Plasma exchange versus intravenous immunoglobulin for Guillain-Barré syndrome

Abstract

Previous randomized controlled trials in the U.S.A. and France have provided strong evidence that plasma exchange (PE) hastens recovery from Guillain-Barré syndrome (GBS). A Dutch trial compared intravenous immunoglobulin (IVIg) with PE in an open study and showed that recovery was as fast or slightly faster in the group treated with IVIg. This report was followed by accounts of a small series of patients who had seemed to progress or relapse after treatment with IVIg. To resolve this controversy, the Plasma Exchange Sandoglobulin GBS Trial Group (PS GBS Trial Group) selected 383 patients randomly to receive PE, IVIg, or PE followed by IVIg. After 4 weeks, the outcome was similar in each of the 3 groups. These 3 regimens also had similar outcomes during 48 weeks of follow-up.