Cannabis Use Is Associated With Increased Healthcare Utilization and Poorer Outcomes in Cyclical Vomiting Syndrome—A Propensity Matched Analysis of 34,988 Individuals

BACKGROUND: Cyclical Vomiting Syndrome (CVS) poses a significant financial burden on the healthcare system due to frequent emergency department (ED) visits and hospitalizations. Data on the impact of cannabis use in CVS is conflicting. AIMS: This study evaluates the impact of cannabis use on outcomes in individuals with CVS using real-world data. METHODS: A retrospective cohort study was conducted using the TriNetX research network to identify adults (≥ 18 years) with CVS. Patients were categorized into two groups: CVS with cannabis use and CVS without cannabis use (controls). Using propensity score matching on demographics, body mass index, comorbidities and treatments (e.g., abortive and prophylactic therapy) cohorts were matched 1:1. Outcomes included all-cause ED visits and hospitalizations. RESULTS: A total of 18,588 individuals with CVS and cannabis use were matched with 18,588 individuals with CVS who did not use cannabis (controls). Cannabis users were younger (mean age [SD]: 31.9 [12.5] vs. 39.0 [19.9] years) and had higher rates of mood/anxiety disorders, gastroparesis, and substance use. They were more likely to receive abortive therapy and less likely to receive prophylactic therapy. CVS patients who used cannabis had increased rates of ED visits (hazard ratio (HR) = 1.35, 95% confidence interval (CI): 1.31-1.39) and hospitalizations (HR = 1.11, 95% CI: 1.06-1.16) in comparison to those that did not. CONCLUSIONS: This study is the first using real-world evidence to demonstrate increased risks of ED visits and hospitalizations among individuals with CVS who use cannabis. Cannabis use in this population should be approached with caution due to the increased risk of adverse outcomes and associated financial burden.