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Review
. 2025 Oct 1;38(5):471-477.
doi: 10.1097/WCO.0000000000001408. Epub 2025 Jul 21.

New insights in the immune treatment of Guillain-Barré syndrome

Eveline J A Wiegers  1 , Bart C Jacobs  1   2
Affiliations
Review

New insights in the immune treatment of Guillain-Barré syndrome

Eveline J A Wiegers et al. Curr Opin Neurol. .

Abstract

Purpose of review: Guillain-Barré syndrome (GBS) is a severe but treatable form of immune-mediated neuropathy. The purpose of this review is to provide an update on current immune treatments for GBS, highlight challenges in clinical practice and research, and discuss new developments in therapies that focus on reducing inflammation and preventing further nerve damage.

Recent findings: In 2023, a GRADE-based guideline was published on the diagnosis and treatment of GBS on behalf of EAN/PNS. Several clinical trials have been conducted in GBS recently, including studies with an observational comparative study design.

Summary: Since 30 years, intravenous immunoglobulins and plasma exchange are the only proven effective immune treatments for GBS. Despite these treatments, a substantial proportion of patients recover incompletely and have residual disability or complaints with a high impact on quality of life. New treatment trials focus on reducing immunoglobulin G antibodies to nerves and inhibition of complement activation. Observational comparative studies based on extensive and well defined cohorts are an alternative method to evaluate the effect of treatments in GBS. Several novel study designs are discussed that aim to facilitate the conduct of future trials with more sustainable use of data.

Keywords: Guillain–Barré syndrome; clinical trials; comparative effectiveness research; complement; immunoglobulin G; treatments.

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Conflict of interest statement

E.W. does not report any conflicts of interest. B.J. received support for research from Prinses Beatrix Spierfonds, GBS-CIDP Foundation International, Annexon, CSL-Behring, Grifols, Roche, Hansa Biopharma and Octapharma. B.J. is chairing the Steering Committee of the International GBS Outcome Study (IGOS).

Figures

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