ClinicalTrials.gg
RecruitingNCT07071441Updated Jun 15, 2026

Indomethacin vs Diclofenac for Preventing PEP

An interventional study of Indomethacin 100 MG and Diclofenac 100mg in ERCP, Pancreatitis and Non-steroidal Anti-inflammatory (NSAID), sponsored by Air Force Military Medical University, China. Recruiting at 20 sites in China. Open to participants aged 18 Years to 90 Years. Per ClinicalTrials.gov, last updated 2026-06-15.

Sponsored by Air Force Military Medical University, China · Not applicable, Interventional, and Prevention

From the registry’s dates

  • Started Jun 2025; still recruiting 1 year 5 months later.

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Phase
Not applicable
Study type
Interventional
Enrollment
4,050
Allocation
Randomized
Ages
18 Years to 90 Years
Sex
All
01

Where this study stands

Counted across the records on this site · 2026-11-14

Among 20 studies testing indomethacin in Pancreatitis — 6 open to participants now, 6 under way, 1 of them phase 3. Indomethacin · Pancreatitis.

Planned enrollment
Largest of 20
4,050 · median 492
Started
2025
with 1 other
No phase
6 of 20
2 open now
Registered
17th of 20
by date
Lead sponsor
2 of 20
Air Force Military Medical University, China

Among the 20 studies testing indomethacin in Pancreatitis, this one has the largest planned enrollment, is one of 2 that started in 2025, is one of 6 with no phase, and was the 17th registered.

Pancreatitis

558 studies on the registry are indexed under Pancreatitis; 165 are open to participants now.

Browse Pancreatitis studies →

Open to participants now

6 of the 20 studies testing indomethacin in Pancreatitis are open now, in 5 countries. Recruiting first, the newest first:

By country, each count listing its studies:

All 6 open studies →

About indomethacin

Indomethacin: first FDA approval 1965 (INDOCIN). What it is approved for, and how studies give it, is on its page →

Who these studies take

Of the 112 Pancreatitis studies recruiting now, 62 (55%) set no upper age limit and 27 (24%) stop at 75 or younger; 14 take children under 18; 12 take healthy volunteers.

This study: 18 Years to 90 Years · all sexes · no healthy volunteers.

The full table on the hub →

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Watch this landscapeDownload CSVNarrow it in search →With an account: a weekly mail of what changed among 20 studies testing indomethacin in Pancreatitis, or all of them as a file.
02

Study summary

Pancreatitis is the most common and serious complication following post-endoscopic retrograde cholangiopancreatography (ERCP) and is associated with occasional mortality, extended hospital stays, and increased healthcare expenses. Preprocedural administration of rectal non-steroidal anti-inflammatory drugs (NSAIDs) was demonstrated to be an effective and convenient strategy for post-ERCP pancreatitis (PEP). Furthermore, several meta-analyses found that only 100mg indomethacin and diclofenac could effectively reduce PEP. Therefore, updated international clinical practice guidelines uniformly recommended administration of 100mg indomethacin or diclofenac in patients without contradictions. However, it was unclear which one of the two drug is more superior.

A recent meta-analysis suggested 100mg rectal diclofenac was more efficacious than same-dose rectal indomethacin in PEP prevention (relative risk (RR) 0·59, 95% confidence intervals (CI) 0·40-0·89). Based on the results, we conducted a multicenter, double-blind, control trial to investigate whether 100mg diclofenac is superior than same-dose indomethacin. This trial planned to enroll 3612 patients in total. However, in the first interim analysis, PEP occurred in 53 patients (8.8%) of 600 patients allocated to diclofenac group and 37 patients (6.1%) of 604 patients allocated to indomethacin group (relative risk (RR) 1.44; 95% confidence interval (CI) 0.96-2.16, p=0.074). Thus, the trial was stopped according to the futility rule of conditional power. However, it was worth noticing that PEP tended to be higher in diclofenac group than that in indomethacin group. A sample size of 1204 was under power to draw the conclusion of significantly lower PEP rate in indomethacin group and thus a new trial with larger sample size of sufficient power is predicted to prove the superiority of indomethacin over diclofenac. Here we conducted a multicenter, randomized, double-blind trial to investigate whether 100mg indomethacin is superior to 100mg diclofenac in preventing PEP.

03

Conditions studied

  • ERCP
  • Pancreatitis
  • Non-steroidal Anti-inflammatory (NSAID)
  • Indomethacin
  • Diclofenac

Browse trials for

04

Who can participate

Ages eligible
18 Years to 90 Years
Sexes eligible
All
Accepts healthy volunteers
No

Go through the criteria one by one — yes, no or not sure — and take the list to your doctor or the study team. Kept in this browser only.

