ObjectiveTo define the current treatment practice of Guillain-Barre syndrome (GBS).MethodsThe study was based on prospective observational data from the first 1,300 patients included in the International GBS Outcome Study. We described the treatment practice of GBS in general, and for (1) severe forms (unable to walk independently), (2) no recovery after initial treatment, (3) treatment-related fluctuations, (4) mild forms (able to walk independently), and (5) variant forms including Miller Fisher syndrome, taking patient characteristics and hospital type into account.ResultsWe excluded 88 (7%) patients because of missing data, protocol violation, or alternative diagnosis. Patients from Bangladesh (n = 189, 15%) were described separately because 83% were not treated. IV immunoglobulin (IVIg), plasma exchange (PE), or other immunotherapy was provided in 941 (92%) of the remaining 1,023 patients, including patients with severe GBS (724/743, 97%), mild GBS (126/168, 75%), Miller Fisher syndrome (53/70, 76%), and other variants (33/40, 83%). Of 235 (32%) patients who did not improve after their initial treatment, 82 (35%) received a second immune modulatory treatment. A treatment-related fluctuation was observed in 53 (5%) of 1,023 patients, of whom 36 (68%) were re-treated with IVIg or PE.ConclusionsIn current practice, patients with mild and variant forms of GBS, or with treatment-related fluctuations and treatment failures, are frequently treated, even in absence of trial data to support this choice. The variability in treatment practice can be explained in part by the lack of evidence and guidelines for effective treatment in these situations.

Verboon, C., Doets, A.y., Galassi, G., Davidson, A., Waheed, W., Pereon, Y., et al. (2019). Current treatment practice of Guillain-Barré syndrome. NEUROLOGY, 93(1), E59-E76 [10.1212/WNL.0000000000007719].

