Cochrane · systematic review · CD008630

Pharmacological treatment other than corticosteroids, intravenous immunoglobulin and plasma exchange for Guillain‐Barré syndrome

Doets, AY, Hughes, RAC, Brassington, R, et al. · Cochrane Database of Systematic Reviews · 2020 · Cochrane Library

Neuromuscular4 versionsAMSTAR 2: not assessed
SoF tableOnly the outcomes this review put in its Summary of Findings table are listed (the Cochrane Handbook caps them at about seven per comparison). Its other analyses are not shown here.
Questions
35
current version
GRADE rated
25
No studies
8
Included studies
NR
No studies 8 · 22.9%Ungraded 2 · 5.7%Very low 19 · 54.3%Low 6 · 17.1%Moderate 0 · 0%High 0 · 0%

Ungraded means an effect was reported without a GRADE rating; it is not a gap. No studies means the review found nothing to answer the question. The six categories are a display order, not a score.

Questions and results

Show all 4 versions

Interferon beta‐1a versus placebo for Guillain‐Barré syndrome

Population: people with Guillain‐Barré syndrome
7 questions
OutcomeEffectEvidenceStatus / GRADE
Improvement in disability grade after 4 weeks Scale ranges from grade 0 to 6 where 0 is healthy and 6 is dead
Interferon beta‐1a vs placebo
no estimate extracted1 study · 19 participantsVery low
Downgraded: imprecision
Improvement in disability grade Defined as achievement of a specified degree of improvement
Interferon beta‐1a vs placebo
RR 1.08 [0.42, 2.77]1 study · 19 participantsVery low
Downgraded: imprecision
Time from randomisation until recovery of unaided walking (median, days (95% CI))
Interferon beta‐1a vs placebo
no estimate extracted1 study · 19 participantsVery low
Downgraded: imprecision
Time from randomisation until discontinuation of ventilation (for those ventilated)
Interferon beta‐1a vs placebo
no estimate extractedNRNo studies
Death
Interferon beta‐1a vs placebo
RR 1.5 [0.07, 32.29]1 study · 19 participantsLow
Downgraded: imprecision
Death or disability after 12 months
Interferon beta‐1a vs placebo
no estimate extractedNRNo studies
Participants with 1 or more serious adverse events
Interferon beta‐1a vs placebo
RR 0.92 [0.23, 3.72]1 study · 19 participantsVery low
Downgraded: imprecision

Brain‐derived neurotrophic factor versus placebo for Guillain‐Barré syndrome

Population: people with Guillain‐Barré syndrome
7 questions
OutcomeEffectEvidenceStatus / GRADE
Improvement in disability grade after 4 weeks Scale ranges from grade 0 to 6 where 0 is healthy and 6 is dead
Brain‐derived neurotrophic factor vs placebo
no estimate extracted1 study · 10 participantsVery low
Downgraded: risk of bias, imprecision
Improvement in disability grade Defined as achievement of a specified degree of improvement
Brain‐derived neurotrophic factor vs placebo
RR 1 [0.28, 3.54]1 study · 10 participantsVery low
Downgraded: risk of bias, imprecision
Time from randomisation until recovery of unaided walking, (median, days (95% CI))
Brain‐derived neurotrophic factor vs placebo
no estimate extracted1 study · 10 participantsVery low
Downgraded: risk of bias, imprecision
Time from randomisation until discontinuation of ventilation (for those ventilated) (median, weeks (range))
Brain‐derived neurotrophic factor vs placebo
no estimate extracted1 study · 5 participantsVery low
Downgraded: risk of bias, imprecision
Death
Brain‐derived neurotrophic factor vs placebo
RR 0.67 [0.06, 7.85]1 study · 10 participantsVery low
Downgraded: risk of bias, imprecision
Death or disability after 12 months
Brain‐derived neurotrophic factor vs placebo
RR 1.33 [0.17, 10.25]1 study · 10 participantsVery low
Downgraded: risk of bias, imprecision
Participants with 1 or more serious adverse events
Brain‐derived neurotrophic factor vs placebo
RR 1 [0.28, 3.54]1 study · 10 participantsVery low
Downgraded: risk of bias, imprecision

Cerebrospinal fluid filtration versus plasma exchange for Guillain‐Barré syndrome

