Trial Outcomes & Findings for Rectal Indomethacin to Prevent Post-Endoscopic Retrograde Cholangiopancreatography (ERCP) Pancreatitis (NCT NCT01774604)

NCT ID: NCT01774604

Last Updated: 2016-11-04

Results Overview

Number of patients who developed pancreatitis following ERCP based on Atlanta Classification

Recruitment status

TERMINATED

Study phase

PHASE3

Target enrollment

449 participants

Primary outcome timeframe

From randomization to 30 days after ERCP

Results posted on

2016-11-04

Participant Flow

All patients who presented to Dartmouth-Hitchcock Medical Center for Endoscopic Retrograde Cholangiopancreatography (ERCP) for any reason between March 2013 and December 2014

Participant milestones

Participant milestones
Measure
Indomethacin
Indomethacin 100 mg Per Rectum (PR) x 1 in peri-procedural period Indomethacin: 100 mg Indomethacin PR x 1
Placebo
Placebo suppositories (#2) Placebo
Overall Study
STARTED
223
226
Overall Study
COMPLETED
223
226
Overall Study
NOT COMPLETED
0
0

Reasons for withdrawal

Withdrawal data not reported

Baseline Characteristics

Rectal Indomethacin to Prevent Post-Endoscopic Retrograde Cholangiopancreatography (ERCP) Pancreatitis

