Universität zu Köln

Verboon, Christine, Harbo, Thomas ORCID: 0000-0003-2178-6076, Cornblath, David R., Hughes, Richard A. C., van Doorn, Pieter A., Lunn, Michael P., Gorson, Kenneth C., Barroso, Fabio ORCID: 0000-0002-3647-1803, Kuwabara, Satoshi ORCID: 0000-0002-4716-8578, Galassi, Giuliana, Lehmann, Helmar C., Kusunoki, Susumu, Reisin, Ricardo C., Binda, Davide, Cavaletti, Guido ORCID: 0000-0003-4128-2406 and Jacobs, Bart C. (2021). Intravenous immunoglobulin treatment for mild Guillain-Barre syndrome: an international observational study. J. Neurol. Neurosurg. Psychiatry, 92 (10). S. 1080 - 1089. LONDON: BMJ PUBLISHING GROUP. ISSN 1468-330X

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Abstract

Objective To compare the disease course in patients with mild Guillain-Barre 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.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Verboon, Christine UNSPECIFIED UNSPECIFIED UNSPECIFIED Harbo, Thomas UNSPECIFIED orcid.org/0000-0003-2178-6076 UNSPECIFIED Cornblath, David R. UNSPECIFIED UNSPECIFIED UNSPECIFIED Hughes, Richard A. C. UNSPECIFIED UNSPECIFIED UNSPECIFIED van Doorn, Pieter A. UNSPECIFIED UNSPECIFIED UNSPECIFIED Lunn, Michael P. UNSPECIFIED UNSPECIFIED UNSPECIFIED Gorson, Kenneth C. UNSPECIFIED UNSPECIFIED UNSPECIFIED Barroso, Fabio UNSPECIFIED orcid.org/0000-0002-3647-1803 UNSPECIFIED Kuwabara, Satoshi UNSPECIFIED orcid.org/0000-0002-4716-8578 UNSPECIFIED Galassi, Giuliana UNSPECIFIED UNSPECIFIED UNSPECIFIED Lehmann, Helmar C. UNSPECIFIED UNSPECIFIED UNSPECIFIED Kusunoki, Susumu UNSPECIFIED UNSPECIFIED UNSPECIFIED Reisin, Ricardo C. UNSPECIFIED UNSPECIFIED UNSPECIFIED Binda, Davide UNSPECIFIED UNSPECIFIED UNSPECIFIED Cavaletti, Guido UNSPECIFIED orcid.org/0000-0003-4128-2406 UNSPECIFIED Jacobs, Bart C. UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-602536
DOI:	10.1136/jnnp-2020-325815
Journal or Publication Title:	J. Neurol. Neurosurg. Psychiatry
Volume:	92
Number:	10
Page Range:	S. 1080 - 1089
Date:	2021
Publisher:	BMJ PUBLISHING GROUP
Place of Publication:	LONDON
ISSN:	1468-330X
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language DIAGNOSIS; NEUROPATHIES; DISEASE Multiple languages Clinical Neurology; Psychiatry; Surgery Multiple languages
URI:	http://kups.ub.uni-koeln.de/id/eprint/60253