Management of cyclic vomiting syndrome in adults: Evidence review.

TitleManagement of cyclic vomiting syndrome in adults: Evidence review.
Publication TypeJournal Article
Year of Publication2019
AuthorsSharaf RN, Venkatesan T, Shah R, Levinthal DJ, Tarbell SE, Jaradeh SS, Hasler WL, Issenman RM, Adams KA, Sarosiek I, Stave CD, Li BUK, Sultan S
JournalNeurogastroenterol Motil
Volume31 Suppl 2
Paginatione13605
Date Published2019 Jun
ISSN1365-2982
Abstract

BACKGROUND: This evidence review was conducted to inform the accompanying clinical practice guideline on the management of cyclic vomiting syndrome (CVS) in adults.

METHODS: We followed the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) framework and focused on interventions aimed at prophylactic management and abortive treatment of adults with CVS. Specifically, this evidence review addresses the following clinical questions: (a) Should the following pharmacologic agents be used for prophylaxis of CVS: amitriptyline, topiramate, aprepitant, zonisamide/levetiracetam, or mitochondrial supplements? (b) Should the following pharmacologic agents be used for abortive treatment: triptans or aprepitant?

RESULTS: We found very low-quality evidence to support the use of the following agents for prophylactic and abortive treatment of CVS: amitriptyline, topiramate, aprepitant, zonisamide/levetiracetam, and mitochondrial supplements. We have moderate certainty of evidence for the use of triptans as abortive therapy. We found limited evidence to support the use of ondansetron and the treatment of co-morbid conditions and complementary therapies.

CONCLUSIONS: This evidence review helps inform the accompanying guideline for the management of adults with CVS which is aimed at helping clinicians, patients, and policymakers, and should improve patient outcomes.

DOI10.1111/nmo.13605
Alternate JournalNeurogastroenterol. Motil.
PubMed ID31241818
Grant List / / Cyclic Vomiting Syndrome Association (CVSA) /
Division: 
Biostatistics and Epidemiology
Category: 
Faculty Publication