Management of cyclic vomiting syndrome in adults: Evidence review

Ravi N. Sharaf; Thangam Venkatesan; Raj Shah; David J. Levinthal; Sally E. Tarbell; Safwan S. Jaradeh; William L. Hasler; Robert M. Issenman; Kathleen A. Adams; Irene Sarosiek; Christopher D. Stave; B. U.K. Li; Shahnaz Sultan

doi:10.1111/nmo.13605

Management of cyclic vomiting syndrome in adults: Evidence review

Ravi N. Sharaf, Thangam Venkatesan, Raj Shah, David J. Levinthal, Sally E. Tarbell, Safwan S. Jaradeh, William L. Hasler, Robert M. Issenman, Kathleen A. Adams, Irene Sarosiek, Christopher D. Stave, B. U.K. Li, Shahnaz Sultan

Medicine - Veteran's Administration Medical Center

Research output: Contribution to journal › Review article › peer-review

13 Scopus citations

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.

Original language	English (US)
Article number	e13605
Journal	Neurogastroenterology and Motility
Volume	31
Issue number	S2
DOIs	https://doi.org/10.1111/nmo.13605
State	Published - Jun 2019

Bibliographical note

Funding Information:
None of the authors had any competing interests. Full disclo‐ sure statement included. Dr. Sharaf was supported by Academy Health DSSF, NY State ECRIP Award, NCI K07CA216326 and NCI R01CA211723. Dr. Sharaf is a paid consultant for the non‐profit Institute for Clinical and Economic Review, Boston, Massachusetts. Dr. Sultan has no financial disclosures.

Funding Information:
This work was funded by the Cyclic Vomiting Syndrome Association (CVSA), a non‐profit organization for patients with CVS and their caregivers.

Publisher Copyright:
© 2019 The Authors. Neurogastroenterology & Motility Published by John Wiley & Sons Ltd

Keywords

cyclic vomiting
technical review
treatment

PubMed: MeSH publication types

Review
Journal Article

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10.1111/nmo.13605

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@article{7dc790ed93534403a0672476a1b674d4,

title = "Management of cyclic vomiting syndrome in adults: Evidence review",

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.",

keywords = "cyclic vomiting, technical review, treatment",

author = "Sharaf, {Ravi N.} and Thangam Venkatesan and Raj Shah and Levinthal, {David J.} and Tarbell, {Sally E.} and Jaradeh, {Safwan S.} and Hasler, {William L.} and Issenman, {Robert M.} and Adams, {Kathleen A.} and Irene Sarosiek and Stave, {Christopher D.} and Li, {B. U.K.} and Shahnaz Sultan",

note = "Funding Information: None of the authors had any competing interests. Full disclo‐ sure statement included. Dr. Sharaf was supported by Academy Health DSSF, NY State ECRIP Award, NCI K07CA216326 and NCI R01CA211723. Dr. Sharaf is a paid consultant for the non‐profit Institute for Clinical and Economic Review, Boston, Massachusetts. Dr. Sultan has no financial disclosures. Funding Information: This work was funded by the Cyclic Vomiting Syndrome Association (CVSA), a non‐profit organization for patients with CVS and their caregivers. Publisher Copyright: {\textcopyright} 2019 The Authors. Neurogastroenterology & Motility Published by John Wiley & Sons Ltd",

year = "2019",

month = jun,

doi = "10.1111/nmo.13605",

language = "English (US)",

volume = "31",

journal = "Neurogastroenterology and Motility",

issn = "1350-1925",

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T1 - Management of cyclic vomiting syndrome in adults

T2 - Evidence review

AU - Sharaf, Ravi N.

AU - Venkatesan, Thangam

AU - Shah, Raj

AU - Levinthal, David J.

AU - Tarbell, Sally E.

AU - Jaradeh, Safwan S.

AU - Hasler, William L.

AU - Issenman, Robert M.

AU - Adams, Kathleen A.

AU - Sarosiek, Irene

AU - Stave, Christopher D.

AU - Li, B. U.K.

AU - Sultan, Shahnaz

N1 - Funding Information: None of the authors had any competing interests. Full disclo‐ sure statement included. Dr. Sharaf was supported by Academy Health DSSF, NY State ECRIP Award, NCI K07CA216326 and NCI R01CA211723. Dr. Sharaf is a paid consultant for the non‐profit Institute for Clinical and Economic Review, Boston, Massachusetts. Dr. Sultan has no financial disclosures. Funding Information: This work was funded by the Cyclic Vomiting Syndrome Association (CVSA), a non‐profit organization for patients with CVS and their caregivers. Publisher Copyright: © 2019 The Authors. Neurogastroenterology & Motility Published by John Wiley & Sons Ltd

PY - 2019/6

Y1 - 2019/6

N2 - 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.

AB - 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.

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KW - technical review

KW - treatment

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U2 - 10.1111/nmo.13605

DO - 10.1111/nmo.13605

M3 - Review article

C2 - 31241818

AN - SCOPUS:85067978542

SN - 1350-1925

VL - 31

JO - Neurogastroenterology and Motility

JF - Neurogastroenterology and Motility

IS - S2

M1 - e13605

ER -

Management of cyclic vomiting syndrome in adults: Evidence review

Abstract

Bibliographical note

Keywords

PubMed: MeSH publication types

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