Utility of Aprepitant in the Management of Pediatric Patients with Cyclical Vomiting Syndrome

<b>Introduction</b>: Cyclical vomiting syndrome (CVS) is a recurrent debilitating illness characterized by intense episodes of nausea and emesis with widely varied pharmacological management across the country. Aprepitant is now increasingly used in patients with CVS. The impact of aprep...

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Main Authors: Aravind Thavamani, Sindhoosha Malay, Jasmine Khatana, Sujithra Velayuthan, Senthilkumar Sankararaman
Format: Article
Language:English
Published: MDPI AG 2024-12-01
Series:Medicines
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Online Access:https://www.mdpi.com/2305-6320/11/8/21
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author Aravind Thavamani
Sindhoosha Malay
Jasmine Khatana
Sujithra Velayuthan
Senthilkumar Sankararaman
author_facet Aravind Thavamani
Sindhoosha Malay
Jasmine Khatana
Sujithra Velayuthan
Senthilkumar Sankararaman
author_sort Aravind Thavamani
collection DOAJ
description <b>Introduction</b>: Cyclical vomiting syndrome (CVS) is a recurrent debilitating illness characterized by intense episodes of nausea and emesis with widely varied pharmacological management across the country. Aprepitant is now increasingly used in patients with CVS. The impact of aprepitant as an abortive therapy in the readmission of pediatric patients with CVS is currently unknown. <b>Methodology</b>: We analyzed all pediatric patients with a primary diagnosis of CVS using the ICD-10 code in the Pediatric Health Information System database of the Children’s Hospital Association. We evaluated the demographic data, comorbid conditions, and management details during the inpatient stay. CVS patients who received aprepitant during their inpatient hospitalization were compared with patients without aprepitant use. Seven-day readmission rate for CVS was used as the outcome variable to assess the effectiveness of the aprepitant in aborting an episode. Propensity score matching was used to match the two cohorts. <b>Results</b>: We analyzed 1775 patients of which 96 received aprepitant during the inpatient hospitalization. The aprepitant group had a more severe hospitalization course as evidenced by an increased duration of hospital stay (5 vs. 3 days) and total hospitalization costs ($11,790 vs. $6380). There were no significant differences in the 7-day (17% vs. 16%, <i>p</i> = 0.91) readmission rate and results were not altered by propensity score matching. <b>Conclusions</b>: Aprepitant use as an abortive therapy did not affect the 7-day CVS-related readmission rate. Further prospective studies are needed to explore the role of aprepitant as an abortive agent in the management of CVS in the pediatric population.
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spelling doaj-art-3bb97f2fe3fb4f5eaa64cab81239ed6b2024-12-27T14:39:12ZengMDPI AGMedicines2305-63202024-12-011182110.3390/medicines11080021Utility of Aprepitant in the Management of Pediatric Patients with Cyclical Vomiting SyndromeAravind Thavamani0Sindhoosha Malay1Jasmine Khatana2Sujithra Velayuthan3Senthilkumar Sankararaman4Division of Pediatric Gastroenterology, Hepatology and Nutrition, UH Rainbow Babies and Children’s Hospital, Case Western Reserve University School of Medicine, 2101 Adelbert Rd, Cleveland, OH 44106, USADepartment of Pediatrics, UH Rainbow Babies and Children’s Hospital, Case Western Reserve University School of Medicine, 2101 Adelbert Rd, Cleveland, OH 44106, USADepartment of Pediatrics, Metro Health Medical Center, Case Western Reserve University School of Medicine, 2500 Metrohealth Dr, Cleveland, OH 44109, USADivision of Pediatric Gastroenterology, Hepatology and Nutrition, UH Rainbow Babies and Children’s Hospital, Case Western Reserve University School of Medicine, 2101 Adelbert Rd, Cleveland, OH 44106, USADivision of Pediatric Gastroenterology, Hepatology and Nutrition, UH Rainbow Babies and Children’s Hospital, Case Western Reserve University School of Medicine, 2101 Adelbert Rd, Cleveland, OH 44106, USA<b>Introduction</b>: Cyclical vomiting syndrome (CVS) is a recurrent debilitating illness characterized by intense episodes of nausea and emesis with widely varied pharmacological management across the country. Aprepitant is now increasingly used in patients with CVS. The impact of aprepitant as an abortive therapy in the readmission of pediatric patients with CVS is currently unknown. <b>Methodology</b>: We analyzed all pediatric patients with a primary diagnosis of CVS using the ICD-10 code in the Pediatric Health Information System database of the Children’s Hospital Association. We evaluated the demographic data, comorbid conditions, and management details during the inpatient stay. CVS patients who received aprepitant during their inpatient hospitalization were compared with patients without aprepitant use. Seven-day readmission rate for CVS was used as the outcome variable to assess the effectiveness of the aprepitant in aborting an episode. Propensity score matching was used to match the two cohorts. <b>Results</b>: We analyzed 1775 patients of which 96 received aprepitant during the inpatient hospitalization. The aprepitant group had a more severe hospitalization course as evidenced by an increased duration of hospital stay (5 vs. 3 days) and total hospitalization costs ($11,790 vs. $6380). There were no significant differences in the 7-day (17% vs. 16%, <i>p</i> = 0.91) readmission rate and results were not altered by propensity score matching. <b>Conclusions</b>: Aprepitant use as an abortive therapy did not affect the 7-day CVS-related readmission rate. Further prospective studies are needed to explore the role of aprepitant as an abortive agent in the management of CVS in the pediatric population.https://www.mdpi.com/2305-6320/11/8/21aprepitantcyclic vomiting syndromepopulation basedobservational studycase control studydisorder of brain–gut interaction
spellingShingle Aravind Thavamani
Sindhoosha Malay
Jasmine Khatana
Sujithra Velayuthan
Senthilkumar Sankararaman
Utility of Aprepitant in the Management of Pediatric Patients with Cyclical Vomiting Syndrome
Medicines
aprepitant
cyclic vomiting syndrome
population based
observational study
case control study
disorder of brain–gut interaction
title Utility of Aprepitant in the Management of Pediatric Patients with Cyclical Vomiting Syndrome
title_full Utility of Aprepitant in the Management of Pediatric Patients with Cyclical Vomiting Syndrome
title_fullStr Utility of Aprepitant in the Management of Pediatric Patients with Cyclical Vomiting Syndrome
title_full_unstemmed Utility of Aprepitant in the Management of Pediatric Patients with Cyclical Vomiting Syndrome
title_short Utility of Aprepitant in the Management of Pediatric Patients with Cyclical Vomiting Syndrome
title_sort utility of aprepitant in the management of pediatric patients with cyclical vomiting syndrome
topic aprepitant
cyclic vomiting syndrome
population based
observational study
case control study
disorder of brain–gut interaction
url https://www.mdpi.com/2305-6320/11/8/21
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