Indocin suppository (indomethacin suppository) / Iroko - LARVOL DELTA

When Your Colleague Asks for Help: The EUROPE-FC Approach to ERCP Failure (ACG 2025) - "Sphincterotomy site bled, treated by epinephrine injection...A plan was formed to minimize the risks of pancreatitis (IVF, indomethacin suppository), bleeding (IV pantoprazole, avoidance of the precut sphincterotomy) and ampullary edema (IV methylprednisolone)...Two weeks later, she underwent ERCP by the colleague for removal of the stents. Professional collaboration is important in our complex medical environment. We developed these steps when a colleague asks for help:Empathy: Verbalize awareness of the situation and show sensitivity toward colleague.Understanding: Recognize the indications, technical challenges and risks of complications.Respect: Appreciate and value the clinical judgement, humility and commitment to patient care of colleague.Offer: Accept to intervene or provide alternative solutions.Plan: Strategize to minimize risks and maximize efficacy.Execution: Implement plan.Feedback: Provide input to colleague for mutual growth.Communications: Discuss all..."

Gastroenterology • Pancreatitis

Aggressive Intravenous Hydration With or Without Indometacin to Prevent Pancreatitis After Pancreatic Extracorporeal Shock Wave Lithotripsy (clinicaltrials.gov) - P=N/A | N=1250 | Not yet recruiting | Sponsor: Changhai Hospital

Head-to-Head • New trial • Pancreatitis

Gegen Qinlian decoction prevents post-ERCP pancreatitis by regulating NLRP3 inflammasome-mediated pyroptosis. (PubMed, Front Pharmacol) - "GQD can effectively prevent PEP, and its primary mechanism may be related to the regulation of NLRP3 inflammasome-mediated pyroptosis. Provide theoretical basis for the use of traditional Chinese medicine in clinical practice to prevent diseases."

Journal • Inflammation • Pancreatitis • CASP1 • NLRP3

PEPPER: Prophylaxis of Post-ERCP Acute Pancreatitis (clinicaltrials.gov) - P3 | N=184 | Completed | Sponsor: Azienda USL Reggio Emilia - IRCCS | Recruiting ➔ Completed | N=1250 ➔ 184 | Trial completion date: Feb 2025 ➔ Oct 2024 | Trial primary completion date: Feb 2025 ➔ Oct 2024

Enrollment change • Trial completion • Trial completion date • Trial primary completion date • Pancreatitis

Prophylactic use of indomethacin suppositories during the perioperative period to prevent post-pancreatectomy acute pancreatitis: a study protocol for a multicenter, blind, randomized clinical trial (ChiCTR) - P4 | N=800 | Not yet recruiting | Sponsor: Peking Union Medical College Hospital; Peking Union Medical College Hospital

New P4 trial • Pancreatitis

Efficacy of 2-Mercaptoethane Sulfonate Sodium (MESNA) in the Prevention of Pancreatitis After Endoscopic Retrograde Cholangiopancreatography: A Randomized Open Label Trial. (PubMed, JGH Open) - "In high-risk patients, PEP rate and severity were lower in the mesna plus indomethacin group compared with indomethacin alone group and the statistical analysis showed that the difference was significant (41.7% vs. 51.8%, respectively, p = 0.033). In high-risk patients undergoing ERCP, a combination of intravenous mesna plus rectal indomethacin may decrease the PEP rate and severity."

Journal • Pancreatitis

Efficacy and Cost Savings With Diclofenac Suppository for Post-ERCP Pancreatitis: Experience From a Tertiary Care Center (ACG 2024) - "353 patients were included, of whom 171 (48.4%) received indomethacin and 182 (51.6%) received diclofenac. PEP rates were not significantly different between patients who received indomethacin {n=17 (9.9%, 95%CI=5.9–15.4)} vs. diclofenac {n=9 (4.9%, 95%CI=2.3–9.2)} (p=0.07)."

