Blog Viewer

Second Intravenous Immunoglobulin Dose in Patients with Guillain-Barré Syndrome with Poor Prognosis (SID-GBS): A Double-Blind, Randomised, Placebo-Controlled Trial

By Currents Editor posted 06-30-2021 09:47


The Lancet Neurology (04/01/21)  DOI: 10.1016/S1474-4422(20)30494-4

Walgaard, Christa; Jacobs, Bart C; Lingsma, Hester F; et al. 

New research finds no benefit but a risk of serious adverse events from a second intravenous immunoglobulin dose (SID) for patients with Guillain-Barré syndrome with a poor prognosis. Investigators had investigated the efficacy of a SID in this population, as treatment with one standard dose of I.V. immunoglobulin is not sufficient for some patients with severe Guillain-Barré syndrome. The randomized, double-blind study included patients with Guillain-Barré syndrome on their first day of standard I.V. immunoglobulin treatment (2 g/kg over 5 days). Using the modified Erasmus Guillain-Barré syndrome Outcome Score, patients with a poor prognosis score were randomized to receive SID or to placebo, 7-9 days after inclusion. Among the 93 patients with a poor prognosis who were included in the modified intention-to-treat analysis, 49 received SID and 44 received placebo. At 4 weeks, the adjusted common odds ratio for improvement on the Guillain-Barré syndrome disability score was 1.4. According to the data, more than twice as many patients who received a SID experienced serious adverse events in the first 30 days, including thromboembolic events, at 35% vs. 16% in the placebo group. In addition, four patients in the SID group died, 13-24 weeks after randomization. Based on the findings, the researchers say a SID should not be considered for the treatment of Guillain-Barré syndrome with a poor prognosis, and they call for more research into other immune modulators for these patients.


Disorders of Consciousness Associated With COVID-19: A Prospective, Multimodal Study of Recovery and Brain Connectivity Neurology (12/03/21) DOI: 10.1212/WNL.0000000000013067 Fischer, David; Snider, Samuel B.; Barra, Megan E.; et al. ...
Yingying Su, Guoping Ren, Linlin Fan, and Huijin Huang The functional recovery of nerve cells after brain injury is extremely complex and difficult. Finding effective ways to save as many nerve cells as possible while retaining and maximizing neural function has become a common goal for neuroscientists, ...
van Veen E, van der Jagt M, Citerio G, et al. Occurrence and timing of withdrawal of life-sustaining measures in traumatic brain injury patients: a CENTER-TBI study. Intensive Care Med . 2021;47(10):1115-1129. doi:10.1007/s00134-021-06484-1   Read the Full Article. Background: In patients with ...