Inclusion criteria

  • 18-90 years old patients with native papilla who planned to undergo ERCP

Exclusion criteria

Exclusion Criteria:

  • Previous biliary sphincterotomy and papillary large balloon dilation
  • Planned for placements of pancreatic duct stents (eg. pancreatic duct strictures, planned ampullectomy)
  • Allergy to NSAIDs
  • The administration of NSAIDs within 7 days
  • Not suitable for NSAIDs administration (gastrointestinal hemorrhage within 4 weeks, renal dysfunction [Cr >1.4mg/dl=120umol/l]; presence of coagulopathy before the procedure)
  • Acute pancreatitis within 7 days before ERCP or acute pancreatitis with obvious Pancreatic edema and peripancreatic fluid collections
  • Hemodynamical instability
  • Pregnancy or lactation
  • Unable to give
Terms in these criteria, in plain language(1)

Underlined terms in the criteria open these too. Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.

Informed consent

Before you join, the study team explains what taking part involves — its purpose, what happens, the risks and possible benefits — and answers your questions, so you can decide freely. Consent is usually recorded on a form (the informed consent form, ICF) signed by you or, where the law allows, by someone legally authorised to decide for you.

You can keep asking questions during the study, you are told of new information that matters, and you can choose to leave at any time.

05

Study design

Phase
Not applicable
Primary purpose
Prevention
Allocation
Randomized
Intervention model
Parallel assignment
Masking
Quadruple (Participant, Care provider, Investigator, Outcomes assessor)
Enrollment
4,050 participants (estimated)

Study arms

  • Experimental
    Indomethacin

    All patients without contraindications should receive 100mg rectal indomethacin within 30mins before ERCP procedure

    Drug: Indomethacin 100 MG

  • Active comparator
    Diclofenac group

    All patients without contraindications should receive 100mg rectal diclofenac within 30mins before ERCP procedure

    Drug: Diclofenac 100mg

Interventions

  • All patients without contraindications should receive 100mg rectal indomethacin within 30mins before ERCP procedure

  • All patients without contraindications should receive 100mg rectal diclofenac within 30mins before ERCP procedure

06

What researchers measure

Primary outcomes

  1. Rate of post-ERCP Pancreatitis

    a new or aggravated upper abdominal pain, with an elevated pancreatic enzyme of at least 3 times as the upper limit of normal value 24h after procedure and prolonged hospitalization days for at least 2 days. This definition was based on a widely recognized Cotton consensus

    Time frame: 30 days

Secondary outcomes

  1. Rate of mild, moderate or severe PEP

    The severity classification of post-ERCP pancreatitis was defined according to the Cotton Criteria. Mild PEP: with an extension of hospitalization period of 2-3 days; Moderate PEP: with an extension of hospitalization period of 4-10 days; Severe PEP: with an extension of more than 10 days, or hemorrhagic pancreatitis, phlegmon, or pseudocyst, intervention (percutaneous drainage or surgery), or death.

    Time frame: 30 days

  2. Rate of patients with different severity of pancreatitis evaluated by revised Atlanta criteria

    Mild: The most common form of acute pancreatitis, without organ failure or local or systemic complications, generally resolving within 1 week of onset. Moderately Severe: the presence of transient organ failure, local complications or exacerbation of co-morbid disease. Severe: persistent organ failure, that is, organ failure \>48 h. Local complications are peripancreatic fluid collections, pancreatic and peripancreatic necrosis (sterile or infected), pseudocyst and walled-off necrosis (sterile or infected).

    Time frame: 30 days

  3. Rate of ERCP-related perforation

    Perforation was established according to Cotton criteria, Mild: slight leakage of fluid or contrast dye, manageable through fluid administration and suction therapy ≤3 days Moderate: definite perforation required to be managed for 4-10 days Severe: management for more than 10 days or requiring for percutaneous or surgical intervention.

    Time frame: 30 days

  4. Rate of ERCP-related infection

    Infection was established according to Cotton criteria. Mild: temperature \>38℃ for 24-48h Moderate: Febrile illness requiring \>3 days of hospital treatment; endoscopic or percutaneous interventions; Severe: septic shock or requiring surgery.

    Time frame: 30 days

  5. Rate of ERCP-related bleeding

    Bleeding was established according to Cotton criteria. Mild: a documented decrease in hemoglobin concentration by \<3 g/L, without requiring the blood transfusion; Moderate: blood transfusion ≤4 units; without need for angiographic or surgery interventions Severe: Transfusion: ≥5 units or requiring for angiographic or surgery interventions.

