Abstract | BACKGROUND: OBJECTIVES: SEARCH STRATEGY: SELECTION CRITERIA: We included all randomised and quasi-randomised trials. DATA COLLECTION AND ANALYSIS: Two authors independently selected papers, extracted data and assessed quality. MAIN RESULTS: Another Cochrane systematic review has shown that plasma exchange significantly hastens recovery. We found six randomised trials comparing intravenous immunoglobulin with plasma exchange. We undertook a meta-analysis of five trials involving 536, mostly adult participants who were unable to walk unaided and had been ill for less than two weeks. Our primary outcome measure was the change in a seven-grade disability scale four weeks after randomisation. The weighted mean difference of this measure was not statistically significant, being only -0.02 (95% confidence interval -0.25 to 0.20) of a disability grade more improvement in the intravenous immunoglobulin than the plasma exchange group. There were no statistically significant differences in other measures. One trial involving 249 participants compared plasma exchange followed by intravenous immunoglobulin with plasma exchange alone. Another involving 37 participants compared immunoabsorption followed by intravenous immunoglobulin with immunoabsorption alone. Neither revealed significant extra benefit from intravenous immunoglobulin. One study with 39 participants showed a trend towards more improvement with high-dose compared with low-dose intravenous immunoglobulin. Another trial with 51 children found no significant difference in outcome when the standard dose was given over two days rather than five days. Three studies including a total of 75 participants suggested that in children intravenous immunoglobulin significantly hastens recovery compared with supportive care. AUTHORS' CONCLUSIONS:
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Authors | R A C Hughes, J C Raphaël, A V Swan, P A van Doorn |
Journal | The Cochrane database of systematic reviews
(Cochrane Database Syst Rev)
Issue 1
Pg. CD002063
(Jan 25 2006)
ISSN: 1469-493X [Electronic] England |
PMID | 16437439
(Publication Type: Journal Article, Meta-Analysis, Review, Systematic Review)
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Chemical References |
- Immunoglobulins, Intravenous
|
Topics |
- Child
- Guillain-Barre Syndrome
(therapy)
- Humans
- Immunoglobulins, Intravenous
(therapeutic use)
- Outcome Assessment, Health Care
- Randomized Controlled Trials as Topic
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