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:
CreatorsEmailORCIDORCID Put Code
Verboon, ChristineUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Harbo, ThomasUNSPECIFIEDorcid.org/0000-0003-2178-6076UNSPECIFIED
Cornblath, David R.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Hughes, Richard A. C.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
van Doorn, Pieter A.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Lunn, Michael P.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Gorson, Kenneth C.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Barroso, FabioUNSPECIFIEDorcid.org/0000-0002-3647-1803UNSPECIFIED
Kuwabara, SatoshiUNSPECIFIEDorcid.org/0000-0002-4716-8578UNSPECIFIED
Galassi, GiulianaUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Lehmann, Helmar C.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Kusunoki, SusumuUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Reisin, Ricardo C.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Binda, DavideUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Cavaletti, GuidoUNSPECIFIEDorcid.org/0000-0003-4128-2406UNSPECIFIED
Jacobs, Bart C.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
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:
KeywordsLanguage
DIAGNOSIS; NEUROPATHIES; DISEASEMultiple languages
Clinical Neurology; Psychiatry; SurgeryMultiple languages
URI: http://kups.ub.uni-koeln.de/id/eprint/60253

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