Possible benefit of second intravenous immunoglobulin course in Guillain−Barré syndrome patients with potentially poor prognosis

Therefore, we would anticipate that the benefit of SID might be found with some modification of the study design, including selecting poor-outcome patients based on the risk score on admission instead of after the standard course, taking the inability to walk independently at 6 months as the primary end-point, and using the interval between onset and first course as a covariate for adjustment. Furthermore, the SID-GBS trial found that patients with thromboembolic events did not have higher immunoglobulin concentrations after one standard IVIg course or SID [2]. More severe disease in patients receiving SID might be related to more adverse events, including thromboembolic events. Considering the devastating effect of poor GBS outcomes, we argue for a possible benefit of SID in patients with potentially poor prognosis, especially by giving SID immediately after the standard course when there is still progression. Hai-Feng Li: Conceptualization; writing – original draft; writing – review and editing. Zuneng Lu: Writing – review and editing; writing – original draft. None. Data sharing is not applicable to this article as no new data were created or analyzed in this study.