Population: people with Guillain‐Barré syndrome
7 questions
OutcomeEffectEvidenceStatus / GRADE
Improvement in disability grade after 4 weeks Scale ranges from grade 0 to 6 where 0 is healthy and 6 is dead
Cerebrospinal fluid filtration vs plasma exchange
no estimate extracted1 study · 37 participantsVery low
Downgraded: risk of bias, imprecision
Improvement in disability grade Defined as achievement of a specified degree of improvement
Cerebrospinal fluid filtration vs plasma exchange
RR 0.94 [0.48, 1.84]1 study · 37 participantsVery low
Downgraded: risk of bias, imprecision
Time from randomisation until recovery of unaided walking (median, days (range))
Cerebrospinal fluid filtration vs plasma exchange
no estimate extracted1 study · 37 participantsVery low
Downgraded: risk of bias, imprecision
Time from randomisation until discontinuation of ventilation (for those ventilated)
Cerebrospinal fluid filtration vs plasma exchange
no estimate extractedNRNo studies
Death
Cerebrospinal fluid filtration vs plasma exchange
RR 1.18 [0.08, 17.42]1 study · 37 participantsLow
Downgraded: imprecision
Death or disability after 12 months
Cerebrospinal fluid filtration vs plasma exchange
no estimate extractedNRNo studies
Participants with 1 or more serious adverse events
Cerebrospinal fluid filtration vs plasma exchange
RR 0.13 [0.01, 2.25]1 study · 37 participantsVery low
Downgraded: risk of bias, imprecision

Tripterygium polyglycoside versus corticosteroids for Guillain‐Barré syndrome

Population: people with Guillain‐Barré syndrome
7 questions
OutcomeEffectEvidenceStatus / GRADE
Improvement in disability grade after 4 weeks Scale ranges from grade 0 to 6 where 0 is healthy and 6 is dead
Tripterygium polyglycoside vs corticosteroids
no estimate extractedNRNo studies
Improvement in disability grade Defined as achievement of a specified degree of improvement
Tripterygium polyglycoside vs corticosteroids
RR 1.47 [1.02, 2.11]1 study · 43 participantsVery low
Downgraded: risk of bias, imprecision, indirectness
Time from randomisation until recovery of unaided walking
Tripterygium polyglycoside vs corticosteroids
no estimate extractedNRNo studies
Time from randomisation until discontinuation of ventilation (for those ventilated)
Tripterygium polyglycoside vs corticosteroids
no estimate extractedNRNo studies
Death
Tripterygium polyglycoside vs corticosteroids
no estimate extracted1 study · 43 participantsUngraded
Death or disability after 12 months
Tripterygium polyglycoside vs corticosteroids
no estimate extractedNRNo studies
Participants with 1 or more serious adverse events
Tripterygium polyglycoside vs corticosteroids
no estimate extracted1 study · 43 participantsUngraded

Eculizumab versus placebo for Guillain‐Barré syndrome

Population: adults with severe Guillain‐Barré syndrome (GBS disability score > 2), within 2 weeks form onset
7 questions
OutcomeEffectEvidenceStatus / GRADE
Improvement in disability grade after 4 weeks Scale ranges from grade 0 to 6 where 0 is healthy and 6 is dead
Eculizumab vs placebo
no estimate extracted2 studies · 40 participantsVery low
Downgraded: imprecision, inconsistency
Improvement in disability grade Defined as achievement of a specified degree of improvement
Eculizumab vs placebo
RR 0.85 [0.43, 1.69]2 studies · 40 participantsLow
Downgraded: imprecision
Time from randomisation until recovery of unaided walking (mean, weeks)
Eculizumab vs placebo
no estimate extracted1 study · 7 participantsLow
Downgraded: imprecision
Time from randomisation until discontinuation of ventilation (for those ventilated)
Eculizumab vs placebo
no estimate extracted2 studies · 8 participantsVery low
Downgraded: imprecision, inconsistency
Death
Eculizumab vs placebo
RR 1.5 [0.08, 26.86]2 studies · 38 participantsLow
Downgraded: imprecision
Death or disability after 12 months In the absence of data at 12 months, we report the outcome at 6 months
Eculizumab vs placebo
RR 1.21 [0.15, 10.11]2 studies · 38 participantsVery low
Downgraded: imprecision, indirectness
Participants with 1 or more serious adverse events
Eculizumab vs placebo
RR 1.9 [0.34, 10.5]2 studies · 41 participantsLow
Downgraded: imprecision