Bronchitol® benefit

Question

Bronchitol® is proposed to CF patients. Is the treatment added to inhaled hypertonic saline serum/ inhalation with salbutamole or does it subsitue the treatment?
What about differences between lipromatase and CREON®?

Answer

Bronchitol® (or inhaled mannitol) induces modifications in the viscosity of mucus, leads to hydration of the mucus improvement of the mucociliary clearance. It has therefore a similar action as hypertonic saline and DNase. It can therefore act as a subsitute of these treatments. Beneficial effects of this treatment have been small during controlled clinical trials and were only observed in adult patients.

Lipromatase is not available in France. It is composed of pancreatic enzymes that include lipase, protease and amylase enzymes. It is a microbial production that seems to be more stable. Digestion and absortpion of macronutrients and micronutrients is concerned. The clinical studies that were conducted in the USA seemed to show a good activity on the excretion of fat and a good tolerance. I didn't have read results of controlled clinical trials comparing lipromatase and classical pancreatic enzymes like CREON®.
Yours sincerely,
Pr I Durieu

13.05.2013

13.05.13
The drug is developed in the USA, the latest information found on the internet are:
"Apr 11: The FDA issues a complete response letter asking Lilly to conduct an additional clinical trial before the NDA can be re-submitted [5].
20/04/2011 09:00:49
Jan 11: Negative opinion in the US. The committee questioned the degree of efficacy of liprotamase & recommended that additional studies be conducted prior to consideration of approval"
D. d'Alquen