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Peptide

Sincalide (Kinevac)

Sincalide is the synthetic C-terminal octapeptide of cholecystokinin (CCK-8). FDA-approved in 1976 for diagnostic imaging. Stimulates gallbladder contraction for ejection fraction measurement. GBEF <38% (60-min infusion) indicates dysfunction. 81% symptom relief post-cholecystectomy in dyskinesia patients. Also used for pancreatic function testing with secretin.

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Best evidence
Grade A
Conditions studied
2
Outcomes
9
Graded outcomes
3231

Evidence by condition

  • Strong
  • Moderate
  • Limited
  • Very limited

2 conditions, plus general outcomes

Biliary Dyskinesia

Biliary Dyskinesia: outcomes studied for Sincalide (Kinevac)
GradeOutcomeEffectSizeStudiesPeopleStudies list
Gallbladder Ejection Fraction

Standard 60-min sincalide infusion establishes GBEF normal values. Lower limit of normal: 38% at 1% CI. GBEF <35-40% indicates gallbladder dysfunction. Coefficient of variation 19% for 60-min protocol.

Improves (the measure goes up)Large effect12 studies

Studies that measured gallbladder ejection fraction

and 2 more in the citations list

Gallbladder Contraction

Reduces gallbladder radiographic size by ≥40% in normal patients. Enables visualization of gallbladder function via cholescintigraphy. Gold standard for acalculous cholecystitis diagnosis.

Improves (the measure goes up)Large effect12 studies

Studies that measured gallbladder contraction

and 2 more in the citations list

Surgical Outcome Prediction

81.4% complete symptom resolution after cholecystectomy in low GBEF patients. Systematic review of 1,710 patients. GBEF alone may not reliably predict outcomes; other factors contribute.

Improves (the measure goes up)Moderate effect9 studies

Studies that measured surgical outcome prediction

Pancreatitis

Pancreatitis: outcomes studied for Sincalide (Kinevac)
GradeOutcomeEffectSizeStudiesPeopleStudies list
Pancreatic Enzyme Secretion

Combined with secretin for pancreatic function testing. Stimulates enzyme (lipase, amylase) secretion into duodenum. Used for duodenal aspirate analysis in chronic pancreatitis evaluation.

Improves (the measure goes up)Large effect6 studies

Studies that measured pancreatic enzyme secretion

General

General: outcomes studied for Sincalide (Kinevac)
GradeOutcomeEffectSizeStudiesPeopleStudies list
Liver Protection

7 human trials support this finding. Human clinical trial data available.

Improves (the measure goes up)Small effect8 studies

Studies that measured liver protection

GI Protection

4 human trials support this finding. Human clinical trial data available.

Improves (the measure goes up)Small effect5 studies

Studies that measured gi protection

Pain

3 preclinical studies support this finding. Primarily preclinical evidence.

Improves (the measure goes down)Small effect4 studies

Studies that measured pain

Anti-Cancer Activity

3 preclinical studies support this finding. Primarily preclinical evidence.

Improves (the measure goes up)Small effect4 studies

Studies that measured anti-cancer activity

Blood Glucose Control

2 preclinical studies support this finding. Primarily preclinical evidence.

Improves (the measure goes down)Small effect3 studies

Studies that measured blood glucose control

Key findings

  • Gallbladder Ejection FractionBiliary DyskinesiaImproves (the measure goes up)
  • Gallbladder ContractionBiliary DyskinesiaImproves (the measure goes up)
  • Pancreatic Enzyme SecretionPancreatitisImproves (the measure goes up)

