Management of cyclic vomiting syndrome in adults: Evidence review.
Management of cyclic vomiting syndrome in adults: Evidence review.
复制标题
成人周期性呕吐综合征的治疗：证据审查。
DOI：
10.1111/nmo.13605
复制
发表时间：
2019
期刊：
影响因子：
--
通讯作者：
Sultan,Shahnaz
中科院分区：
文献类型：
--
作者：
Sharaf,RaviN;Venkatesan,Thangam;Shah,Raj;Levinthal,DavidJ;Tarbell,SallyE;Jaradeh,SafwanS;Hasler,WilliamL;Issenman,RobertM;Adams,KathleenA;Sarosiek,Irene;Stave,ChristopherD;Li,BUK;Sultan,Shahnaz
BackgroundThis证据审查进行通知的管理周期性呕吐综合征（CVS）在adultes.MethodsWe遵循分级的建议评估，发展和评价（GRADE）框架，并专注于干预措施，旨在预防性管理和流产治疗的成年人与CVS的伴随临床实践指南。具体而言，该证据审查解决了以下临床问题：（a）是否应使用以下药物预防CVS：阿米替林、托吡酯、阿瑞匹坦、唑尼沙胺/左乙拉西坦或线粒体补充剂？(b)下列药物是否应用于流产治疗：曲坦类或阿瑞匹坦类？结果我们发现了极低质量的证据来支持使用以下药物预防和流产CVS：阿米替林，托吡酯，阿瑞匹坦，唑尼沙胺/左乙拉西坦，和线粒体补充剂。我们对曲坦类药物作为流产治疗的证据有一定的把握。我们发现有限的证据来支持使用昂丹司琼和治疗的共病条件和complementary therapies.ConclusionsThis证据审查有助于通知附带的指导方针与CVS的成人管理，旨在帮助临床医生，患者和决策者，并应改善患者的预后。
BackgroundThis evidence review was conducted to inform the accompanying clinical practice guideline on the management of cyclic vomiting syndrome (CVS) in adults.MethodsWe 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?ResultsWe 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.ConclusionsThis 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.