From the Guidelines
The dose of Intravenous Immunoglobulin (IVIG) in Guillain-Barré Syndrome (GBS) is 0.4 g/kg daily for 5 days.
Treatment Overview
- IVIG is considered the first choice of treatment for GBS due to its ease of administration, wide availability, and reduced frequency of adverse effects compared to plasma exchange 1.
- The efficacy of IVIG and plasma exchange has been established in several studies, with both treatments being equally effective in treating GBS 1.
Dosage and Administration
- The recommended dose of IVIG is 0.4 g/kg daily for 5 days, which is the standard adult regimen 1.
- In children, IVIG is usually the first-line therapy, and the same dose of 0.4 g/kg daily for 5 days is recommended, although some pediatric centers may administer a 2-day regimen 1.
Clinical Considerations
- IVIG and plasma exchange carry comparable risks of adverse events, although early studies showed that plasma exchange was more likely to be discontinued 1.
- The efficacy of repeat treatment in patients who have shown insufficient clinical response is uncertain, but this practice is common in patients who show deterioration after an initial treatment response 1.
From the Research
Dose of Intravenous Immunoglobulin (IVIG) in Guillain-Barré Syndrome (GBS)
- The standard dose of IVIG in GBS is 2 g/kg, administered over 5 days 2, 3, 4, 5
- Some studies suggest that this dose may be insufficient for patients with severe GBS, and that a second course of IVIG may be beneficial 2, 6, 5
- However, a randomized controlled trial found that a second course of IVIG did not improve outcomes in patients with poor prognosis, and was associated with more serious adverse events 2
- The optimal dose of IVIG in GBS remains to be determined, and further studies are needed to establish the most effective treatment regimen 6, 4
Pharmacokinetics of IVIG in GBS
- The pharmacokinetics of IVIG can vary significantly between patients, and may be related to disease severity and outcome 6
- Patients with a low increase in serum IgG levels after IVIG treatment may have a poorer outcome, and may benefit from a higher dose or second course of IVIG 6
Clinical Trials of IVIG in GBS
- Several clinical trials have compared IVIG to plasma exchange or other treatments in GBS, and have found that IVIG is effective in speeding recovery 4
- However, the optimal dose and duration of IVIG treatment remain to be determined, and further studies are needed to establish the most effective treatment regimen 4, 5