{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,3]],"date-time":"2026-06-03T04:50:08Z","timestamp":1780462208332,"version":"3.54.1"},"reference-count":14,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2023,2,5]],"date-time":"2023-02-05T00:00:00Z","timestamp":1675555200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Neurogastroenterology Motil"],"published-print":{"date-parts":[[2023,4]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Aprepitant is a neurokinin\u20101 receptor antagonist, and recent guidelines by the American Neurogastoenterology and Motility Society recommend its use as prophylaxis in moderate\u2010to severe cyclic vomiting syndrome (CVS). Data are limited to small studies in children. We aimed to determine its efficacy in adults with CVS.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A retrospective review of CVS patients diagnosed using Rome criteria at a tertiary referral center was conducted. Drug response was defined as &gt;50% reduction in symptoms and\/or healthcare utilization. An intent\u2010to\u2010treat (ITT) analysis was conducted.<\/jats:p><\/jats:sec><jats:sec><jats:title>Key Results<\/jats:title><jats:p>Of 96 patients prescribed aprepitant, 26 (27%) were unable to start due to cost\/lack of insurance coverage. Of 70 receiving therapy, mean age was 33\u2009\u00b1\u200911\u2009years; 51 (73%) were female and 56 (80%) Caucasian. The majority (93%) were refractory to other prophylactic medications. Aprepitant was taken thrice weekly in 51 (73%), daily in 16 (23%) and a few times a month in 3 (4%) due to cost. Fifty (71.4%) had a global symptom response to aprepitant. There was significant reduction in the number of CVS episodes (14.5\u00a0\u00b1\u200911.7 to 6.2\u00a0\u00b1\u20098.0, <jats:italic>p<\/jats:italic>\u00a0&lt;\u20090.0001), emergency department visits (4.2\u00a0\u00b1\u20097.7 to 1.8\u00a0\u00b1\u20093.4, <jats:italic>p<\/jats:italic>\u00a0=\u20090.006), and hospital admissions (1.6\u00a0\u00b1\u20093.9 to 0.8\u00a0\u00b1\u20092.1, <jats:italic>p<\/jats:italic>\u00a0=\u20090.02) in patients treated with aprepitant. Seven (10%) discontinued the drug due to minor side effects.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions and Inferences<\/jats:title><jats:p>Aprepitant is a safe and effective prophylactic medication in adults with refractory CVS. Adequate insurance coverage is a major barrier preventing its use.<\/jats:p><\/jats:sec>","DOI":"10.1111\/nmo.14530","type":"journal-article","created":{"date-parts":[[2023,2,6]],"date-time":"2023-02-06T06:19:52Z","timestamp":1675664392000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["Efficacy of aprepitant as a prophylactic medication in adults with cyclic vomiting syndrome"],"prefix":"10.1111","volume":"35","author":[{"given":"Milan","family":"Patel","sequence":"first","affiliation":[{"name":"Medical College of Wisconsin  Milwaukee Wisconsin USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Omeed","family":"Partovi","sequence":"additional","affiliation":[{"name":"Medical College of Wisconsin  Milwaukee Wisconsin USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Harrison","family":"Mooers","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology Medical College of Wisconsin  Milwaukee Wisconsin USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2520-7396","authenticated-orcid":false,"given":"Katja","family":"Kovacic","sequence":"additional","affiliation":[{"name":"Children's Hospital of Wisconsin  Milwaukee Wisconsin USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhuping","family":"Garacchi","sequence":"additional","affiliation":[{"name":"Center for Advancing Population Science Medical College of Wisconsin  Milwaukee Wisconsin USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8095-7456","authenticated-orcid":false,"given":"Thangam","family":"Venkatesan","sequence":"additional","affiliation":[{"name":"The Ohio State University  Columbus Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2023,2,5]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2005.11.059"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2016.02.011"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cgh.2018.05.020"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1186\/1741-7015-3-20"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1186\/1471-227X-10-4"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10286-018-0506-2"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1111\/nmo.13604"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1097\/MCG.0b013e3181ac6489"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.1186\/1471-230X-12-52"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.1111\/apt.16457"},{"key":"e_1_2_10_12_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11912-015-0486-5"},{"key":"e_1_2_10_13_1","doi-asserted-by":"publisher","DOI":"10.1111\/apt.12822"},{"key":"e_1_2_10_14_1","doi-asserted-by":"publisher","DOI":"10.1080\/J354v19n03_06"},{"key":"e_1_2_10_15_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2017.08.033"}],"container-title":["Neurogastroenterology &amp; Motility"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/nmo.14530","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/nmo.14530","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/nmo.14530","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,8,22]],"date-time":"2023-08-22T03:27:25Z","timestamp":1692674845000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/nmo.14530"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,2,5]]},"references-count":14,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2023,4]]}},"alternative-id":["10.1111\/nmo.14530"],"URL":"https:\/\/doi.org\/10.1111\/nmo.14530","archive":["Portico"],"relation":{},"ISSN":["1350-1925","1365-2982"],"issn-type":[{"value":"1350-1925","type":"print"},{"value":"1365-2982","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,2,5]]},"assertion":[{"value":"2022-09-27","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2022-12-20","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-02-05","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e14530"}}