| E.1 Medical condition or disease under investigation | 
| E.1.1 | Medical condition(s) being investigated  | 
 | 
| E.1.1.1 | Medical condition in easily understood language  | 
| Cystic fibrosis, disorder of the lungs | 
 
 
 | 
| E.1.1.2 | Therapeutic area  | Diseases [C] - Respiratory Tract Diseases [C08] | 
| MedDRA Classification | 
| E.1.2 Medical condition or disease under investigation | 
| E.1.2 | Version  | 17.1 | 
 
| E.1.2 | Level  | LLT | 
 
| E.1.2 | Classification code  | 10011765 | 
 
| E.1.2 | Term  | Cystic fibrosis pancreas | 
 
| E.1.2 | System Organ Class  | 100000004850 | 
 
 
 | 
| E.1.3 | Condition being studied is a rare disease  |  No  | 
| E.2 Objective of the trial | 
| E.2.1 | Main objective of the trial  | 
| The purpose of this study is to assess the effectiveness and safety of oral pancrelipase MT in the treatment of adult and pediatric/adolescent cystic fibrosis (CF) patients with clinical symptoms of exocrine pancreatic insufficiency (EPI). | 
 
 
 | 
| E.2.2 | Secondary objectives of the trial  | 
 | 
| E.2.3 | Trial contains a sub-study  |  No  | 
| E.3 | Principal inclusion criteria  | 
- Have a diagnosis of CF documented by sweat chloride results (>60 mmol/L) and require pancreatic enzyme replacement therapy (PERT) to control clinical symptoms of EPI (nausea, vomiting, bloating, diarrhea, and abdominal pain) with a history of excess fat in the feces
 -  Have documentation of an abnormal COA-fat and a fecal elastase result of <100 micrograms fecal elastase/gram stool
 -  Must be on a stable diet and dose of pancreatic enzyme supplementation that has provided satisfactory symptom control for at least the past 1 month | 
 
 
 | 
| E.4 | Principal exclusion criteria | 
- No extreme physical wasting with loss of weight and muscle mass
 -  No severe, acute, or chronic pulmonary disease unrelated to complications of CF
 -  No worsening of pulmonary disease in past 30 days
 -  No use of drugs known to affect blood uric acid concentrations (e.g., aspirin, diflunisal, allopurinol, probenecid, thiazide diuretics, phenylbutazone, sulfinpyrazone)
 -  No known congenital (present at birth) abnormalities of the gastrointestinal tract, heart, or liver
 -  No distal intestinal obstruction syndrome (DIOS) | 
 
 
 | 
| E.5 End points | 
| E.5.1 | Primary end point(s) | 
| Change in the coefficient of fat absorption (COA-fat percent) | 
 
 
 | 
| E.5.1.1 | Timepoint(s) of evaluation of this end point | 
| 72-hours stool collection in the open-label phase to the end of 72-hours stool collection in the double-blind withdrawal phase. | 
 
 
 | 
| E.5.2 | Secondary end point(s) | 
- Change in Percent COA-Protein (Nitrogen)
 - Percent of Patients Reporting Clinical Signs and Symptoms of Exocrine Pancreatic Insufficiency (EPI) During the Double-Blind Phase | 
 
 
 | 
| E.5.2.1 | Timepoint(s) of evaluation of this end point | 
- 72-hours stool collection in the open-label phase to the end of 72-hours stool collection in the double-blind withdrawal phase.
 - Entire 7 days double-blind phase | 
 
 
 | 
| E.6 and E.7 Scope of the trial | 
| E.6 | Scope of the trial | 
| E.6.1 | Diagnosis |  No  | 
| E.6.2 | Prophylaxis |  No  | 
| E.6.3 | Therapy |  Yes  | 
| E.6.4 | Safety |  Yes  | 
| E.6.5 | Efficacy |  Yes  | 
| E.6.6 | Pharmacokinetic |  No  | 
| E.6.7 | Pharmacodynamic |  No  | 
| E.6.8 | Bioequivalence |  No  | 
| E.6.9 | Dose response |  No  | 
| E.6.10 | Pharmacogenetic |  No  | 
| E.6.11 | Pharmacogenomic |  No  | 
| E.6.12 | Pharmacoeconomic |  No  | 
| E.6.13 | Others |  No  | 
| E.7 | Trial type and phase | 
| E.7.1 | Human pharmacology (Phase I) |  No  | 
| E.7.1.1 | First administration to humans |  No  | 
| E.7.1.2 | Bioequivalence study |  No  | 
| E.7.1.3 | Other |  No  | 
| E.7.1.3.1 | Other trial type description |  | 
| E.7.2 | Therapeutic exploratory (Phase II) |  No  | 
| E.7.3 | Therapeutic confirmatory (Phase III) |  Yes  | 
| E.7.4 | Therapeutic use (Phase IV) |  No  | 
| E.8 Design of the trial | 
| E.8.1 | Controlled |  Yes  | 
| E.8.1.1 | Randomised |  Yes  | 
| E.8.1.2 | Open |  No  | 
| E.8.1.3 | Single blind |  No  | 
| E.8.1.4 | Double blind  |  Yes  | 
| E.8.1.5 | Parallel group |  No  | 
| E.8.1.6 | Cross over  |  No  | 
| E.8.1.7 | Other |  No  | 
| E.8.2 |  Comparator of controlled trial | 
| E.8.2.1 | Other medicinal product(s) |  No  | 
| E.8.2.2 | Placebo  |  Yes  | 
| E.8.2.3 | Other |  No  | 
| E.8.2.4 | Number of treatment arms in the trial | 2 | 
| E.8.3 | 
                                Will this trial be conducted at a single site globally?
                             |  No  | 
| E.8.4 |  Will this trial be conducted at multiple sites globally?  |  Yes  | 
| E.8.6 Trial involving sites outside the EEA | 
| E.8.6.2 | Trial being conducted completely outside of the EEA |  Yes  | 
| E.8.6.3 | Specify the countries outside of the EEA in which trial sites are planned | 
 | 
| E.8.7 | Trial has a data monitoring committee |  Yes  | 
| E.8.8 | 
                        Definition of the end of the trial and justification where it is not the last
                        visit of the last subject undergoing the trial
                     | 
 | 
| E.8.9 Initial estimate of the duration of the trial | 
| E.8.9.2 | In all countries concerned by the trial months | 6 |