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Both intravenous immunoglobulin and plasma exchange are established treatments for Guillain-Barré syndrome, and the choice often depends on availability, patient factors and local expertise. This systematic review compared the two strategies across the clinical literature. Overall, IVIG and plasma exchange produced broadly similar improvements in major GBS outcomes. The review suggested some practical advantages for IVIG, including easier delivery and fewer treatment discontinuations, while plasma exchange may have advantages in selected paediatric or treatment-specific contexts. The evidence base is heterogeneous, so small differences should not be interpreted as proof that one treatment is universally superior. For HCPs, the main clinical lesson is that treatment should be started promptly once significant GBS is recognised rather than delayed while debating which modality is theoretically best. Respiratory and autonomic monitoring remain essential because neurological deterioration can continue despite immunotherapy. Patient vascular access, haemodynamic stability, comorbidities and local resources can reasonably influence selection. The study is relevant to IANCON's focus on peripheral nervous system infections and inflammatory disorders, and it supports pragmatic treatment pathways for acute immune neuropathy.
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Both intravenous immunoglobulin and plasma exchange are established treatments for Guillain-Barré syndrome, and the choice often depends on availability, patient factors and local expertise. This systematic review compared the two strategies across the clinical literature. Overall, IVIG and plasma exchange produced broadly similar improvements in major GBS outcomes. The review suggested some practical advantages for IVIG, including easier delivery and fewer treatment discontinuations, while plasma exchange may have advantages in selected paediatric or treatment-specific contexts. The evidence base is heterogeneous, so small differences should not be interpreted as proof that one treatment is universally superior. For HCPs, the main clinical lesson is that treatment should be started promptly once significant GBS is recognised rather than delayed while debating which modality is theoretically best. Respiratory and autonomic monitoring remain essential because neurological deterioration can continue despite immunotherapy. Patient vascular access, haemodynamic stability, comorbidities and local resources can reasonably influence selection. The study is relevant to IANCON's focus on peripheral nervous system infections and inflammatory disorders, and it supports pragmatic treatment pathways for acute immune neuropathy.
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