Current therapy in Guillain–Barré syndrome

Abstract

Guillain–Barré syndrome (GBS) is a monophasic immune–mediated neuropathy. Approximately 20% of GBS patients can't walk without aid at one year from onset. The effectiveness of second IVIg couldn't be shown in the recent SID–GBS trial. Thus, novel therapies are required for improvement of the prognosis in GBS. Complement inhibitors are notable as the novel therapies for GBS. The inhibitor of C5, eculizumab, is expected for the improvements of long–term prognosis in GBS. In addition, the inhibitor of C1q also possibly has an effectiveness as well as C5 inhibitor. Previous in vitro and in vivo studies have shown that IgG–degrading enzyme of Streptococcus pyogenes (IdeS) inhibits deposition of complement and prevents axonal degeneration. At present, several trials regarding those complement inhibitors are in progress.