Efgartigimod as a potential alternative to intravenous immunoglobulin in Guillain-Barré syndrome: a retrospective study

Purpose A disabling peripheral nervous system disorder, Guillain-Barré syndrome (GBS), has very limited treatment options. However, some patients have poor outcomes even after receiving treatment. This study aimed to compare the efficacy of efgartigimod versus intravenous immunoglobulin (IVIG) for treating GBS with disability. Patients and methods We retrospectively analyzed data from GBS patients who were unable to walk independently and were admitted between January 1, 2023, and February 28, 2025. Our primary outcome was the proportion of patients able to walk independently at week 4 and able to run at week 12. Results After including 34 patients in the study, we divided them into two groups: 12 in the efgartigimod group and 22 in the IVIG group. Patients on efgartigimod displayed numerically better short-term (100% vs. 64%, p = 0.03) and long-term (100% vs. 55%, p = 0.006) outcomes than those treated with IVIG. Conclusion Efgartigimod showed favorable safety and clinical efficacy for treating GBS with disability in this single-center retrospective study, with notable clinical improvement observed in patients with ophthalmoplegia and respiratory insufficiency. Larger prospective studies are needed to validate these preliminary findings.