Plasma exchange (PE) versus intravenous immunoglobulin (IVIG) for the treatment of Guillain-Barré syndrome (GBS) in patients with severe symptoms: A systematic review and meta-analysis

<h3>Background and purpose</h3><p dir="ltr">Guillain- Barré syndrome (GBS) is a neuropathic condition that leads to the rapid development of impairments and is characterized by weakness and numbness or tingling sensation in the legs and arms and sometimes loss of movement...

وصف كامل

محفوظ في:
التفاصيل البيبلوغرافية
المؤلف الرئيسي: Hany A. Zaki (15954222) (author)
مؤلفون آخرون: Haris Iftikhar (15954223) (author), Mavia Najam (15954224) (author), Maarij Masood (15954225) (author), Nood Dhafi R. Al-Marri (15954227) (author), Mohamed Abdelgadir M. Elgassim (15954228) (author), Mohamed Fayed (15954231) (author), Eman E. Shaban (15954234) (author)
منشور في: 2023
الموضوعات:
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author Hany A. Zaki (15954222)
author2 Haris Iftikhar (15954223)
Mavia Najam (15954224)
Maarij Masood (15954225)
Nood Dhafi R. Al-Marri (15954227)
Mohamed Abdelgadir M. Elgassim (15954228)
Mohamed Fayed (15954231)
Eman E. Shaban (15954234)
author2_role author
author
author
author
author
author
author
author_facet Hany A. Zaki (15954222)
Haris Iftikhar (15954223)
Mavia Najam (15954224)
Maarij Masood (15954225)
Nood Dhafi R. Al-Marri (15954227)
Mohamed Abdelgadir M. Elgassim (15954228)
Mohamed Fayed (15954231)
Eman E. Shaban (15954234)
author_role author
dc.creator.none.fl_str_mv Hany A. Zaki (15954222)
Haris Iftikhar (15954223)
Mavia Najam (15954224)
Maarij Masood (15954225)
Nood Dhafi R. Al-Marri (15954227)
Mohamed Abdelgadir M. Elgassim (15954228)
Mohamed Fayed (15954231)
Eman E. Shaban (15954234)
dc.date.none.fl_str_mv 2023-06-01T00:00:00Z
dc.identifier.none.fl_str_mv 10.1016/j.ensci.2023.100468
dc.relation.none.fl_str_mv https://figshare.com/articles/journal_contribution/Plasma_exchange_PE_versus_intravenous_immunoglobulin_IVIG_for_the_treatment_of_Guillain-Barr_syndrome_GBS_in_patients_with_severe_symptoms_A_systematic_review_and_meta-analysis/23259323
dc.rights.none.fl_str_mv CC BY 4.0
info:eu-repo/semantics/openAccess
dc.subject.none.fl_str_mv Biomedical and clinical sciences
Cardiovascular medicine and haematology
Neurosciences
Immunoglobulins
Intravenous
Plasma exchange
Review
Systematic
Guillain-Barre syndrome
Al Jufairi Diagnosis and Treatment (Doha, Qatar)
dc.title.none.fl_str_mv Plasma exchange (PE) versus intravenous immunoglobulin (IVIG) for the treatment of Guillain-Barré syndrome (GBS) in patients with severe symptoms: A systematic review and meta-analysis
dc.type.none.fl_str_mv Text
Journal contribution
info:eu-repo/semantics/publishedVersion
text
contribution to journal
description <h3>Background and purpose</h3><p dir="ltr">Guillain- Barré syndrome (GBS) is a neuropathic condition that leads to the rapid development of impairments and is characterized by weakness and numbness or tingling sensation in the legs and arms and sometimes loss of movement and feeling in the legs, arms, upper body, and face. Currently, the cure for the disease is yet to be developed. However, treatment options such as intravenous immunoglobulin (IVIG) and plasma exchange (PE) have been used to minimize the symptoms and duration of the disease. Therefore, this systematic review and meta-analysis compared the efficacy of IVIG and PE in treating GBS patients with severe symptoms.</p><h3>Methodology</h3><p dir="ltr">Six electronic databases, including PubMed, Embase, Scopus, ScienceDirect, Medline, and Google scholar, were scoured for articles related and relevant to our research. Additionally, more studies were obtained through the reference lists of the studies retrieved from these electronic databases. Quality assessment and statistical data analysis were conducted using Review Manager software (RevMan 5.4.1).