GBS
Conditions
Brief summary
This is an observations study evaluating safety and efficacy of immunoadsorption compared to plasma exchange in Guillain-Barré Syndrome.
Interventions
1 cycle, consisting of 5 sessions on 5 consecutive days with processing of the 0.7-fold individual plasma volume (maximum 2.5 l) each days with tryptophan adsorbers.
1 cycle, consisting of 5 sessions on 5 consecutive days with exchange of 0.7-fold plasma volume (maximum 2.5 l) each day with albumin solution as volume replacement solution.
Sponsors
Study design
Eligibility
Inclusion criteria
* Diagnosis of Guillain-Barré Syndrome according to the diagnostic criteria proposed by Doorn et al. (Clinical features, pathogenesis, and treatment of Guillain-Barré syndrome, Lancet neurology 2008) * age 18 years or above
Exclusion criteria
* Clinical or laboratory (C-reactive protein 20 mg/l or above, or evidence of nitrite-positive urinary tract infection) evidence of manifest systemic infection * Intake of angiotensin converting enzyme inhibitor within1 weeks before first treatment * Other contraindications against immunoadsorption or plasma exchange
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Chronic Inflammatory Demyelinating Polyneuropathy (CIDP) Score | 2 weeks | Combined score consisting of Inflammatory Neuropathy Cause and Treatment (INCAT) disability score, Oxford muscle strength score, and vibration score, equally weighted |
| Inflammatory Neuropathy Cause and Treatment (INCAT) disability score | 2 weeks | Standard clinical score for inflammatory neuropathies. |
| Oxford Muscle Strength Score (Medical Research Council, MRC) | 2 weeks | Standard clinical score for evaluating muscle strength / paresis. Muscle strength will be measured on a scale between 0 (no movement) and 5 (full strength) on 8 pre-defined muscles (one proximal and one distal muscle at each extremity). |
| Vibration Score | 2 weeks | Standard clinical score for evaluation of vibration sensitivity on a scale between 0 and 8, using a 256 tuning fork at 4 predefined spots (processus styloideus radii and malleolus lateralis on both sides). |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Vibration Score | 1, 3, and 5 weeks | Standard clinical score for evaluation of vibration sensitivity on a scale between 0 and 8, using a 256 tuning fork at 4 predefined spots (processus styloideus radii and malleolus lateralis on both sides). |
| Chronic Inflammatory Demyelinating Polyneuropathy (CIDP) Score | 1, 3, and 5 weeks | Combined score consisting of Inflammatory Neuropathy Cause and Treatment (INCAT) disability score, Oxford muscle strength score, and vibration score, equally weighted |
| Inflammatory Neuropathy Cause and Treatment (INCAT) disability score | 1, 3, and 5 weeks | Standard clinical score for inflammatory neuropathies. |
| Oxford Muscle Strength Score (Medical Research Council, MRC) | 1, 3, and 5 weeks | Standard clinical score for evaluating muscle strength / paresis. Muscle strength will be measured on a scale between 0 (no movement) and 5 (full strength) on 8 pre-defined muscles (one proximal and one distal muscle at each extremity). |
| Hughes Score | 1, 2, 3, and 5 weeks | Standard clinical score to quantify disability in Guillain-Barré syndrome |
| Pain | 1, 2, 3, and 5 weeks | Pain quantified on a visual analog scale between 0 (no pain) and 10 (maximum pain). |
| N20 | 2 and 5 weeks | N20 latency of nervus medianus (both sides) as measured by somatosensory evoked potentials (SEPs) |
| P40 | 2 and 5 weeks | P40 latency of nervus tibialis (both sides) as measured by somatosensory evoked potentials |
| Nerve Conduction Velocity | 2 and 5 weeks | Nerve conduction velocity of clinically affected nerves as measured by electroneurography (ENG) |
| Euro Quality of Life 5 Dimensions 5 Levels (EQ-5D-5L) | 1, 2, 3, and 5 weeks | Quality of Life Scale |
| Immunoglobulin A in serum | 1, 2, 3, and 5 weeks | Immunoglobulin A serum concentration |
| Immunoglobulin A in cerebrospinal fluid (CSF) | 2 weeks | Immunoglobulin A concentration in cerebrospinal fluid |
| Immunoglobulin G in serum | 1, 2, 3, and 5 weeks | Immunoglobulin G serum concentration |
| Immunoglobulin G in cerebrospinal fluid (CSF) | 2 weeks | Immunoglobulin G concentration in cerebrospinal fluid |
| Immunoglobulin M in serum | 1, 2, 3, and 5 weeks | Immunoglobulin M serum concentration |
| Immunoglobulin M in cerebrospinal fluid (CSF) | 2 weeks | Immunoglobulin M concentration in cerebrospinal fluid |
| Interleukin-1 | 1, 2, 3, and 5 weeks | Interleukin-1 serum concentration |
| Interleukin-6 | 1, 2, 3, and 5 weeks | Interleukin-6 serum concentration |
| Anti-GM1 antibodies | 1, 2, 3, and 5 weeks | Anti-GM1 antibody serum levels |
| Anti-GQ1b | 1, 2, 3, and 5 weeks | Anti-GQQ1b antibody serum levels |
| Neurofilament light chain (NfL) serum | 1, 2, 3, and 5 weeks | Neurofilament light chain (NfL) serum levels |
| Neurofilament light chain (NfL) in cerebrospinal fluid (CSF) | 2 weeks | Neurofilament light chain (NfL) levels in cerebrospinal fluid (CSF) |
| Safety and Tolerability | 1, 2, 3, and 5 weeks | Kind and frequency of Adverse Events (AEs) and Serious Adverse Events (SAEs) |
| Therapeutic Response | 1, 2, 3, and 5 weeks | Share of patients with at least 20% improvement in CIDP score |
Countries
Germany