    Time frame: 30 days

  6. Rate of NSAIDs-related complications

    NSAIDs-related complications include: acute kidney injury, allergic reaction, gastrointestinal bleeding, myocardial infarction, cerebrovascular accident, and death

    Time frame: 30 days

  7. Rate of mortality

    Time frame: 30 days

  8. The rate of total adverse events

    Adverse events include ERCP-related or non ERCP-related adverse events

    Time frame: 30 days

07

Study locations

16 of 20 sites recruiting
08

References and documents

Publications

  • Akshintala VS, Sperna Weiland CJ, Bhullar FA, Kamal A, Kanthasamy K, Kuo A, Tomasetti C, Gurakar M, Drenth JPH, Yadav D, Elmunzer BJ, Reddy DN, Goenka MK, Kochhar R, Kalloo AN, Khashab MA, van Geenen EJM, Singh VK. Non-steroidal anti-inflammatory drugs, intravenous fluids, pancreatic stents, or their combinations for the prevention of post-endoscopic retrograde cholangiopancreatography pancreatitis: a systematic review and network meta-analysis. Lancet Gastroenterol Hepatol. 2021 Sep;6(9):733-742. doi: 10.1016/S2468-1253(21)00170-9. Epub 2021 Jun 30. PubMed 34214449 ↗
  • Dumonceau JM, Kapral C, Aabakken L, Papanikolaou IS, Tringali A, Vanbiervliet G, Beyna T, Dinis-Ribeiro M, Hritz I, Mariani A, Paspatis G, Radaelli F, Lakhtakia S, Veitch AM, van Hooft JE. ERCP-related adverse events: European Society of Gastrointestinal Endoscopy (ESGE) Guideline. Endoscopy. 2020 Feb;52(2):127-149. doi: 10.1055/a-1075-4080. Epub 2019 Dec 20. PubMed 31863440 ↗
  • Kang X, Xia M, Wang J, Wang X, Luo H, Qin W, Liang Z, Zhao G, Yang L, Sun H, Tao J, Ning B, Zhong L, Zhang R, Ma X, Zhao J, Yue L, Jin H, Kang C, Ren G, Liang S, Wang H, Wang L, Nie Y, Wu K, Fan DM, Pan Y. Rectal diclofenac versus indomethacin for prevention of post-ERCP pancreatitis (DIPPP): a multicentre, double-blind, randomised, controlled trial. Gut. 2025 Jun 6;74(7):1094-1102. doi: 10.1136/gutjnl-2024-334466. PubMed 40113243 ↗
  • Luo H, Zhao L, Leung J, Zhang R, Liu Z, Wang X, Wang B, Nie Z, Lei T, Li X, Zhou W, Zhang L, Wang Q, Li M, Zhou Y, Liu Q, Sun H, Wang Z, Liang S, Guo X, Tao Q, Wu K, Pan Y, Guo X, Fan D. Routine pre-procedural rectal indometacin versus selective post-procedural rectal indometacin to prevent pancreatitis in patients undergoing endoscopic retrograde cholangiopancreatography: a multicentre, single-blinded, randomised controlled trial. Lancet. 2016 Jun 4;387(10035):2293-2301. doi: 10.1016/S0140-6736(16)30310-5. Epub 2016 Apr 28. PubMed 27133971 ↗

Individual participant data

Plan to share: Undecided

09

Timeline

Tracking since Sep 25, 2026
ElapsedEstimatedEstimated, not yet reachedSimilar studies: half by the dot; the band is the middle halfHalf of similar studies reached it by the dot; the band is the middle half, from a quarter to three quarters

Started Jun 2025 (actual). Primary completion is estimated for Dec 2026, 18 months after the start.

Of 91 non-industry interventional studies with no phase under Pancreatitis, half reached primary completion within 32 months of starting (the median), counting those still running; a quarter within 23 and three quarters within 59. This study's planned 18 months is below that.

Counting every sponsor, half of 94 studies reached it within 32 months; a quarter within 23 and three quarters within 59.

How these figures are worked out, and which studies are left out of them.

Registered
Jul 8, 2025
First posted
Jul 17, 2025
StartActual
Jun 1, 2025
Primary completionEst.
Dec 31, 2026
CompletionEst.
Dec 31, 2026
Last update
Jun 15, 2026
What these dates mean
Start.
When the first participant enrolled; while estimated, when the study expects to open to recruitment.
Primary completion.
When the last participant was examined or treated to collect data for the study's main question, its primary outcome. A study that stopped early gives the date its data collection stopped.
Completion.
When the last participant's last visit took place, for every outcome, secondary ones and side effects included: the end of the study. Often later than primary completion, sometimes the same day.
Actual and Est.
Actual means the registry says the date has happened. Est. (estimated) is a date the sponsor plans or expects. It can still move, and the sponsor is expected to change it to actual once it has passed.
No changes since tracking began. The registry record was last updated on Jun 15, 2026, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
10

Registry details

Key details

Study ID
NCT07071441
Responsible party
Yanglin Pan (Professor, Air Force Military Medical University, China) — Principal investigator
First posted
Jul 17, 2025
Start date
Jun 1, 2025
Primary completion
Dec 31, 2026 (estimated)
Completion
Dec 31, 2026 (estimated)
Last update
Jun 15, 2026

Study contacts

Yanglin Pan, MD
Contact
yanglinpan@hotmail.com
86-84771536

Oversight

Data monitoring committee
Yes
FDA-regulated drug
No
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

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Studies of the drug tested here: Indomethacin

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