Intravenous immunoglobulin treatment for mild Guillain-Barré syndrome: an international observational study. Issue 10 (8th June 2021)

• Record Type: Journal Article
• Authors: Verboon, Christine; Harbo, Thomas; Cornblath, David R; Hughes, Richard A C; van Doorn, Pieter A; Lunn, Michael P; Gorson, Kenneth C; Barroso, Fabio; Kuwabara, Satoshi; Galassi, Giuliana; Lehmann, Helmar C; Kusunoki, Susumu; Reisin, Ricardo C; Binda, Davide; Cavaletti, Guido; Jacobs, Bart C
• Other Names: author non-byline.; Andersen H. author non-byline.; Attarian S. author non-byline.; Badrising U.A. author non-byline.; Bateman K. author non-byline.; Benedetti L. author non-byline.; van den Berg B. author non-byline.; Van den Bergh P. author non-byline.; Bertorini T.E. author non-byline.; Bhavaraju-Sanka R. author non-byline.; Bianco M. author non-byline.; Briani C. author non-byline.; Bürmann J. author non-byline.; Casasnovas C. author non-byline.; Chao C.C. author non-byline.; Chavada G. author non-byline.; Claeys K.G. author non-byline.; Cosgrove J.S. author non-byline.; Dalakas M.C. author non-byline.; Davidson A. author non-byline.; van Dijk G.W. author non-byline.; Dardiotis E. author non-byline.; Derejko M. author non-byline.; Dimachkie, C M.M. author non-byline.; Cour Dornonville de la author non-byline.; Echaniz-Laguna A. author non-byline.; Eftimov F. author non-byline.; Faber C.G. author non-byline.; Fazio R. author non-byline.; Fehmi J. author non-byline.; Fulgenzi E.A. author non-byline.; García-Sobrino T. author non-byline.; Gijsbers C.J. author non-byline.; Granit V. author non-byline.; Grisanti S. author non-byline.; Gutiérrez-Gutiérrez G. author non-byline.; Holbech J. V. author non-byline.; Holt J.K.L. author non-byline.; Homedes C. author non-byline.; Islam B. author non-byline.; Islam Z. author non-byline.; Jahan I. author non-byline.; Jericó Pascual I. author non-byline.; Karafiath S. author non-byline.; Kerkhoff H. author non-byline.; Kimpinski K. author non-byline.; Kohler A. author non-byline.; Kolb N. author non-byline.; Kuitwaard K. author non-byline.; Kuwahara M. author non-byline.; Ladha S.S. author non-byline.; Lee Pan E. author non-byline.; Marfia G.A. author non-byline.; Magot A. author non-byline.; Márquez Infante C. author non-byline.; Martín-Aguilar L. author non-byline.; Martinez Hernandez E. author non-byline.; Mataluni G. author non-byline.; Meekins G. author non-byline.; Miller J.A.L. author non-byline.; Monges M.S. author non-byline.; Nobile Orazio E. author non-byline.; Pardal A. author non-byline.; Pardo Fernandez J. author non-byline.; Péréon Y. author non-byline.; Pulley M. author non-byline.; Querol Gutierrez L. author non-byline.; Reddel S.W. author non-byline.; van der Ree T. author non-byline.; Rinaldi S. author non-byline.; Samijn J.P.A. author non-byline.; Samukawa M. author non-byline.; Santoro L. author non-byline.; Savransky A. author non-byline.; Schwindling L. author non-byline.; Sedano Tous M.J. author non-byline.; Sekiguchi Y. author non-byline.; Shahrizaila N. author non-byline.; Silvestri N.J. author non-byline.; Sommer C.L. author non-byline.; Spyropoulos A. author non-byline.; Tan C.Y. author non-byline.; Tankisi H. author non-byline.; Vermeij F. author non-byline.; Vytopil M.V. author non-byline.; Waheed W. author non-byline.; Addington J.M. author non-byline.; Ajroud-Driss S. author non-byline.; Antonini G. author non-byline.; Bella I.R. author non-byline.; Brannagan T.H. author non-byline.; Bunschoten C. author non-byline.; Busby M. author non-byline.; Butterworth S. author non-byline.; Conti M.E. author non-byline.; Chen S. author non-byline.; Doets A. author non-byline.; Feasby T.E. author non-byline.; Fokke C. author non-byline.; Fujioka T. author non-byline.; Garssen M.P.J. author non-byline.; Gilchrist J.M. author non-byline.; Gilhuis J. author non-byline.; Goldstein J.M. author non-byline.; Goyal N. A. author non-byline.; Hadden R.D.M. author non-byline.; Hsieh S.T. author non-byline.; Htut M. author non-byline.; Illa I. author non-byline.; Jellema K. author non-byline.; Kaida K. author non-byline.; Katzberg H.D. author non-byline.; Kiers L. author non-byline.; Kokubun N. author non-byline.; van Koningsveld R. author non-byline.; van der Kooi A.J. author non-byline.; Kwan J.Y. author non-byline.; Landschoff Lassen L. author non-byline.; Lawson V. author non-byline.; Leonhard S.E. author non-byline.; Mandarakas M. author non-byline.; Manji H. author non-byline.; McDermott C.J. author non-byline.; Mohammad, G Q.D. author non-byline.; Tassa Morís de la author non-byline.; Nascimbene C. author non-byline.; Niks E.H. author non-byline.; Nowak R.J. author non-byline.; Osei-Bonsu M. author non-byline.; Pascuzzi R.M. author non-byline.; Roberts R.C. author non-byline.; Rojas-Marcos I. author non-byline.; Roodbol J. author non-byline.; Rudnicki S.A. author non-byline.; Sachs G.M. author non-byline.; Schenone A. author non-byline.; Sheikh K. author non-byline.; Twydell P. author non-byline.; Van Damme P. author non-byline.; Varrato J.D. author non-byline.; Visser L.H. author non-byline.; Willison H.J. author non-byline.; van Woerkom M. author non-byline.; Zhou L. author non-byline.; Zivkovich S.A. author non-byline.; Sindrup S. author non-byline.; Stein B. author non-byline.; Wirtz P.W. author non-byline.; Mattiazzi M.G. author non-byline.;
• Is Part Of: Journal of neurology, neurosurgery and psychiatry. Volume 92:Issue 10(2021)
• Page Start: 1080
• Page End: 1088
• Publication Date: 2021-06-08
• Subjects: Neurology -- Periodicals; Nervous system -- Surgery -- Periodicals; Psychiatry -- Periodicals; 616.8
• DOI: 10.1136/jnnp-2020-325815
• Languages: English
• ISSNs: 0022-3050

