[Combination therapy with methylprednisolone (mPSL) and high-dose immunoglobulin (IVIg)]

An open study in the Netherlands have investigated the efficacy of combination therapy with methylprednisolone(mPSL) and high-dose immunoglobulin (IVIg) for Guillain-Barré syndrome (GBS) patients. The study suggested that the combination therapy is more effective than treatment with IVIg alone. Following the study, randomized trial of the combination therapy for the GBS patients was performed by the Dutch GBS study group in 2004. The randomized trial revealed that it was associated with a slightly, but not significantly, higher percentage of patients who recovered by more than grade 1 in the disability score. In addition, the long-term outcome (52 weeks) of the combination did not significantly differ from that of non-combination therapy; however, the median time to independent ambulation tended to be shorter in patients undergoing the combination therapy. We have summarized the recent advances in our understanding of the therapy for the patients with GBS. GBS consists of at least two subtypes of acute peripheral neuropathy, such as acute motor axonal neuropathy (AMAN) and acute inflammatory demyelinating polyneuropathy (AIDP). It has been reported that the subtype of AMAN is morecommon in Japan, as compared with the Western countries. Further studies are needed to clarify the effectiveness of the combination therapy, because of the difference of the subtype between Japan and the Western countries.