Clinical • HEOR • Pancreatitis

PRECISE: Efficacy and Safety of Parecoxib vs. Indomethacin in Preventing Post-ERCP Pancreatitis (clinicaltrials.gov) - P2 | N=100 | Not yet recruiting | Sponsor: Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine

New P2 trial • Pancreatitis

To study the preventive effect and mechanism of Gegen Qinlian decoction on post-ERCP pancreatitis based on NLRP3 inflammasome (ChiCTR) - P=N/A | N=120 | Not yet recruiting | Sponsor: The first affiliated hospital of Henan university of CM; The first affiliated hospital of Henan university of CM

New trial • Pancreatitis

Electroacupuncture combined with Indomethacin Suppositories for Postoperative Pain Management in Patients with Mixed Hemorrhoids: A Clinical Study (ChiCTR) - P=N/A | N=100 | Recruiting | Sponsor: Affiliated Municipal Hospital of Shanghai University of Traditional Chinese Medicine; Affiliated Municipal Hospital of Shanghai University of Traditio

New trial • Gastroenterology • Gastrointestinal Disorder • Pain

The Optimal Dose of Indomethacin Suppository for Preventing Post-ERCP Pancreatitis (clinicaltrials.gov) - P=N/A | N=192 | Completed | Sponsor: The First Affiliated Hospital of Soochow University | Recruiting ➔ Completed

Trial completion • Pancreatitis

The Optimal Dose of Indomethacin Suppository for Preventing Post-ERCP Pancreatitis (clinicaltrials.gov) - P=N/A | N=192 | Recruiting | Sponsor: The First Affiliated Hospital of Soochow University

New trial • Pancreatitis

Value of indomethacin suppository for preoperative analgesia and anti-inflammation in laparoscopic appendectomy: a protocol of prospective, double-blinded, single-centre, randomised controlled trial in China. (PubMed, BMJ Open) - "The trial was divided into two groups (n=64) using a randomised number table: group A will be given 100 mg of indomethacin suppository rectally and group B will be given 8 mg of intravenous lornoxicam. We will disseminate our study findings at national and international paediatric research conferences. Chinese Clinical Trial Registry (ChiCTR2200062004)."

Journal • Anesthesia • Gastroenterology • Gastrointestinal Disorder • Immunology • Inflammation • Inflammatory Bowel Disease • Pain • Pediatrics

Efficacy of Rectal Indomethacin in Prevention of Post-pancreatectomy Acute Pancreatitis (clinicaltrials.gov) - P2 | N=200 | Not yet recruiting | Sponsor: Shanghai Jiao Tong University School of Medicine

New P2 trial • Pancreatitis

ORAL N-ACETYL CYSTEINE VERSUS RECTAL INDOMETHACIN FOR PREVENTION OF POST ERCP PANCREATITIS: A MULTICENTER MULTINATIONAL RANDOMIZED CONTROLLED TRIAL. (PubMed, Arq Gastroenterol) - "Oral NAC is more effective than rectal indomethacin when compared to placebo for prevention of PEP and the combination of NAC and Indomethacin had the lowest incidence of PEP and may have synergistic effect in preventing of PEP (IRCT20201222049798N1; 29/12/2020)."

Journal • Pancreatitis

Efficacy of Rectal Indomethacin in Prevention of Post-operative Pancreatitis After Pancreaticoduodenectomy (clinicaltrials.gov) - P=N/A | N=44 | Completed | Sponsor: Institute of Liver and Biliary Sciences, India | Recruiting ➔ Completed | N=80 ➔ 44 | Trial completion date: Dec 2022 ➔ May 2022 | Trial primary completion date: Dec 2022 ➔ Apr 2022

Enrollment change • Trial completion • Trial completion date • Trial primary completion date • Pancreatitis

PEPPER: Prophylaxis of Post-ERCP Acute Pancreatitis (clinicaltrials.gov) - P3 | N=1250 | Recruiting | Sponsor: Azienda Unità Sanitaria Locale Reggio Emilia

