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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
Verboon C.;Doets A. Y.;Galassi G.;Davidson A.;Waheed W.;Pereon Y.;Shahrizaila N.;Kusunoki S.;Lehmann H. C.;Harbo T.;Monges S.;Van Den Bergh P.;Willison H. J.;Cornblath D. R.;Jacobs B. C.;Hughes R. A. C.;Gorson K. C.;Hartung H. P.;Van Doorn P. A.;Van den Berg B.;Roodbol J.;Van Woerkom M.;Reisin R. C.;Reddel S. W.;Islam Z.;Islam B.;Mohammad Q. D.;Feasby T. E.;Dardiotis E.;Nobile-Orazio E.;Bateman K.;Illa I.;Querol L.;Hsieh S. T.;Chavada G.;Addington J. M.;Ajroud-Driss S.;Andersen H.;Antonini G.;Ariatti A.;Attarian S.;Badrising U. A.;Barroso F. A.;Benedetti L.;Beronio A.;Bianco M.;Binda D.;Briani C.;Bunschoten C.;Burmann J.;Bella I. R.;Bertorini T. E.;Bhavaraju-Sanka R.;Brannagan T. H.;Busby M.;Butterworth S.;Casasnovas C.;Cavaletti G.;Chao C. C.;Chen S.;Chetty S.;Claeys K. G.;Conti M. E.;Cosgrove J. S.;Dalakas MC.;Demichelis C.;Derejko M. A.;Dillmann U.;Dimachkie M. M.;Doppler K.;Dornonville de la Cour C.;Echaniz-Laguna A.;Eftimov F.;Faber C. G.;Fazio R.;Fokke C.;Fujioka T.;Fulgenzi E. A.;Garcia-Sobrino T.;Garssen M. P. J.;Georgios H. M.;Gijsbers C. J.;Gilchrist J. M.;Gilhuis J.;Giorli E.;Goldstein J. M.;Goyal N. A.;Granit V.;Grapperon A.;Gutierrez G.;Hadden R. D. M.;Holbech J. V.;Holt J. K. L.;Pedret C. H.;Htut M.;Jellema K.;Pascual I. J.;Jimeno-Montero M. C.;Kaida K.;Karafiath S.;Katzberg H. D.;Kiers L.;Kieseier B. C.;Kimpinski K.;Kleyweg R. P.;Kokubun N.;Kolb N. A.;Kuitwaard K.;Kuwabara S.;Kwan J. Y.;Ladha S. S.;Lassen L. L.;Lawson V.;Ledingham D.;Lucy S. T.;Lunn M. P. T.;Magot A.;Manji H.;Marchesoni C.;Marfia G. A.;Infante C. M.;Hernandez E. M.;Mataluni G.;Mattiazi M.;McDermott C. J.;Meekins G. D.;Miller J. A. L.;Moris de la Tassa G.;Physiotherapist J. M.;Nascimbene C.;Nowak R. J.;Balaguer P. O.;Osei-Bonsu M.;Pan E. B. L.;Pardal A. M.;Pardo J.;Pasnoor M.;Pulley M.;Rajabally Y. A.;Rinaldi S.;Ritter C.;Roberts R. C.;Rojas-Marcos I.;Rudnicki S. A.;Ruiz M.;Sachs G. M.;Samijn J. P. A.;Santoro L.;Savransky A.;Schenone A.;Schwindling L.;Tous M. J. S.;Sekiguchi Y.;Sheikh K. A.;Silvestri N. J.;Sindrup S. H.;Sommer C. L.;Stein B.;Stino A. M.;Spyropoulos A.;Srinivasan J.;Styliani R.;Suzuki H.;Tankisi H.;Tigner D.;Twydell P.;Van Damme P.;Van der Kooi A. J.;Van Dijk G. W.;Van der Ree T.;Van Koningsveld R.;Valzania F.;Varrato J. D.;Vermeij F. H.;Verschuuren J.;Visser L. H.;Vytopil M. V.;Wilken M.;Wilkerson C.;Wirtz P. W.;Yamagishi Y.;Zhou L.;Zivkovic S. A.
2019-07-01
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.
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].
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/2108/236869
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simulazione ASN
Il report seguente simula gli indicatori relativi alla propria produzione scientifica in relazione alle soglie ASN 2023-2025 del proprio SC/SSD. Si ricorda che il superamento dei valori soglia (almeno 2 su 3) è requisito necessario ma non sufficiente al conseguimento dell'abilitazione. La simulazione si basa sui dati IRIS e sugli indicatori bibliometrici alla data indicata e non tiene conto di eventuali periodi di congedo obbligatorio, che in sede di domanda ASN danno diritto a incrementi percentuali dei valori. La simulazione può differire dall'esito di un’eventuale domanda ASN sia per errori di catalogazione e/o dati mancanti in IRIS, sia per la variabilità dei dati bibliometrici nel tempo. Si consideri che Anvur calcola i valori degli indicatori all'ultima data utile per la presentazione delle domande.
La presente simulazione è stata realizzata sulla base delle specifiche raccolte sul tavolo ER del Focus Group IRIS coordinato dall’Università di Modena e Reggio Emilia e delle regole riportate nel DM 589/2018 e allegata Tabella A. Cineca, l’Università di Modena e Reggio Emilia e il Focus Group IRIS non si assumono alcuna responsabilità in merito all’uso che il diretto interessato o terzi faranno della simulazione. Si specifica inoltre che la simulazione contiene calcoli effettuati con dati e algoritmi di pubblico dominio e deve quindi essere considerata come un mero ausilio al calcolo svolgibile manualmente o con strumenti equivalenti.