</p><h3>Results</h3><p dir="ltr">The search for relevant articles resulted in 3253 articles, of which only 20 were included for review in the current study. A sub-group analysis indicated no significant difference in the curative effect (Hughes score reduces by at least one score 4 weeks after GBS treatment; OR: 1.00; 95% CI: 0.66–1.52; <i>p</i> = 1.00 and Achieving grade 0 or 1 on Hughes scale; OR: 1.03; 95% CI: 0.27–3.94; <i>p</i> = 0.97). Similarly, the statistical showed that the difference in length of hospitalization and duration of mechanical ventilation was insignificant between the IVIG and PE group (Standard Mean Difference (SMD): -0.45; 95% CI: −0.92, 0.02; I2 = 91%; <i>p</i> = 0.06 and SMD: -0.54; 95% CI: −1.67, 0.59; I2 = 93%; <i>p</i> = 0.35, respectively). Moreover, the meta-analysis did not find any significant difference in the risk of GBS relapse (RR: 0.47; 95% CI: 0.20–1.14; <i>p</i> = 0.10) and risk of complications related to the treatment regimens (RR: 1.03; 95% CI: 0.71–1.48; <i>p</i> = 0.89). However, the statistical analysis of outcomes from 3 studies showed that the risk of discontinuation was significantly lower in the IVIG group than in the PE group (RR: 0.22; 95% CI: 0.06–0.88; <i>p</i> = 0.03).</p><h3>Conclusion</h3><p dir="ltr">Our study suggests that IVIG and PE have similar curative effects. Similarly, IVIG seems easier to use and thus can be preferred for treating GBS.</p><h2>Other Information</h2><p dir="ltr">Published in: eNeurologicalSci<br>License: <a href="http://creativecommons.org/licenses/by/4.0/" target="_blank">http://creativecommons.org/licenses/by/4.0/</a><br>See article on publisher's website: <a href="https://doi.org/10.1016/j.ensci.2023.100468" target="_blank">https://doi.org/10.1016/j.ensci.2023.100468</a></p>
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spelling Plasma exchange (PE) versus intravenous immunoglobulin (IVIG) for the treatment of Guillain-Barré syndrome (GBS) in patients with severe symptoms: A systematic review and meta-analysisHany A. Zaki (15954222)Haris Iftikhar (15954223)Mavia Najam (15954224)Maarij Masood (15954225)Nood Dhafi R. Al-Marri (15954227)Mohamed Abdelgadir M. Elgassim (15954228)Mohamed Fayed (15954231)Eman E. Shaban (15954234)Biomedical and clinical sciencesCardiovascular medicine and haematologyNeurosciencesImmunoglobulinsIntravenousPlasma exchangeReviewSystematicGuillain-Barre syndromeAl Jufairi Diagnosis and Treatment (Doha, Qatar)<h3>Background and purpose</h3><p dir="ltr">Guillain- Barré syndrome (GBS) is a neuropathic condition that leads to the rapid development of impairments and is characterized by weakness and numbness or tingling sensation in the legs and arms and sometimes loss of movement and feeling in the legs, arms, upper body, and face. Currently, the cure for the disease is yet to be developed. However, treatment options such as intravenous immunoglobulin (IVIG) and plasma exchange (PE) have been used to minimize the symptoms and duration of the disease. Therefore, this systematic review and meta-analysis compared the efficacy of IVIG and PE in treating GBS patients with severe symptoms.</p><h3>Methodology</h3><p dir="ltr">Six electronic databases, including PubMed, Embase, Scopus, ScienceDirect, Medline, and Google scholar, were scoured for articles related and relevant to our research. Additionally, more studies were obtained through the reference lists of the studies retrieved from these electronic databases. Quality assessment and statistical data analysis were conducted using Review Manager software (RevMan 5.4.1).