Management of cyclic vomiting syndrome in adults: Evidence review.

Antiemetics / therapeutic use Humans Treatment Outcome Vomiting / drug therapy
cyclic vomiting technical review treatment

Journal

Neurogastroenterology and motility
ISSN: 1365-2982
Titre abrégé: Neurogastroenterol Motil
Pays: England
ID NLM: 9432572

Informations de publication

Date de publication:
06 2019
Historique:
entrez: 27 6 2019
pubmed: 27 6 2019
medline: 17 9 2020
Statut: ppublish

Résumé

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

Sections du résumé

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.

Identifiants

DOI: 10.1111/nmo.13605 PMID: 31241818 PMC: PMC6899798
pubmed: 31241818
doi: 10.1111/nmo.13605
pmc: PMC6899798
doi:

Substances chimiques

Antiemetics 0

Types de publication

Journal Article Research Support, Non-U.S. Gov't Review

Langues

eng

Sous-ensembles de citation

IM

Pagination

e13605

Subventions

Organisme : NCI NIH HHS
ID : K07 CA216326
Pays : United States

Informations de copyright

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

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Auteurs

Ravi N Sharaf (RN)

Division of Gastroenterology, Department of Medicine, Weill Cornell Medical Center, New York, New York.

Thangam Venkatesan (T)

Division of Gastroenterology, Department of Medicine, Medical College of Wisconsin, Milwaukee, Wisconsin.

Raj Shah (R)

Division of Gastroenterology and Liver Disease, Department of Internal Medicine, Case Western Reserve University School of Medicine, Cleveland, Ohio.

David J Levinthal (DJ)

Department of Medicine, Division of Gastroenterology, Hepatology, and Nutrition, University of Pittsburgh Medical Center, Pittsburg, Pennsylvania.

Sally E Tarbell (SE)

Department of Psychiatry and Behavioral Sciences, Northwestern Feinberg University School of Medicine, Chicago, Illinois.

Safwan S Jaradeh (SS)

Department of Neurology and Neurological Sciences, Stanford University Medical Center, Stanford, California.

William L Hasler (WL)

Division of Gastroenterology, Department of Medicine, University of Michigan Medical School, Ann Arbor, Michigan.

Robert M Issenman (RM)

Division of Pediatric Gastroenterology, Department of Pediatrics, McMaster University, Hamilton, Ontario.

Kathleen A Adams (KA)

Founder/President Emerita, Cyclic Vomiting Syndrome Association.

Irene Sarosiek (I)

Division of Gastroenterology, Department of Internal Medicine, Texas Tech University Health Sciences Center, Lubbock, Texas.

Christopher D Stave (CD)

Lane Medical Library, Stanford University, Stanford, California.

B U K Li (BUK)

Division of Pediatric Gastroenterology, Hepatology and Nutrition, Department of Pediatrics, Medical College of Wisconsin, Milwaukee, Wisconsin.

Shahnaz Sultan (S)

Division of Gastroenterology, Department of Medicine, University of Minnesota, Minneapolis Veterans Affairs Healthcare System, Minneapolis, Minnesota.

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Classifications MeSH

questionsmedicales.fr › Actions chimiques et utilisations › Actions pharmacologiques › Utilisations thérapeutiques › Agents gastro-intestinaux › Antiémétiques › Management of cyclic vomiting syndrome in...
questionsmedicales.fr › Eucaryotes › Animaux › Chordés › Vertébrés › Mammifères › Eutheria › Primates › Haplorhini › Catarrhini › Hominidae › Humains › Management of cyclic vomiting syndrome in...
questionsmedicales.fr › Qualité, accès, évaluation des soins de santé › Qualité des soins de santé › Mécanismes d'évaluation des soins de santé › Évaluation des résultats et des processus en soins de santé › Évaluation de résultat (soins) › Résultat thérapeutique › Management of cyclic vomiting syndrome in...
questionsmedicales.fr › États, signes et symptômes pathologiques › Signes et symptômes › Signes et symptômes digestifs › Vomissement › Management of cyclic vomiting syndrome in...