Studies cited

29 studies from PubMed

  1. Gastrointestinal cholecystokinin signaling pathway drugs modulate osteogenic/cementogenic differentiation of human periodontal ligament stem cells.Journal of dentistry, 2025 · PMID 40032153
  2. Ojeok-san enhances platinum sensitivity in ovarian cancer by regulating adipocyte paracrine IGF1 secretion.Adipocyte, 2024 · PMID 37993991
  3. HDAC1-Mediated Downregulation of NEU1 Exacerbates the Aggressiveness of Cervical Cancer.Critical reviews in eukaryotic gene expression, 2024 · PMID 38505872
  4. Defining Biliary Hyperkinesia and the Role of CholecystectomyDig Dis Sci, 2023 · PMID 37366537
  5. C1QTNF6 Targeted by MiR-184 Regulates the Proliferation, Migration, and Invasion of Lung Adenocarcinoma Cells.Molecular biotechnology, 2022 · PMID 35578071
  6. Cholescintigraphy may have a role in selecting patients with biliary dyskinesia for cholecystectomy: a systematic reviewSurg Endosc, 2020 · PMID 32479706
  7. Utilizing the Cholecystagogue, Ensure Plus, Results in Similar Hepatobiliary Scintigraphy Study Results and Patient Outcomes Status Post Cholecystectomy, in Comparison With Sincalide.Clinical nuclear medicine, 2020 · PMID 31789906
  8. Sincalide: A Review of Clinical Utility, Proper Infusion Methodology, and Alternative Cholecystogogues.Journal of nuclear medicine technology, 2019 · PMID 31019045
  9. Endoscopic Pancreatic Function Test using Combined Secretin and Cholecystokinin Stimulation for the Evaluation of Chronic PancreatitisGastrointest Endosc, 2015 · PMID 25773097
  10. Pain provocation and low gallbladder ejection fraction with CCK cholescintigraphy are not predictive of chronic acalculous gallbladder disease symptom relief after cholecystectomySurg Endosc, 2014 · PMID 24852884
  11. Classification schema of symptomatic enterogastric reflux utilizing sincalide augmentation on hepatobiliary scintigraphy.Journal of nuclear medicine technology, 2014 · PMID 25033884
  12. Optimum utilization of cholecystokinin cholescintigraphy (CCK-HIDA) in clinical practice: an evidence based reviewJ Gastrointest Surg, 2012 · PMID 22655428
  13. Dicyclomine: cause of abnormally decreased gall bladder ejection with sincalide-stimulated hepatobiliary scintigraphy.Clinical nuclear medicine, 2012 · PMID 22157036
  14. Sincalide-Stimulated Cholescintigraphy: A Multicenter Investigation to Determine Optimal Infusion Methodology and Gallbladder Ejection Fraction Normal ValuesJ Nucl Med, 2010 · PMID 20124048
  15. Extended application of 99mTc-mebrofenin cholescintigraphy with cholecystokinin in the evaluation of abdominal pain of hepatobiliary and gastrointestinal origin.Nuclear medicine communications, 2010 · PMID 20147863
  16. Diagnosis of BD relied in great measure on gallbladder ejection fraction (GBEF) after sincalide stimulation on hepatobiliary scintigraphy.Journal of pediatric surgery, 2009 · PMID 19853777
  17. Biliary dyskinesiaCurr Treat Options Gastroenterol, 2008 · PMID 18992594
  18. Laparoscopic cholecystectomy for biliary dyskinesia: correlation of preoperative cholecystokinin cholescintigraphy results with postoperative outcomeSurg Laparosc Endosc Percutan Tech, 2004 · PMID 15054652
  19. Systematic review and meta-analysis: does gall-bladder ejection fraction on cholecystokinin cholescintigraphy predict outcome after cholecystectomy in suspected functional biliary pain?Aliment Pharmacol Ther, 2003 · PMID 12869076
  20. Effect of atropine and sincalide on the intestinal uptake of F-18 fluorodeoxyglucose.Clinical nuclear medicine, 1999 · PMID 10595478
  21. Cholecystokinin octapeptide (CCK-8): a negative feedback control mechanism for opioid analgesia.Progress in brain research, 1995 · PMID 7568886
  22. Hemobilia presenting as intermittent gastrointestinal hemorrhage with sincalide confirmation. A case report.Clinical nuclear medicine, 1995 · PMID 7628138
  23. Abnormal gallbladder nuclear ejection fraction predicts success of cholecystectomy in patients with biliary dyskinesiaAm J Surg, 1993 · PMID 8273847
  24. Cholecystokinin enhanced hepatobiliary scanning with ejection fraction calculation as an indicator of disease of the gallbladderSurg Gynecol Obstet, 1991 · PMID 1985336
  25. Kinevac (sincalide for injection)/Squibb DiagnosticsRadiology, 1991 · PMID 1932168
  26. Sincalide-augmented quantitative hepatobiliary scintigraphy (QHBS): definition of normal parameters and preliminary relationship between QHBS and sphincter of Oddi (SO) manometry in patients suspected of having SO dysfunction.Journal of nuclear medicine : official publication, Society of Nuclear Medicine, 1990 · PMID 2395012
  27. Dopamine neuronal tracts in schizophrenia: their pharmacology and in vivo glucose metabolism.Annals of the New York Academy of Sciences, 1988 · PMID 2904785
  28. Cholecystokinin and pain.Pain and headache, 1987 · PMID 3317368
  29. Practical hepatobiliary imaging using pretreatment with sincalide in 139 hepatobiliary studies.Clinical nuclear medicine, 1985 · PMID 4017380