TY - JOUR
T1 - Cyclic vomiting syndrome
T2 - Pathophysiology, comorbidities, and future research directions
AU - Hasler, William L.
AU - Levinthal, David J.
AU - Tarbell, Sally E.
AU - Adams, Kathleen A.
AU - Li, B. U.K.
AU - Issenman, Robert M.
AU - Sarosiek, Irene
AU - Jaradeh, Safwan S.
AU - Sharaf, Ravi N.
AU - Sultan, Shahnaz
AU - Venkatesan, Thangam
N1 - Funding Information:
This work was supported by funding from the Cyclic Vomiting
Publisher Copyright:
© 2019 The Authors. Neurogastroenterology & Motility Published by John Wiley & Sons Ltd
PY - 2019/6
Y1 - 2019/6
N2 - Cyclic vomiting syndrome (CVS) is characterized by severe episodic emesis in adults and children. Cannabinoid hyperemesis syndrome is an increasingly recognized CVS-like illness that has been associated with chronic cannabis use. There are significant gaps in our understanding of the pathophysiology, clinical features, comorbidities, and effective management options of CVS. Recommendations for treating CVS are based on limited clinical data, as no placebo-controlled, randomized trials have yet been conducted. Diseases associated with CVS, including migraine, mitochondrial disorders, autonomic dysfunction, and psychiatric comorbidities, provide clues about pathophysiologic mechanisms and suggest potential therapies. We review our current understanding of CVS and propose future research directions with the aim of developing effective therapy. Establishing a multicenter, standardized registry of CVS patients could drive research on multiple fronts including developing CVS-specific outcome measures to broaden our understanding of clinical profiles, to serve as treatment end points in clinical trials, and to provide a platform for patient recruitment for randomized clinical trials. Such a robust database would also facilitate conduct of research that aims to determine the underlying pathophysiological mechanisms and genetic basis for CVS, as well as identifying potential biomarkers for the disorder. Soliciting government and industry support is crucial to establishing the necessary infrastructure and achieving these goals. Patient advocacy groups such as the Cyclic Vomiting Syndrome Association (CVSA), which partner with clinicians and researchers to disseminate new information, to promote ongoing interactions between patients, their families, clinicians, investigators, to support ongoing CVS research and education, must be an integral part of this endeavor.
AB - Cyclic vomiting syndrome (CVS) is characterized by severe episodic emesis in adults and children. Cannabinoid hyperemesis syndrome is an increasingly recognized CVS-like illness that has been associated with chronic cannabis use. There are significant gaps in our understanding of the pathophysiology, clinical features, comorbidities, and effective management options of CVS. Recommendations for treating CVS are based on limited clinical data, as no placebo-controlled, randomized trials have yet been conducted. Diseases associated with CVS, including migraine, mitochondrial disorders, autonomic dysfunction, and psychiatric comorbidities, provide clues about pathophysiologic mechanisms and suggest potential therapies. We review our current understanding of CVS and propose future research directions with the aim of developing effective therapy. Establishing a multicenter, standardized registry of CVS patients could drive research on multiple fronts including developing CVS-specific outcome measures to broaden our understanding of clinical profiles, to serve as treatment end points in clinical trials, and to provide a platform for patient recruitment for randomized clinical trials. Such a robust database would also facilitate conduct of research that aims to determine the underlying pathophysiological mechanisms and genetic basis for CVS, as well as identifying potential biomarkers for the disorder. Soliciting government and industry support is crucial to establishing the necessary infrastructure and achieving these goals. Patient advocacy groups such as the Cyclic Vomiting Syndrome Association (CVSA), which partner with clinicians and researchers to disseminate new information, to promote ongoing interactions between patients, their families, clinicians, investigators, to support ongoing CVS research and education, must be an integral part of this endeavor.
KW - Cannabinoids
KW - cyclic vomiting
KW - migraine headaches
KW - multicenter registry
KW - psychosocial dysfunction
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U2 - 10.1111/nmo.13607
DO - 10.1111/nmo.13607
M3 - Review article
C2 - 31241816
AN - SCOPUS:85067985638
SN - 1350-1925
VL - 31
JO - Neurogastroenterology and Motility
JF - Neurogastroenterology and Motility
IS - S2
M1 - e13607
ER -