Takaisin Tulosta

Intravenous immunoglobulin for Guillain-Barré syndrome

Evidence summaries
27.9.2012 • Latest change 23.1.2015
Editors

Level of evidence: A

Intravenous immunoglobulin started within two weeks from the onset of severe Guillain-Barre syndrome hastens recovery as much as plasma exchange.

A Cochrane review «Intravenous immunoglobulin for Guillain‐Barré syndrome»1 «Hughes RA, Swan AV, van Doorn PA. Intravenous immunoglobulin for Guillain-Barré syndrome. Cochrane Database Syst Rev 2014;9():CD002063. »1 included 5 studies with 536 patients comparing intravenous immunoglobulin (IVIg) with plasma exchange. The IVIg given was the standard regimen of 0.4 g/kg daily for 5 days and in one trial 0.5 g/kg daily for 4 days. Patients were unable to walk unaided and had been ill for less than two weeks. There was not statistically significant mean difference (MD) in a 7-grade disability scale 4 weeks after randomisation (MD 0.02, 95% CI 0.25 to -0.20). Giving IVIg after plasma exchange is not significantly better than plasma exchange alone (one trial, n=249). In adults, there are no adequate comparisons with placebo. In children IVIg significantly hastened recovery compared with supportive care (3 studies, n=75). Adverse events were not significantly more frequent with either treatment but IVIg is significantly more likely to be completed than plasma exchange.

References

  1. Hughes RA, Swan AV, van Doorn PA. Intravenous immunoglobulin for Guillain-Barré syndrome. Cochrane Database Syst Rev 2014;9():CD002063. «PMID: 25238327»PubMed