The objective of this study is to analyse treatment outcomes and safety of efgartigimod in Guillain-Barré Syndrome (GBS) and its variants.

GBS is an immune mediated polyneuropathy, with treatment being IV immunoglobulins and plasma exchange. Efgartigimod, a neonatal Fc receptor blocker, is an emerging therapy option.

We searched PubMed, MEDLINE, Scopus, Embase and Scielo using keywords ”Guillain-Barré syndrome”, “Variants” and  “Efgartigimod” and retrieved 9 case reports/series. Two were excluded due to inaccessible text and 13 patients finalised.

Of 13 patients analysed, the mean age was 52 years, with 7 males (53.8%) and 6 females (46.1%). GBS variants included 1 patient with Miller-fisher syndrome (MFS), 6 with GBS/MFS overlap syndrome, 2 with Acute Motor Axonal Neuropathy (AMAN), 1 with Acute Motor Sensory Axonal Neuropathy (AMSAN), 2 with Acute Inflammatory Demyelinating Polyneuropathy (AIDP) and 1 with Myasthenia Gravis/Anti-Gq1b antibodies. 

The mean symptom onset to treatment time was 20.5 days, and Efgartigimod was administered in doses of 10mg/kg/week in 10 patients,  80mg/week in one and 800mg/week in two, with a mean of 1.3 cycles.

It was used as a first-line drug in 3 patients (23%), as rescue drug in 5 (38.4%) and as refractory drug in 5 (38.4%). Prior treatment in 11 patients was with IVIg alone (45.4%), IVIg and steroids (18.1%), Steroids alone (9.09%) and IVIg with Plasma Exchange (27.2%). Only one patient received concomitant therapy with IVIg. Clinical improvement was seen in all patients (100%), with the mean time to improvement being 15.6 days. Except for one upper respiratory infection,no serious adverse events or relapses occurred. Overall, the drug was well tolerated.

Efgartigimod showed promising clinical improvement in GBS and can be considered as an adjunct in it’s treatment.