Abstract Details

Title Efficacy and Safety of Intravenous Immunoglobulin and Eculizumab in the Treatment of Guillain-Barré Syndrome: A Systematic Review and Meta-analysis

Topic Neuromuscular and Clinical Neurophysiology (EMG)

Presentation(s) P7 - Poster Session 7 (8:00 AM-9:00 AM)

Poster/Presentation
Number 9-021

Objective This study aims to evaluate the efficacy and safety of Eculizumab+IVIG in combination with placebo+IVIG in GBS patients.

Background Guillain-Barré Syndrome (GBS) is an acute autoimmune polyradiculoneuropathy that causes increasing deterioration and sudden paralysis. The current standard therapy includes intravenous immunoglobulin (IVIG) and plasma exchange, resulting in partial recoveries in GBS patients, which underscores the need for more advanced treatments. Recent studies suggest that complement activation plays a crucial role in GBS pathophysiology. Eculizumab targets complement component C5, but its efficacy and safety in conjunction with IVIG remain uncertain.

Design/Methods Databases including PubMed, Google Scholar, Scopus, and Cochrane Library were thoroughly searched from inception up to May 2025. RevMan software was used for data analysis. Pooled risk ratios with 95% confidence intervals were estimated using a random-effects model for the dichotomous outcomes. Heterogeneity was assessed via I2 statistics.

Results 63 articles were screened, and only 3 RCTs met the inclusion criteria. Eculizumab +IVIG shows a mild but non-significant enhancement in GBS disability grade (RR = 0.85; 95% CI: 0.55–1.33, p = 0.46) at the 4th week, but shows no improvement at the 24th week (RR = 0.99; 95% CI: 0.82–1.19, p = 0.19). Additionally, walking ability also shows slight but non-significant improvement (RR=1.28: 95% CI: 0.88–1.85; p = 0.20). Secondary outcomes, including ventilation requirements, headache, rash, and serious adverse events (SAEs), showed no significant results, though trends toward increased adverse events (AEs) were found. The study’s reliability is based on low heterogeneity (I2 = 0%), indicating consistency across results.

Conclusions Eculizumab plus IVIG shows no significant effect over standard IVIG in improving walking ability and GBS disability grade, and is associated with more AEs. Some improvement was observed at week 4, indicating its short-term therapeutic effects. Future trials should focus on large and biomarker-based RCTs to evaluate Eculizumab efficacy in GBS sub-phenotypes.

Authors/Disclosures
Syed Hassan Ali PRESENTER	Mr. Ali has nothing to disclose.
Umais Ahmed Shaikh	Mr. Shaikh has nothing to disclose.
Kanza Farhan, MBBS	Dr. Farhan has nothing to disclose.
Sughra Memon, MBBS	Ms. Memon has nothing to disclose.
Atiqa NOOR, MBBS	Miss NOOR has nothing to disclose.
Mushk Fatima, MBBS	Dr. Fatima has nothing to disclose.
Ayesha Ejaz, MBBS	Miss Ejaz has nothing to disclose.
Syed Ibad Ali, MBBS	Mr. Ibad Ali has nothing to disclose.
Shanza Shaikh, MBBS	Miss Shaikh has nothing to disclose.
Farhan Memon, MBBS	Mr. Memon has nothing to disclose.
Umaimah Naeem	Dr. Naeem has nothing to disclose.
Haleema Mansoor	Miss Mansoor has nothing to disclose.

��ɫ��

��ɫ��