Kinevac
Evidence Grade A — Regulatory approved. 104 published studies. 8 registered clinical trials.
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Sincalide (sold as Kinevac) is not a treatment — it is a diagnostic tool. It is a synthetic version of the active portion of cholecystokinin (CCK), a gut hormone that makes the gallbladder contract. Doctors use it during imaging scans (HIDA scans) to measure how well the gallbladder empties — helping diagnose gallbladder dysfunction in patients with symptoms but no gallstones.
104 published studies: 83 human, 12 animal, 5 in-vitro, 13 reviews
Sincalide is marketed as Kinevac (Bracco Diagnostics, approved approximately 1976). Its primary use is during hepatobiliary scintigraphy (HIDA scans) to assess gallbladder function. It is also used to stimulate pancreatic secretion for collection during diagnostic testing and to accelerate barium transit during small bowel imaging.
Sincalide is one of the longest-established peptide compounds in clinical use and one of the few used purely for diagnostic purposes. Its role in gallbladder ejection fraction testing is well-established, though debate continues about the clinical significance of a low ejection fraction and whether it reliably predicts symptom improvement after gallbladder removal.
After a meal, the gut releases cholecystokinin to signal the gallbladder to contract and release bile into the intestine for fat digestion. Sincalide mimics this signal by activating CCK receptors on the gallbladder muscle, producing a controlled contraction. During a HIDA scan, this allows radiologists to calculate the gallbladder ejection fraction — essentially how much bile the gallbladder can push out. A low ejection fraction (below 35–40%) suggests gallbladder dysfunction and may support a decision for surgery.
Sincalide's role in the gallbladder ejection fraction test during HIDA scans is well established. A low ejection fraction (below 35-40%) suggests the gallbladder is not functioning properly and may support a decision for surgical removal. However, there is ongoing debate about how reliable this test is at predicting which patients will actually feel better after gallbladder surgery — the clinical significance of a low ejection fraction in the absence of gallstones remains contested. No significant research programmes exist for sincalide itself. The broader CCK receptor field remains active in research, with CCK-1 receptor activation explored for appetite control and weight management, though no therapeutics have reached approval through this pathway.
Mechanisms and Targeted Therapy of Airway Basal Cell Dysfunction in Bronchiolitis Obliterans Syndrome
Study to Assess the Way the Body Absorbs, Distributes, Breaks Down and Eliminates Radioactive BMS-986278 in Healthy Male Participants
A Study Evaluating the Effect of Albiglutide on Gallbladder Emptying in Healthy Subjects
Impact of Two Genetic Variants of OATP1B3 or MRP2 or Rifampin on Systemic Disposition and Biological Efficacy of CCK-8
Thyroid Hormones Homeostasis and Energy Metabolism Changes During Stimulation of Endogenously Secreted Bile Acids (BAs)
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