Table 1.

Treatment of aduLt GuiUain-Barré syndrome based on evidence of cLinicaL trials.

Treatment	Trial	Year	Trial design	Patients (n)	Outcome
Effective treatment
Plasma exchange	The Guillain-Barré syndrome Study Group	1985	PE versus supportive care, single-blind	245	Improvement at 4 weeks, time to improve one clinical grade, time to independent walking, and outcome at 6 months in the PE-group.
	French CooperativeGroup on Plasma Exchange in Guillain-Barré syndrome	1987	PE (4x) with albumin (n=57) versus PE (4x) with fresh frozen plasma (n=52) versus no PE (n= 111), non-blind	220	Shorter time to recover walking with assistance (30 d versus 44 d, p<0.01) in PE group. Reduced number of patients requiring assisted ventilation, shorter time to onset of motor recovery. No differences between PE groups.
	The French Cooperative Group on Plasma Exchange in Guillain– Barré Syndrome	1997	3 groups: ‘mild’ affected: 0 versus 2 PE treatments; ‘moderate’ affected: 2 versus 4 PEs; ‘severe’ affected: 4 versus 6 PEs. non-blind	556	2 PEs more effective than 0 for time to onset of motor recovery (4 d versus 8d, p=0.0002) in mild group. 4 PEs superior as 2 PEs for time to walk with assistance (20 versus 24 d; p=0.04) in moderate group. No difference between 4 and 6 PEs in the severe group.
IVIg	The Dutch Guillain–Barré Study Group	1992	IVIG (0.4 g/kgxd, 5x), versus PE (5x) non-blind, bias-controlled	150	Improvement one or more points on functional score 34% in PE-group versus 53% in IVIGgroup (p=0.024). Time to improvement by one grade 41 d versus 27 d (p=0.05). Both treatments are of equal efficacy.
	Plasma Exchange/ Sandog lobulin Guillain–Barré Syndrome Trial Group	1997	PE 5x(n=121) versus IVIG (0.4 g/kg, 5d) (n=130) versus PE (5x)+IVIG (0.4 g/kg, 5 d), single-blind	383	No significant difference in major outcome measure (improvement on disability scale after 4 weeks and in secondary outcome measures (time to recovery of unaided walking, time to discontinuation of ventilation)
Uncertain benefit or resumably ineffective treatment (compared to PE or IVIg)
Combination of PE and IVIg	Plasma Exchange/ Sandog lobulin Guillain–Barré Syndrome Trial Group	1997	PE 5x(n=121) versus IVIG (0.4 g/kg, 5d) (n=130) versus PE (5x)+IVIG (0.4 g/kg, 5 d), single-blind	383	No significant difference in major outcome measure (improvement on disability scale after 4 weeks and in secondary outcome measures (time to recovery of unaided walking, time to discontinuation of ventilation)
Combination of IVIg and Methylprednisolone (intravenously)	Konigsveld et al., Dutch GBS trial group	2004	IVIg (0.4 g/kg, 5 d)+methylprednisolone (n=112) versus IVIg (0.4 g/kg, 5d)+placebo (n=113), double-blind, randomized-controlled	225	No significant difference between number of patients improved by 1 disability grade after 4 weeks. No significant differences in secondary outcome measures (ability to walk unaided after 8 weeks or time to walk independently)
Combination of IVIg, methylprednisolone and mycophenolate mofetil	Garssen et al.	2007	IVIg (0.4 g/kg/5 d+500mg methylprednisolone i.v. 5 d+mycophenolate mofetil (2000 mg/d 6 weeks) (n=26) compared to historical control (Koningsveld et al.) IVIg (0.4 g/kg, 5d)+methylprednisolone (n=112), open-labeled pilot study	26	No statistical differences in primary endpoint (improvement by at least one grade on the GBS disability score after 4 weeks)
Combination of IVIg, and interferon beta 1a	Pritchard et al.	2003	IVIg+interferon beta 1a (22 mg 1 week then 44 mg up to 24 weeks) (n=13) versus IVIg+placebo (n=6)	19	No statistical differences between the two groups

PE, plasma exchange; IVIg, intravenous immunoglobuUns; NDS, neurological disability score; i.v., intravenously.