New P3 trial • Pancreatitis

Efficacy of Rectal Indomethacin in Prevention of Post-operative Pancreatitis After Pancreaticoduodenectomy (clinicaltrials.gov) - P=N/A | N=80 | Recruiting | Sponsor: Institute of Liver and Biliary Sciences, India | Trial completion date: Mar 2022 ➔ Dec 2022 | Trial primary completion date: Dec 2021 ➔ Dec 2022

Trial completion date • Trial primary completion date • Pancreatitis

Efficacy of Rectal Indomethacin in Prevention of Post-operative Pancreatitis After Pancreaticoduodenectomy (clinicaltrials.gov) - P=N/A; N=80; Recruiting; Sponsor: Institute of Liver and Biliary Sciences, India

Clinical • New trial • Pancreatitis

[VIRTUAL] ORAL N-ACETYL CYSTEINE VERSUS RECTAL INDOMETHACIN FOR PREVENTION OF POST ERCP PANCREATITIS: A MULTICENTER MULTINATIONAL RANDOMIZED CONTROLLED TRIAL (UEGW 2021) - "The efficacy of oral or IV N-acetyl cysteine (NAC) in the prevention of PEP is unclear based on studies with discrepant results.so this multicenter multinational RCT designed to evaluate and compare efficacy of suppository indomethacin and NAC for prevention of PEP. Oral NAC is more effective than rectal indomethacin when compared to placebo for prevention of PEP and the combination of NAC and Indomethacin had the lowest incidence of PEP and may have synergistic effect in prevention of PEP."

Clinical • Pain • Pancreatitis

Comparison of stent and indomethacin suppository efficacy in the prevention of acute pancreatitis after ERCP. (PubMed, Acta Biomed) - "According to the results of our study, rectal indomethacin administration decreased the frequency of PEP in high-risk patients. However, there was no significant difference in PEP prophylaxis between the stent and indomethacin groups."

Clinical • Journal • Pancreatitis

Prospective study on the effect of parecoxib sodium analgesia on pain and stress response after surgery in elderly patients with hip fracture (PubMed, Zhongguo Gu Shang) - "The advanced analgesic application of parecoxib sodium can significantly reduce the postoperative stress response of elderly hip fracture patients, enhance the postoperative analgesic effect, reduce the incidence of postoperative delirium, and improve the quality of rehabilitation of patients."

Clinical • Journal • CNS Disorders • Musculoskeletal Diseases • Orthopedics • Pain

Rectal Indomethacin Versus Intraperitoneal Lidocaine for Analgesia After Laparoscopic Cholecystectomy (clinicaltrials.gov) - P=N/A; N=80; Completed; Sponsor: South Valley University

New trial • Pain

Prophylactic effect of rectal indomethacin plus nitroglycerin administration for preventing pancreatitis after endoscopic retrograde cholangiopancreatography in female patients. (PubMed, Ann Palliat Med) - "The risk of post-ERCP pancreatitis in the indomethacin + nitroglycerin group was 7% lower than that in the PSP. Indomethacin + nitroglycerin is superior to PSP in preventing and relieving the severity of post-ERCP pancreatitis in patients with difficult intubation. Indomethacin plus nitroglycerin can avoid the need for PSP in the prevention of post-ERCP pancreatitis."

Clinical • Journal • Pancreatitis

Does melatonin addition to indomethacin decrease post endoscopic retrograde cholangiopancreatography pancreatitis? A randomized double-blind controlled trial. (PubMed, Eur J Gastroenterol Hepatol) - "The results of the present study showed that, administration of melatonin 3 mg tablets plus indomethacin suppository 100 mg 1 h before ERCP could decrease the PEP rate and amylase and lipase levels compared to administration of indomethacin suppository 100 mg alone."

Clinical • Journal • Pancreatitis