Abstract

Abstract : Objective: To compare the disease course in patients with mild Guillain-Barré syndrome (GBS) who were treated with intravenous immunoglobulin (IVIg) or supportive care only. Methods: We selected patients from the prospective observational International GBS Outcome Study (IGOS) who were able to walk independently at study entry (mild GBS), treated with one IVIg course or supportive care. The primary endpoint was the GBS disability score four weeks after study entry, assessed by multivariable ordinal regression analysis. Results: Of 188 eligible patients, 148 (79%) were treated with IVIg and 40 (21%) with supportive care. The IVIg group was more disabled at baseline. IVIg treatment was not associated with lower GBS disability scores at 4 weeks (adjusted OR (aOR) 1.62, 95% CI 0.63 to 4.13). Nearly all secondary endpoints showed no benefit from IVIg, although the time to regain full muscle strength was shorter (28 vs 56 days, p=0.03) and reported pain at 26 weeks was lower (n=26/121, 22% vs n=12/30, 40%, p=0.04) in the IVIg treated patients. In the subanalysis with persistent mild GBS in the first 2 weeks, the aOR for a lower GBS disability score at 4 weeks was 2.32 (95% CI 0.76 to 7.13). At 1 year, 40% of all patients had residual symptoms. Conclusion: In patients with mild GBS, one course of IVIg did not improve the overall disease course. The certainty of this conclusion is limited by confounding factors, selection bias and wide confidence limits. Residual symptoms were often present after one year, indicating the need for better treatments in mild GBS.