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Intravenous immunoglobulin treatment for mild Guillain-Barré syndrome: an international observational study

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dc.contributor.author Verboon, Christine
dc.contributor.author Harbo, Thomas
dc.contributor.author Cornblath, David R.
dc.contributor.author Hughes, Richard A. C.
dc.contributor.author van Doorn, Pieter A.
dc.contributor.author Lunn, Michael P.
dc.contributor.author Gorson, Kenneth C.
dc.contributor.author Barroso, Fabio Adrián
dc.contributor.author Kuwabara, Satoshi
dc.contributor.author Galassi, Giuliana
dc.contributor.author Lehmann, Helmar C.
dc.contributor.author Kusunoki, Susumu
dc.contributor.author Reisin, Ricardo C.
dc.contributor.author Binda, Davide
dc.contributor.author Cavaletti, Guido
dc.contributor.author Jacobs, Bart C.
dc.contributor.author IGOS consortium
dc.contributor.author GOS consortium
dc.date.accessioned 2021-06-28T12:37:39Z
dc.date.available 2021-06-28T12:37:39Z
dc.date.issued 2021-06-08
dc.identifier.citation Verboon C, Harbo T, Cornblath DR, Hughes RAC, van Doorn PA, Lunn MP, Gorson KC, Barroso F, Kuwabara S, Galassi G, Lehmann HC, Kusunoki S, Reisin RC, Binda D, Cavaletti G, Jacobs BC; IGOS consortium; GOS consortium. Intravenous immunoglobulin treatment for mild Guillain-Barré syndrome: an international observational study. J Neurol Neurosurg Psychiatry. 2021 Jun 8:jnnp-2020-325815. doi: 10.1136/jnnp-2020-325815 es_ES
dc.identifier.uri https://doi.org/10.1136/jnnp-2020-325815
dc.identifier.uri https://repositorio.fleni.org.ar/xmlui/handle/123456789/500
dc.description.abstract Objective: To compare the disease course in patients with mild Guillain-Barré 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. es_ES
dc.language.iso eng es_ES
dc.publisher BMJ Publishing Group es_ES
dc.rights info:eu-repo/semantics/openAccess
dc.rights.uri https://creativecommons.org/licenses/by/2.5/ar/
dc.subject Immunoglobulins, Intravenous es_ES
dc.subject Imunoglobulinas Intravenosas es_ES
dc.subject Guillain-Barre Syndrome es_ES
dc.subject Síndrome de Guillain-Barré es_ES
dc.title Intravenous immunoglobulin treatment for mild Guillain-Barré syndrome: an international observational study es_ES
dc.type info:eu-repo/semantics/article es_ES
dc.type info:eu-repo/semantics/publishedVersion
dc.description.fil Fil: Verboon, Christine. Erasmus MC; Países Bajos.
dc.description.fil Fil: Harbo, Thomas. Aarhus University Hospital; Dinamarca.
dc.description.fil Fil: Cornblath, David R. Johns Hopkins University; Estados Unidos.
dc.description.fil Fil: Hughes, Richard A. C. National Hospital for Neurology and Neurosurgery; Reino Unido.
dc.description.fil Fil: van Doorn, Pieter A. Erasmus MC; Países Bajos.
dc.description.fil Fil: Lunn, Michael P. National Hospital for Neurology and Neurosurgery; Reino Unido.
dc.description.fil Fil: Gorson, Kenneth C. St. Elizabeth's Medical Center; Estados Unidos.
dc.description.fil Fil: Barroso, Fabio Adrián. Fleni. Departamento de Neurología. Sección de Enfermedades Neuromusculares; Argentina.
dc.description.fil Fil: Kuwabara, Satoshi. Chiba University; Japón.
dc.description.fil Fil: Galassi, Giuliana. University Hospital of Modena; Italia.
dc.description.fil Fil: Lehmann, Helmar C. University Hospital of Cologne; Alemania.
dc.description.fil Fil: Kusunoki, Susumu. Kindai University; Japón.
dc.description.fil Fil: Reisin, Ricardo C. Hospital Británico; Argentina.
dc.description.fil Fil: Binda, Davide. University Milano-Bicocca; Italia.
dc.description.fil Fil: Cavaletti, Guido. Erasmus MC; Países Bajos.
dc.description.fil Fil: Jacobs, Bart C. Erasmus MC; Países Bajos.
dc.relation.ispartofCOUNTRY Reino Unido
dc.relation.ispartofCITY Londres
dc.relation.ispartofTITLE Journal of neurology, neurosurgery, and psychiatry
dc.relation.ispartofISSN 1468-330X
dc.type.snrd info:ar-repo/semantics/artículo es_ES


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