A Cochrane review[Abstract] 1 included 10 studies (2 parallel design and 8 cross-over design studies) with a total of 361 subjects. Although some individual studies reported a beneficial effect of pancreatic enzyme over placebo in improving pain, incidence of steatorrhoea and analgesic consumption, the results of the studies could not be pooled for these outcomes. With the use of pancreatic enzymes, a non-significant benefit for weight loss (kg) (SMD 0.06; 95% CI -0.23 to 0.34); a significant reduction in faecal fat (g/day) (SMD -1.03; 95% CI -1.60 to -0.46) and non-significant difference in subjects' Clinical Global Impression of Disease Symptom Scale (SMD -0.63; 95% CI -1.41 to 0.14) were observed.
Comment: The quality of evidence is downgraded by study quality (unclear allocation concealment), by inconsistency (heterogeneity in interventions and outcomes), and by imprecise results (limited study size for each comparison).
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