Treatment options for cyclic vomiting syndrome: a real world single-center experience with systematic literature review and meta-analysis.

The optimal therapeutic management of cyclic vomiting syndrome (CVS) remains elusive. The objective of this study is to document our clinical experience in the Pediatric Department of San Marco Hospital and to survey the literature on pediatric CVS treatment, aiming to update information on the most effective treatment strategies for this not-so-uncommon condition. Data from 70 patients with CVS, admitted to our Pediatric Department between September 2011 and December 2021, were aggregated and included in the study. A systematic review of the literature was conducted in accordance with the PRISMA guidelines. The quality of the included studies was assessed using the QUADAS-2 tool and the AMSTAR-2 method. Treatment responses, as observed both in the literature and in our own experience, are variable. In our cohort, Topiramate demonstrated superiority over other pharmacological treatments, exhibiting an efficacy of 85% in the treated patients. A universally accepted treatment protocol for pediatric CVS has yet to be established. The efficacy of first-line treatments is generally suboptimal, suggesting that Topiramate might serve as a safe and effective primary therapeutic option for pediatric CVS. This article is protected by copyright. All rights reserved.