Alternative Therapies to Immunoglobulin for Guillain-Barré Syndrome


Project Status:
Project Line:
Health Technology Review
Project Sub Line:
Rapid Review
Project Number:


  1. What is the clinical effectiveness of alternative treatments to IV immunoglobulin (IVIg) compared to IVIg or placebo for Guillain-Barré syndrome?
  2. What is the safety of alternative treatments to IVIg compared to IVIg or placebo for Guillain-Barré syndrome?
  3. What are the evidence-based guidelines regarding the use of alternate treatments to IVIg for Guillain-Barré syndrome?

Key Message

Plasma exchange may be more effective than placebo in reducing disability scale scores and improving the likelihood of disability improvement in patients with Guillain-Barré syndrome.

Plasma exchange showed similar effectiveness as IV immunoglobulin on disability outcomes in treating Guillain-Barré syndrome.

Limited evidence from a health technology assessment subsection suggests that plasma exchange may have a similar safety profile as IV immunoglobulin.

An evidence-based guideline suggests that plasma exchange can be used as 1 of the immune therapies (IV immunoglobulin alternatives) for children with Guillain-Barré syndrome who have contraindications for IV immunoglobulin or when IV immunoglobulin is ineffective. However, most supporting evidence was from adults.

We did not find any study reporting on the rate of recovery, duration of hospitalization, or cost-effectiveness of plasma exchange for treating Guillain-Barré syndrome that met the inclusion criteria for this report.