR. RANNEY: Education is key and talking about the dosing with them is a part of that. And, you know, for most patients, I'll start CREON at 72,000 lipase units per meal and 36,000 units per snack, and then I'll adjust from there based on their diet and their symptoms to help them manage their EPI.

MELISSA: Many patients cut out a lot of foods and fats based on their symptoms. So when they start to add those kind of fatty foods back into their diet, we might need to adjust their dose. And of course we look at food because diets can look very different from one patient to another depending on their culture. And so I do ask my patients to do a food log and I find that this is actually really helpful. You know, in some cultures, a snack might look something like cheese sticks or chicken wings or yogurt. In other cultures, it might be broth or something a little bit less fatty.

DR. RANNEY: That's why it's important to educate our patients on why they're taking CREON, how CREON works, and that CREON needs to be taken every time they eat.

MELISSA: Absolutely. I think talking to patients about what their daily food intake is like is so important. You'll find that not everybody sits down for three meals a day. Sometimes they have maybe more snacks, or maybe all they do is snack. And so, really educating patients about how and when to take CREON is going to be crucial to them sticking to what we've prescribed and getting the full benefits. One of the reasons I prefer prescribing CREON is because it has a variety of dosing options that can supplement lipase units to help with fat digestion and absorption.

DR. RANNEY: CREON is my preferred PERT for my patients as well, and thankfully the variety of dosing options CREON offers helps us find the right dose for many patients with EPI.

DR. RANNEY: I prescribe CREON because it's been proven to help improve fat absorption in those patients. There's also a wide range of access and affordability options, and it feels good that we can help them start strong and stay the course.

SAFETY VOICE OVER:

Indication

CREON^® (pancrelipase) delayed-release capsules are indicated for the treatment of exocrine pancreatic insufficiency in adult and pediatric patients.

Important Safety Information

• Fibrosing colonopathy has been reported following treatment with pancreatic enzyme products. Do not exceed the recommended dosage of 2,500 lipase units/kg/meal (or 10,000 lipase units/kg/day) or 4,000 lipase units/g fat ingested/day in adult and pediatric patients greater than 12 months of age without further investigation.
• To avoid irritation of oral mucosa, care should be taken to ensure that CREON is not crushed, chewed, or retained in the mouth. CREON should always be taken with food.
• Pancreatic enzyme products contain purines that may increase blood uric acid levels. High dosages have been associated with hyperuricosuria and hyperuricemia. Consider monitoring blood uric acid levels in patients with gout, renal impairment, or hyperuricemia during treatment with CREON.
• There is theoretical risk of viral transmission with all pancreatic enzyme products, including CREON.
• Severe hypersensitivity reactions including anaphylaxis, asthma, hives, and pruritus have been reported with pancreatic enzyme products. Monitor patients with a known hypersensitivity reaction to proteins of porcine origin for hypersensitivity reactions during treatment with CREON.
• Adverse reactions that occurred in at least 2 cystic fibrosis patients (greater than or equal to 4%) receiving CREON were vomiting, dizziness, and cough.
• Adverse reactions that occurred in at least 1 chronic pancreatitis or pancreatectomy patient (greater than or equal to 4%) receiving CREON were hyperglycemia, hypoglycemia, abdominal pain, abnormal feces, flatulence, frequent bowel movements, and nasopharyngitis.

Please see the accompanying full Prescribing Information, including Medication Guide or visit https://www.rxabbvie.com/pdf/creon_pi.pdf