Current treatment practice of Guillain-Barré syndrome

Chen S.;Marfia G. A.;Mataluni G.;Rinaldi S.;Ritter C.;Ruiz M.;
2019

Abstract

ObjectiveTo define the current treatment practice of Guillain-Barre syndrome (GBS).MethodsThe study was based on prospective observational data from the first 1,300 patients included in the International GBS Outcome Study. We described the treatment practice of GBS in general, and for (1) severe forms (unable to walk independently), (2) no recovery after initial treatment, (3) treatment-related fluctuations, (4) mild forms (able to walk independently), and (5) variant forms including Miller Fisher syndrome, taking patient characteristics and hospital type into account.ResultsWe excluded 88 (7%) patients because of missing data, protocol violation, or alternative diagnosis. Patients from Bangladesh (n = 189, 15%) were described separately because 83% were not treated. IV immunoglobulin (IVIg), plasma exchange (PE), or other immunotherapy was provided in 941 (92%) of the remaining 1,023 patients, including patients with severe GBS (724/743, 97%), mild GBS (126/168, 75%), Miller Fisher syndrome (53/70, 76%), and other variants (33/40, 83%). Of 235 (32%) patients who did not improve after their initial treatment, 82 (35%) received a second immune modulatory treatment. A treatment-related fluctuation was observed in 53 (5%) of 1,023 patients, of whom 36 (68%) were re-treated with IVIg or PE.ConclusionsIn current practice, patients with mild and variant forms of GBS, or with treatment-related fluctuations and treatment failures, are frequently treated, even in absence of trial data to support this choice. The variability in treatment practice can be explained in part by the lack of evidence and guidelines for effective treatment in these situations.
Pubblicato
Rilevanza internazionale
Articolo
Esperti anonimi
Settore MED/26
English
Con Impact Factor ISI
Adolescent; Adult; Child; Child, Preschool; Guillain-Barre Syndrome; Humans; Prospective Studies; Severity of Illness Index; Treatment Outcome
Verboon, C., Doets, A.y., Galassi, G., Davidson, A., Waheed, W., Pereon, Y., et al. (2019). Current treatment practice of Guillain-Barré syndrome. NEUROLOGY, 93(1), E59-E76 [10.1212/WNL.0000000000007719].
Verboon, C; Doets, Ay; Galassi, G; Davidson, A; Waheed, W; Pereon, Y; Shahrizaila, N; Kusunoki, S; Lehmann, Hc; Harbo, T; Monges, S; Van Den Bergh, P; Willison, Hj; Cornblath, Dr; Jacobs, Bc; Hughes, Rac; Gorson, Kc; Hartung, Hp; Van Doorn, Pa; Van den Berg, B; Roodbol, J; Van Woerkom, M; Reisin, Rc; Reddel, Sw; Islam, Z; Islam, B; Mohammad, Qd; Feasby, Te; Dardiotis, E; Nobile-Orazio, E; Bateman, K; Illa, I; Querol, L; Hsieh, St; Chavada, G; Addington, Jm; Ajroud-Driss, S; Andersen, H; Antonini, G; Ariatti, A; Attarian, S; Badrising, Ua; Barroso, Fa; Benedetti, L; Beronio, A; Bianco, M; Binda, D; Briani, C; Bunschoten, C; Burmann, J; Bella, Ir; Bertorini, Te; Bhavaraju-Sanka, R; Brannagan, Th; Busby, M; Butterworth, S; Casasnovas, C; Cavaletti, G; Chao, Cc; Chen, S; Chetty, S; Claeys, Kg; Conti, Me; Cosgrove, Js; Dalakas, M; Demichelis, C; Derejko, Ma; Dillmann, U; Dimachkie, Mm; Doppler, K; Dornonville de la Cour, C; Echaniz-Laguna, A; Eftimov, F; Faber, Cg; Fazio, R; Fokke, C; Fujioka, T; Fulgenzi, Ea; Garcia-Sobrino, T; Garssen, Mpj; Georgios, Hm; Gijsbers, Cj; Gilchrist, Jm; Gilhuis, J; Giorli, E; Goldstein, Jm; Goyal, Na; Granit, V; Grapperon, A; Gutierrez, G; Hadden, Rdm; Holbech, Jv; Holt, Jkl; Pedret, Ch; Htut, M; Jellema, K; Pascual, Ij; Jimeno-Montero, Mc; Kaida, K; Karafiath, S; Katzberg, Hd; Kiers, L; Kieseier, Bc; Kimpinski, K; Kleyweg, Rp; Kokubun, N; Kolb, Na; Kuitwaard, K; Kuwabara, S; Kwan, Jy; Ladha, Ss; Lassen, Ll; Lawson, V; Ledingham, D; Lucy, St; Lunn, Mpt; Magot, A; Manji, H; Marchesoni, C; Marfia, Ga; Infante, Cm; Hernandez, Em; Mataluni, G; Mattiazi, M; Mcdermott, Cj; Meekins, Gd; Miller, Jal; Moris de la Tassa, G; Physiotherapist, Jm; Nascimbene, C; Nowak, Rj; Balaguer, Po; Osei-Bonsu, M; Pan, Ebl; Pardal, Am; Pardo, J; Pasnoor, M; Pulley, M; Rajabally, Ya; Rinaldi, S; Ritter, C; Roberts, Rc; Rojas-Marcos, I; Rudnicki, Sa; Ruiz, M; Sachs, Gm; Samijn, Jpa; Santoro, L; Savransky, A; Schenone, A; Schwindling, L; Tous, Mjs; Sekiguchi, Y; Sheikh, Ka; Silvestri, Nj; Sindrup, Sh; Sommer, Cl; Stein, B; Stino, Am; Spyropoulos, A; Srinivasan, J; Styliani, R; Suzuki, H; Tankisi, H; Tigner, D; Twydell, P; Van Damme, P; Van der Kooi, Aj; Van Dijk, Gw; Van der Ree, T; Van Koningsveld, R; Valzania, F; Varrato, Jd; Vermeij, Fh; Verschuuren, J; Visser, Lh; Vytopil, Mv; Wilken, M; Wilkerson, C; Wirtz, Pw; Yamagishi, Y; Zhou, L; Zivkovic, Sa
Articolo su rivista
File in questo prodotto:
Non ci sono file associati a questo prodotto.

I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.

Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/2108/236869
Citazioni
  • ???jsp.display-item.citation.pmc??? 20
  • Scopus 42
  • ???jsp.display-item.citation.isi??? 43
social impact