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Short- and long-term outcomes of children with cyclic vomiting syndrome

Suporn Treepongkaruna, Chaowapong Jarasvaraparn, Pornthep Tanpowpong

    Journal of the Medical Association of Thailand = Chotmaihet Thangphaet
    |January 31, 2015
    PubMed

    Insights

    Amitriptyline showed better results than propranolol for treating cyclic vomiting syndrome (CVS) in children. Many children with CVS experience favorable long-term outcomes, especially those who respond well to initial prophylactic treatment.

    Area of Science:

    • Pediatric Gastroenterology
    • Pharmacology
    • Clinical Outcomes Research

    Background:

    • Cyclic Vomiting Syndrome (CVS) is a debilitating condition in children.
    • Effective prophylactic pharmacotherapy is crucial for managing CVS.
    • Understanding treatment efficacy and long-term outcomes is essential for clinical practice.

    Purpose of the Study:

    • To evaluate the efficacy of prophylactic pharmacotherapy for pediatric cyclic vomiting syndrome.
    • To assess both short-term and long-term outcomes in children with CVS.
    • To compare the effectiveness of different prophylactic medications.

    Main Methods:

    • Retrospective review of medical records for 32 children diagnosed with CVS (2000-2013).
    • Classification of treatment response as 'good' or 'no response' after 3-6 months.
    • Long-term outcome assessment based on episode frequency over the past year for patients diagnosed for ≥2 years.

    Main Results:

    • Amitriptyline demonstrated a significantly higher good response rate (73%) compared to propranolol (36%, p=0.04) at 3-6 months.
    • Among 19 patients with long-term follow-up (mean 6.3 years post-diagnosis), 74% achieved favorable outcomes (excellent or good).
    • A strong correlation was observed: 86% of children with favorable long-term outcomes showed a good initial response to prophylactic medication.

    Conclusions:

    • Amitriptyline may be more effective than propranolol for CVS prophylaxis in children.
    • Children with CVS generally experience favorable long-term outcomes.
    • Early positive response to prophylactic medication predicts better long-term prognosis, warranting further randomized controlled trials.
    Abstract

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