Baseline characteristics by cohort

Baseline characteristics by cohort
Measure
Indomethacin
n=223 Participants
Indomethacin 100 mg PR x 1 in peri-procedural period Indomethacin: 100 mg Indomethacin PR x 1
Placebo
n=226 Participants
Placebo suppositories (#2) Placebo
Total
n=449 Participants
Total of all reporting groups
Age, Continuous
64.9 years
STANDARD_DEVIATION 23.7 • n=99 Participants
64.3 years
STANDARD_DEVIATION 15.1 • n=107 Participants
64.6 years
STANDARD_DEVIATION 19.9 • n=206 Participants
Sex: Female, Male
Female
118 Participants
n=99 Participants
118 Participants
n=107 Participants
236 Participants
n=206 Participants
Sex: Female, Male
Male
105 Participants
n=99 Participants
108 Participants
n=107 Participants
213 Participants
n=206 Participants
Indication
Acute Cholangitis
12 participants
n=99 Participants
13 participants
n=107 Participants
25 participants
n=206 Participants
Indication
Choledocholithiasis
59 participants
n=99 Participants
52 participants
n=107 Participants
111 participants
n=206 Participants
Indication
Malignant Biliary Obstruction
53 participants
n=99 Participants
50 participants
n=107 Participants
103 participants
n=206 Participants
Indication
Biliary Stent Change
25 participants
n=99 Participants
25 participants
n=107 Participants
50 participants
n=206 Participants
Indication
Biliary Leak
11 participants
n=99 Participants
12 participants
n=107 Participants
23 participants
n=206 Participants
Indication
Increased Liver Tests/Jaundice
13 participants
n=99 Participants
9 participants
n=107 Participants
22 participants
n=206 Participants
Indication
Pancreatic Stricture
3 participants
n=99 Participants
5 participants
n=107 Participants
8 participants
n=206 Participants
Indication
Suspected Sphincter of Oddi Dysfunction (SOD)
6 participants
n=99 Participants
8 participants
n=107 Participants
14 participants
n=206 Participants
Indication
Pancreatic Leak/Disruption
11 participants
n=99 Participants
12 participants
n=107 Participants
23 participants
n=206 Participants
Indication
Pancreatic Duct Stone
3 participants
n=99 Participants
2 participants
n=107 Participants
5 participants
n=206 Participants
Indication
Recurrent Acute Pancreatitis
5 participants
n=99 Participants
2 participants
n=107 Participants
7 participants
n=206 Participants
Indication
Ampullectomy
6 participants
n=99 Participants
5 participants
n=107 Participants
11 participants
n=206 Participants
Indication
Other
16 participants
n=99 Participants
31 participants
n=107 Participants
47 participants
n=206 Participants
History of post-ERCP Pancreatitis
Yes
9 participants
n=99 Participants
9 participants
n=107 Participants
18 participants
n=206 Participants
History of post-ERCP Pancreatitis
No
214 participants
n=99 Participants
217 participants
n=107 Participants
431 participants
n=206 Participants
History of Previous Sphincterotomy
Yes
72 participants
n=99 Participants
71 participants
n=107 Participants
143 participants
n=206 Participants
History of Previous Sphincterotomy
No
151 participants
n=99 Participants
155 participants
n=107 Participants
306 participants
n=206 Participants
Previous ERCP
Yes
81 participants
n=99 Participants
79 participants
n=107 Participants
160 participants
n=206 Participants
Previous ERCP
No
142 participants
n=99 Participants
147 participants
n=107 Participants
289 participants
n=206 Participants
Difficult Cannulation
Yes
46 participants
n=99 Participants
42 participants
n=107 Participants
88 participants
n=206 Participants
Difficult Cannulation
No
177 participants
n=99 Participants
184 participants
n=107 Participants
361 participants
n=206 Participants
Precut Biliary Sphincterotomy
Yes
11 participants
n=99 Participants
16 participants
n=107 Participants
27 participants
n=206 Participants
Precut Biliary Sphincterotomy
No
212 participants
n=99 Participants
210 participants
n=107 Participants
422 participants
n=206 Participants
Therapeutic Biliary Sphincterotomy
Yes
106 participants
n=99 Participants
114 participants
n=107 Participants
220 participants
n=206 Participants
Therapeutic Biliary Sphincterotomy
No
117 participants
n=99 Participants
112 participants
n=107 Participants
229 participants
n=206 Participants
Therapeutic Pancreatic Sphincterotomy
Yes
12 participants
n=99 Participants
5 participants
n=107 Participants
17 participants
n=206 Participants
Therapeutic Pancreatic Sphincterotomy
No
211 participants
n=99 Participants
221 participants
n=107 Participants
432 participants
n=206 Participants
Minor Duct Sphincterotomy
Yes
5 participants
n=99 Participants
4 participants
n=107 Participants
9 participants
n=206 Participants
Minor Duct Sphincterotomy
No
218 participants
n=99 Participants
222 participants
n=107 Participants
440 participants
n=206 Participants
Balloon Dilation of Biliary Sphincter
Yes
21 participants
n=99 Participants
20 participants
n=107 Participants
41 participants
n=206 Participants
Balloon Dilation of Biliary Sphincter
No
202 participants
n=99 Participants
206 participants
n=107 Participants
408 participants
n=206 Participants
Wire Cannulation of Pancreatic Duct
Yes
90 participants
n=99 Participants
89 participants
n=107 Participants
179 participants
n=206 Participants
Wire Cannulation of Pancreatic Duct
No
133 participants
n=99 Participants
137 participants
n=107 Participants
270 participants
n=206 Participants
Pancreatography
Yes
50 participants
n=99 Participants
49 participants
n=107 Participants
99 participants
n=206 Participants
Pancreatography
No
173 participants
n=99 Participants
177 participants
n=107 Participants
350 participants
n=206 Participants
Pancreatic Acinarization
Yes
5 participants
n=99 Participants
4 participants
n=107 Participants
9 participants
n=206 Participants
Pancreatic Acinarization
No
218 participants
n=99 Participants
222 participants
n=107 Participants
440 participants
n=206 Participants
Biliary Strent Placement
Yes
89 participants
n=99 Participants
84 participants
n=107 Participants
173 participants
n=206 Participants
Biliary Strent Placement
No
134 participants
n=99 Participants
142 participants
n=107 Participants
276 participants
n=206 Participants
Pancreatic Stent Placement
Yes
36 participants
n=99 Participants
35 participants
n=107 Participants
71 participants
n=206 Participants
Pancreatic Stent Placement
No
187 participants
n=99 Participants
191 participants
n=107 Participants
378 participants
n=206 Participants
Trainee Involvement
Yes
152 participants
n=99 Participants
168 participants
n=107 Participants
320 participants
n=206 Participants
Trainee Involvement
No
71 participants
n=99 Participants
58 participants
n=107 Participants
129 participants
n=206 Participants
Concomitant Endoscopic Ultrasound with Fine Needle Aspiration (EUS/FNA)
Yes
41 participants
n=99 Participants
40 participants
n=107 Participants
81 participants
n=206 Participants
Concomitant Endoscopic Ultrasound with Fine Needle Aspiration (EUS/FNA)
No
182 participants
n=99 Participants
186 participants
n=107 Participants
368 participants
n=206 Participants
Periprocedural Fluid Volume
705 Milliliters
STANDARD_DEVIATION 335 • n=99 Participants
703 Milliliters
STANDARD_DEVIATION 355 • n=107 Participants
704 Milliliters
STANDARD_DEVIATION 345 • n=206 Participants

PRIMARY outcome

Timeframe: From randomization to 30 days after ERCP

Population: Patient who randomized into the study and received either rectal indomethacin or placebo

Number of patients who developed pancreatitis following ERCP based on Atlanta Classification

Outcome measures

Outcome measures
Measure
Indomethacin
n=223 Participants
Indomethacin 100 mg PR x 1 in peri-procedural period Indomethacin: 100 mg Indomethacin PR x 1
Placebo
n=226 Participants
Placebo suppositories (#2) Placebo
Number of Patients Who Developed Acute Pancreatitis
16 participants
11 participants

SECONDARY outcome

Timeframe: From randomization to 30 days after ERCP

Population: Assess the number of patients who developed severe acute pancreatitis

Number of patients with severe acute pancreatitis based on the Atlanta Classification

