A Cochrane review [Abstract] 1 included 5 studies with 536 patients comparing intravenous immunoglobulin (IVIg) with plasma exchange. The IVIg given was the standard regimen of 0.4 g/kg daily for 5 days and in one trial 0.5 g/kg daily for 4 days. Patients were unable to walk unaided and had been ill for less than two weeks. There was not statistically significant mean difference (MD) in a 7-grade disability scale 4 weeks after randomisation (MD 0.02, 95% CI 0.25 to -0.20). Giving IVIg after plasma exchange is not significantly better than plasma exchange alone (one trial, n=249). In adults, there are no adequate comparisons with placebo. In children IVIg significantly hastened recovery compared with supportive care (3 studies, n=75). Adverse events were not significantly more frequent with either treatment but IVIg is significantly more likely to be completed than plasma exchange.
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