Is therapeutic plasma exchange a better treatment than intravenous immunoglobulin in people with severe Guillain-Barre Syndrome (GBS)?

Guillain-Barré Syndrome (GBS) is a rare but serious condition where the immune system mistakenly attacks the nerves, causing rapid-onset weakness that can sometimes progress to paralysis. The two main treatments are intravenous immunoglobulin (IVIg) — which involves infusing antibodies from blood donors — and therapeutic plasma exchange (TPE), which filters the blood to remove the harmful antibodies. Both are proven to help, but it is not clear which works better for the most severely affected patients. This pilot study is randomly assigning patients with severe GBS to receive either IVIg or TPE to compare their recovery outcomes. This is a smaller study designed to test whether a larger definitive trial is feasible. You may be eligible if you are 18 or older and have been diagnosed with GBS at a severity level of 4 or 5 on the standard disability scale, or meet other criteria for severe or respiratory-threatening disease, and can start treatment within two weeks of weakness onset. People with allergies to blood products, IgA deficiency, or who have a medical condition interfering with outcome assessments are not eligible.