Immunoadsorption vs. Plasma Exchange in Guillain-Barre Syndrome: A Meta-Analysis and Systematic Review

Pages: 8-16

Category: Original Research

Published Date: 09-05-2024


Levin Ace Danganan1*, Elizer Montemayor1, Renato Dejan Jr.1

Author Affiliation:

Department of Neurosciences, East Avenue Medical Center, Philippines.


Immunoadsorption, Plasma Exchange, Therapeutic Apheresis, Guillain-Barre Syndrome


Background: Guillain-Barre Syndrome is a debilitating neurological disease with an incidence of 1.1 - 1.8 per 100,000. Autoantibodies affecting peripheral nerve membranes play an important role in understanding the pathophysiology and treatment of it. Treatment options for its cure continue to unfold and evolve. Different clinical trials resulted in increased interest in therapeutic apheresis for treatment of severe and refractory disease.

Objectives: Conflicting results of immunoadsorption compared to plasma exchange in the management of Guillain-Barre Syndrome led us to synthesize available evidence from published studies.
METHODS: Review Manager software was used for this review and classified the outcomes into primary (curative effect) and secondary (safety profile and relapse rate). Quality assessment and statistical data analysis were conducted using the said software.

Result: The odds of achieving at least one grade disability and functional improvement was similar for patients treated with immunoadsorption and plasma exchange (OR: 0.77; 95% CI: 0.34 - 1.74; p = 0.53). Reduced risk of complications for patients treated with immunoadsorption group as compared to plasma exchange group (RR: 0.69; 95% CI: 0.43 - 1.11; p = 0.13) was noted. Increased risk of relapse for patients who underwent immunoadsorption (RR: 1.70; 95% CI: 0.96 - 3.00; p = 0.07).

Conclusion: Immunoadsorption is at least as effective as plasma exchange in the treatment of Guillain-Barre Syndrome based on its curative effect by lowering its disability and improving functional score. Immunoadsorption showed reduced complications but relapse rates were higher compared to plasma exchange.