Outcome measures

Outcome measures
Measure
Indomethacin
n=223 Participants
Indomethacin 100 mg PR x 1 in peri-procedural period Indomethacin: 100 mg Indomethacin PR x 1
Placebo
n=226 Participants
Placebo suppositories (#2) Placebo
Number of Patients Who Developed Severe Pancreatitis
0 participants
1 participants

SECONDARY outcome

Timeframe: From randomization to 30 days after ERCP

Number of patients with moderately severe pancreatitis based on Atlanta Classification

Outcome measures

Outcome measures
Measure
Indomethacin
n=223 Participants
Indomethacin 100 mg PR x 1 in peri-procedural period Indomethacin: 100 mg Indomethacin PR x 1
Placebo
n=226 Participants
Placebo suppositories (#2) Placebo
Number of Patients Who Developed Moderately Severe Pancreatitis
0 participants
1 participants

SECONDARY outcome

Timeframe: From randomization to 30 days after ERCP

Number of patient who developed mild acute pancreatitis based on the Atlanta Classification

Outcome measures

Outcome measures
Measure
Indomethacin
n=223 Participants
Indomethacin 100 mg PR x 1 in peri-procedural period Indomethacin: 100 mg Indomethacin PR x 1
Placebo
n=226 Participants
Placebo suppositories (#2) Placebo
Number of Patients Who Developed Mild Pancreatitis
16 participants
9 participants

SECONDARY outcome

Timeframe: From randomization to 30 days after ERCP

Number of patients who developed any type of gastrointestinal bleeding from time of ERCP to 30 days post procedure

Outcome measures

Outcome measures
Measure
Indomethacin
n=223 Participants
Indomethacin 100 mg PR x 1 in peri-procedural period Indomethacin: 100 mg Indomethacin PR x 1
Placebo
n=226 Participants
Placebo suppositories (#2) Placebo
Number of Patients Who Developed Gastrointestinal Bleeding
4 participants
6 participants

SECONDARY outcome

Timeframe: From randomization to 30 days after ERCP

Number of patients who died from any cause from the time of ERCP until 30 days post-procedure

Outcome measures

Outcome measures
Measure
Indomethacin
n=223 Participants
Indomethacin 100 mg PR x 1 in peri-procedural period Indomethacin: 100 mg Indomethacin PR x 1
Placebo
n=226 Participants
Placebo suppositories (#2) Placebo
Number of Patient Deaths
0 participants
3 participants

SECONDARY outcome

Timeframe: From randomization until 30 days after ERCP

Number of patients admitted to the hospital for any cause following ERCP

Outcome measures

Outcome measures
Measure
Indomethacin
n=223 Participants
Indomethacin 100 mg PR x 1 in peri-procedural period Indomethacin: 100 mg Indomethacin PR x 1
Placebo
n=226 Participants
Placebo suppositories (#2) Placebo
Number of Patients With 30 Days Hospital Re-admission
31 participants
20 participants

Adverse Events

Indomethacin

Serious events: 0 serious events
Other events: 4 other events
Deaths: 0 deaths

Placebo

Serious events: 3 serious events
Other events: 6 other events
Deaths: 0 deaths

Serious adverse events

Serious adverse events
Measure
Indomethacin
n=223 participants at risk
Indomethacin 100 mg PR x 1 in peri-procedural period Indomethacin: 100 mg Indomethacin PR x 1
Placebo
n=226 participants at risk
Placebo suppositories (#2) Placebo
Gastrointestinal disorders
Severe Acute Pancreatitis Leading to Death
0.00%
0/223 • From randomization to 30 days after ERCP
0.44%
1/226 • Number of events 1 • From randomization to 30 days after ERCP
Gastrointestinal disorders
Secondary Bacterial Peritonitis due to Multifocal Hepatocellular Carcinoma Leading to Death
0.00%
0/223 • From randomization to 30 days after ERCP
0.44%
1/226 • Number of events 1 • From randomization to 30 days after ERCP
Respiratory, thoracic and mediastinal disorders
Aspiration Post-Procedure Leading to Death
0.00%
0/223 • From randomization to 30 days after ERCP
0.44%
1/226 • Number of events 1 • From randomization to 30 days after ERCP

Other adverse events

Other adverse events
Measure
Indomethacin
n=223 participants at risk
Indomethacin 100 mg PR x 1 in peri-procedural period Indomethacin: 100 mg Indomethacin PR x 1
Placebo
n=226 participants at risk
Placebo suppositories (#2) Placebo
Gastrointestinal disorders
Gastrointestinal Bleeding
1.8%
4/223 • Number of events 4 • From randomization to 30 days after ERCP
2.7%
6/226 • Number of events 6 • From randomization to 30 days after ERCP

Additional Information

John M. Levenick

Penn State Hershey Medical Center/Dartmouth-Hitchcock Medical Center

Phone: 603-667-1332

Results disclosure agreements

  • Principal investigator is a sponsor employee
  • Publication restrictions are in place