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No evidence of benefits from corticosteroids alone in Guillain–Barré syndrome
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No evidence of benefits from corticosteroids alone in Guillain–Barré syndrome
Compared with placebo or supportive care, how effective are corticosteroids in hastening recovery and reducing the long-term morbidity from Guillain–Barré syndrome (GBS)?
According to moderate-quality evidence, corticosteroids do not significantly hasten recovery from GBS or affect the long-term outcome, and low-quality evidence suggests oral corticosteroids delay recovery. There is moderate-quality evidence that intravenous corticosteroids given in combination with intravenous immunoglobulin might hasten recovery. There is no evidence of harm from corticosteroids except that increased blood glucose concentrations requiring insulin were significantly more common. Unexpectedly, hypertension was significantly less common.
Treatment periods were for 4 weeks, and follow-up lasted for up to 12 months. The lack of benefit from corticosteroids is not understood but might be because the drugs have a harmful effect on muscles which counteract the benefit from reducing inflammation in nerves.
GBS is an acute paralysing disease caused by inflammation of the peripheral nerves, which corticosteroids would be expected to benefit.
Hughes RAC et al. Corticosteroids for Guillain–Barré syndrome. Cochrane Reviews, 2016, Issue 10. Art. No.: CD001466.DOI: 10.1002/14651858. CD001466.pub5. This review contains 8 studies involving 653 participants.