OBJECTIVES: Guillain-Barré syndrome (GBS) is a rare and severe post-infectious immune-mediated neuropathy, resulting from the autoimmune destruction of nerves in the peripheral nervous system. This systematic literature review (SLR) aimed to identify treatment recommendations based on clinical practice guidelines (CPGs) for GBS.

METHODS: Embase^® and MEDLINE^® were searched from database inception to June 2024 to identify relevant English language publications providing CPGs in patients with GBS. Each publication was reviewed by two independent reviewers and disagreements were resolved by a third reviewer.

RESULTS: Of the 458 records screened, nine CPGs from 16 publications were included, providing valuable treatment management-related information. Three CPGs each were identified for the USA and Europe followed by one each for Australia, Canada, and Southeast Asia. Across all the CPGs, intravenous immunoglobulin (IVIg) at 0.4 g/kg/day for 5 days and therapeutic plasma exchange (PE) were highlighted as effective first-line treatments, with IVIg often preferred due to its lower side effect profile. Sequential therapy with PE followed by IVIg was generally not recommended, whereas, for treating relapse, a second course of IVIg treatment was preferred. Corticosteroids were largely discouraged in managing GBS; however, the European Federation of Neurological Societies guidance suggested that high-dose intravenous methylprednisolone combined with IVIg might have a minor short-term benefit. Furthermore, a weak recommendation to use gabapentin or carbamazepine for pain was provided by European Academy of Neurology/Peripheral Nerve Society Guidelines (EAN/PNS). Also, EAN/PNS recommended not to use therapies like immunoadsorption, eculizumab, amantadine, and IVMP either alone or in combination with IVIg.

CONCLUSIONS: Current guidelines provide a strong foundation for the effective treatment of GBS with IVIg and PE, but there remains significant scope for future research. Addressing these research gaps will enhance our understanding and management of GBS, aiding in the development of informed decision-making and optimizing patient care strategies.