Efficacy of therapies in the treatment of Guillain-Barre Syndrome: a network meta-analysis

Abstract

AbstractBackgroundGuillain-Barre syndrome (GBS) is an acute, paralyzing, inflammatory peripheral nerve disease. For treatments of the Guillain-Barre Syndrome, there are many kinds of therapies for this diseases. For comparing all of the therapies, such as immunoglobulin, plasma exchanging, etc. in the treatment of Guillain-Barre Syndrome(GBS) to better inform clinical practice, we used Network meta analysis to get the outcome of the Guillain-Barre Syndrome. The protocol had been submitted to PROSPERO:CRD: 42019119178.MethodsWeb of Science, PubMed, Embase, and the Cochrane library were searched for related articles. We identified citations and of these included 28 trials comprising 2474 patients and control group human beings. Network meta-analysis (NMA) was performed with two kinds of outcomes. We carried on R software with gemtc package and JAGS software to calculate results for different therapies. The consistency of direct and indirect evidence was also assessed by R software.ResultsConcerning for two outcomes, there were no improvement observed in methylprednisolone and prednisolone compared with placebo. PE and IVIg were illustrated to be effective over Placebo. There was no significant difference between different doses and times of PE and IVIg. On consistency examination between direct and indirect evidences, there were no obvious heterogeneity between all of therapies. Funnel plots indicates the possibility of publication bias in this study is small.ConclusionPE or IVIg have a significant efficiency for GBS patients. The effect of some combination treatments should be further explored. Corticosteroids have no significant effects on GBS.