Secretin (ChiRhoStim): Uses, Mechanism, and Side Effects

Patients who undergo tests for pancreatic function or suspected gastrinoma may encounter secretin as part of the diagnostic process rather than as a treatment itself. Understanding what this hormone does and why it is given can make the testing experience less confusing.

Key takeaways

• Secretin is approved under the brand names ChiRhoStim and ChiRhoStim 40 for diagnostic use, not as a standalone therapy.
• It works by stimulating pancreatic ductal cells to release fluid rich in bicarbonate.
• Approved uses include evaluating pancreatic exocrine function, aiding gastrinoma diagnosis, and assisting identification of structures during ERCP.
• The label does not carry a boxed warning.
• More than 70 registered trials have studied secretin across various clinical and research contexts.

What Secretin Is

Secretin is a naturally occurring hormone, normally released from the duodenum when the intestine is exposed to stomach acid, fatty acids, and amino acids. In its pharmaceutical form, it acts on secretin receptors found in the pancreas, stomach, liver, and other tissues. Its main effect is prompting pancreatic ductal cells to produce a large volume of bicarbonate-rich fluid, which is the basis for its diagnostic applications.

What Secretin Is Approved For

Secretin, marketed as ChiRhoStim and ChiRhoStim 40, is approved to help diagnose several conditions. It is used to stimulate pancreatic secretions, including bicarbonate, to assess exocrine pancreatic dysfunction. It also stimulates gastrin secretion, which assists in diagnosing gastrinoma. A third approved use is to stimulate pancreatic secretions during endoscopic retrograde cholangiopancreatography (ERCP) to help locate the ampulla of Vater and the accessory papilla. The label does not carry a boxed warning.

What the Evidence Shows

Secretin has been studied in at least 74 registered trials. One completed study examined MRI's role in the perioperative management of pancreas adenocarcinomas, reflecting its use alongside imaging in pancreatic care. Another trial, a completed phase 2 safety study, investigated a related secretin compound in patients with obsessive compulsive disorder. A third trial, focused on chronic pancreatitis for epidemiologic and translational research, is currently recruiting.

Reported Side Effects

Reported adverse event data for secretin is limited, with only isolated reports on file, including muscle spasms and a product storage error. These figures represent individual reports submitted to a safety database, not confirmed rates of occurrence or evidence of a causal link between secretin and these events.