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

*Corresponding author for this work

Research output: Contribution to journalReview article

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 languageEnglish (US)
Article numbere13605
JournalNeurogastroenterology and Motility
Volume31
Issue numberS2
DOIs
StatePublished - Jun 1 2019

Fingerprint

aprepitant
zonisamide
etiracetam
Tryptamines
Amitriptyline
Therapeutics
Ondansetron
Complementary Therapies
Practice Guidelines
Familial cyclic vomiting syndrome
Guidelines

Keywords

  • cyclic vomiting
  • technical review
  • treatment

ASJC Scopus subject areas

  • Physiology
  • Endocrine and Autonomic Systems
  • Gastroenterology

Cite this

Sharaf, R. N., Venkatesan, T., Shah, R., Levinthal, D. J., Tarbell, S. E., Jaradeh, S. S., ... Sultan, S. (2019). Management of cyclic vomiting syndrome in adults: Evidence review. Neurogastroenterology and Motility, 31(S2), [e13605]. https://doi.org/10.1111/nmo.13605
Sharaf, Ravi N. ; Venkatesan, Thangam ; Shah, Raj ; Levinthal, David J. ; Tarbell, Sally E ; Jaradeh, Safwan S. ; Hasler, William L. ; Issenman, Robert M. ; Adams, Kathleen A. ; Sarosiek, Irene ; Stave, Christopher D. ; Li, B. U.K. ; Sultan, Shahnaz. / Management of cyclic vomiting syndrome in adults : Evidence review. In: Neurogastroenterology and Motility. 2019 ; Vol. 31, No. S2.
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title = "Management of cyclic vomiting syndrome in adults: Evidence review",
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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",
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Sharaf, 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 2019, 'Management of cyclic vomiting syndrome in adults: Evidence review', Neurogastroenterology and Motility, vol. 31, no. S2, e13605. https://doi.org/10.1111/nmo.13605

Management of cyclic vomiting syndrome in adults : Evidence review. / Sharaf, Ravi N.; Venkatesan, Thangam; Shah, Raj; Levinthal, David J.; Tarbell, Sally E; Jaradeh, Safwan S.; Hasler, William L.; Issenman, Robert M.; Adams, Kathleen A.; Sarosiek, Irene; Stave, Christopher D.; Li, B. U.K.; Sultan, Shahnaz.

In: Neurogastroenterology and Motility, Vol. 31, No. S2, e13605, 01.06.2019.

Research output: Contribution to journalReview article

TY - JOUR

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

PY - 2019/6/1

Y1 - 2019/6/1

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

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Sharaf RN, Venkatesan T, Shah R, Levinthal DJ, Tarbell SE, Jaradeh SS et al. Management of cyclic vomiting syndrome in adults: Evidence review. Neurogastroenterology and Motility. 2019 Jun 1;31(S2). e13605. https://doi.org/10.1111/nmo.13605