</p><h3>Results</h3><p dir="ltr">The search for relevant articles resulted in 3253 articles, of which only 20 were included for review in the current study. A sub-group analysis indicated no significant difference in the curative effect (Hughes score reduces by at least one score 4 weeks after GBS treatment; OR: 1.00; 95% CI: 0.66–1.52; <i>p</i> = 1.00 and Achieving grade 0 or 1 on Hughes scale; OR: 1.03; 95% CI: 0.27–3.94; <i>p</i> = 0.97). Similarly, the statistical showed that the difference in length of hospitalization and duration of mechanical ventilation was insignificant between the IVIG and PE group (Standard Mean Difference (SMD): -0.45; 95% CI: −0.92, 0.02; I2 = 91%; <i>p</i> = 0.06 and SMD: -0.54; 95% CI: −1.67, 0.59; I2 = 93%; <i>p</i> = 0.35, respectively). Moreover, the meta-analysis did not find any significant difference in the risk of GBS relapse (RR: 0.47; 95% CI: 0.20–1.14; <i>p</i> = 0.10) and risk of complications related to the treatment regimens (RR: 1.03; 95% CI: 0.71–1.48; <i>p</i> = 0.89). However, the statistical analysis of outcomes from 3 studies showed that the risk of discontinuation was significantly lower in the IVIG group than in the PE group (RR: 0.22; 95% CI: 0.06–0.88; <i>p</i> = 0.03).</p><h3>Conclusion</h3><p dir="ltr">Our study suggests that IVIG and PE have similar curative effects. Similarly, IVIG seems easier to use and thus can be preferred for treating GBS.</p><h2>Other Information</h2><p dir="ltr">Published in: eNeurologicalSci<br>License: <a href="http://creativecommons.org/licenses/by/4.0/" target="_blank">http://creativecommons.org/licenses/by/4.0/</a><br>See article on publisher's website: <a href="https://doi.org/10.1016/j.ensci.2023.100468" target="_blank">https://doi.org/10.1016/j.ensci.2023.100468</a></p>2023-06-01T00:00:00ZTextJournal contributioninfo:eu-repo/semantics/publishedVersiontextcontribution to journal10.1016/j.ensci.2023.100468https://figshare.com/articles/journal_contribution/Plasma_exchange_PE_versus_intravenous_immunoglobulin_IVIG_for_the_treatment_of_Guillain-Barr_syndrome_GBS_in_patients_with_severe_symptoms_A_systematic_review_and_meta-analysis/23259323CC BY 4.0info:eu-repo/semantics/openAccessoai:figshare.com:article/232593232023-06-01T00:00:00Z
spellingShingle Plasma exchange (PE) versus intravenous immunoglobulin (IVIG) for the treatment of Guillain-Barré syndrome (GBS) in patients with severe symptoms: A systematic review and meta-analysis
Hany A. Zaki (15954222)
Biomedical and clinical sciences
Cardiovascular medicine and haematology
Neurosciences
Immunoglobulins
Intravenous
Plasma exchange
Review
Systematic
Guillain-Barre syndrome
Al Jufairi Diagnosis and Treatment (Doha, Qatar)
status_str publishedVersion
title Plasma exchange (PE) versus intravenous immunoglobulin (IVIG) for the treatment of Guillain-Barré syndrome (GBS) in patients with severe symptoms: A systematic review and meta-analysis
title_full Plasma exchange (PE) versus intravenous immunoglobulin (IVIG) for the treatment of Guillain-Barré syndrome (GBS) in patients with severe symptoms: A systematic review and meta-analysis
title_fullStr Plasma exchange (PE) versus intravenous immunoglobulin (IVIG) for the treatment of Guillain-Barré syndrome (GBS) in patients with severe symptoms: A systematic review and meta-analysis
title_full_unstemmed Plasma exchange (PE) versus intravenous immunoglobulin (IVIG) for the treatment of Guillain-Barré syndrome (GBS) in patients with severe symptoms: A systematic review and meta-analysis
title_short Plasma exchange (PE) versus intravenous immunoglobulin (IVIG) for the treatment of Guillain-Barré syndrome (GBS) in patients with severe symptoms: A systematic review and meta-analysis
title_sort Plasma exchange (PE) versus intravenous immunoglobulin (IVIG) for the treatment of Guillain-Barré syndrome (GBS) in patients with severe symptoms: A systematic review and meta-analysis
topic Biomedical and clinical sciences
Cardiovascular medicine and haematology
Neurosciences
Immunoglobulins
Intravenous
Plasma exchange
Review
Systematic
Guillain-Barre syndrome
Al Jufairi Diagnosis and Treatment (Doha, Qatar)