Article Text

Download PDFPDF

Intravenous immune globulins in patients with Guillain-Barré syndrome and contraindications to plasma exchange: 3 days versus 6 days
  1. J-C Raphaela,
  2. S Chevretb,
  3. M Harbounb,
  4. M-Ce Jars-Guincestre for the French Guillain-Barré Syndrome Cooperative Group (see )a
  1. aHôpital Raymond Poincaré, Service de Réanimation Médicale, 104 Boulevard Raymond Poincaré, 92380 Garches, France, bStatistical Center, Hôpital Saint Louis, Département de Biostatistique et Informatique Médicale, 10 Rue Claude Vellefaux, 75475 Paris cedex 10, France
  1. Professor Jean-Claude Raphaëljean-claude.raphael{at}rpc.ap-hop-paris.fr

Abstract

Plasma exchange is contraindicated in 10 to 20% of patients with Guillain-Barré syndrome (GBS). The optimal schedule for intravenous immune globulin (IVIg) therapy has not yet been established in these patients.

 The objective was to compare the efficacy and safety of two IVIg treatment durations in patients with GBS with contraindications for plasma exchange.  In this randomised, double blind, multicentre phase II trial conducted in seven French centres, patients with GBS with severe haemostasis, unstable haemodynamics, or uncontrolled sepsis were randomly assigned to 0.4 g/kg/day IVIg for 3 or 6 days. The primary outcome measure was the time needed to regain the ability to walk with assistance.  Thirty nine patients were included from March 1994 to May 1997, 21 in the 3 day group and 18 in the 6 day group. Time to walking with assistance was non-significantly shorter in the 6 day group (84 (23–121)v 131 days (51–210), p=0.08); the difference was significant in ventilated patients (86 days (13–151) in the 6 day group v 152 days (54–332) in the 3 day group; p=0.04). The prevalence and severity of IVIg related adverse effects were comparable between the two groups.  In conclusion, in patients with GBS and contraindications for plasma exchange, especially those who need ventilatory assistance, IVIg (0.4 g/kg/day) may be more beneficial when given for 6 days rather than 3 days.

  • Guillain-Barré syndrome
  • intravenous immunoglobulins
  • randomised trial
View Full Text

Statistics from Altmetric.com

Footnotes

    Request Permissions

    If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.