{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,17]],"date-time":"2026-09-17T01:38:33Z","timestamp":1789609113096,"version":"build-2803163510"},"reference-count":26,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2024,9,26]],"date-time":"2024-09-26T00:00:00Z","timestamp":1727308800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Muscle and Nerve"],"published-print":{"date-parts":[[2024,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Introduction\/Aims<\/jats:title><jats:p>Randomized controlled trials show that repeat intravenous immunoglobulin (IVIG) dosing and plasma exchange (PLEX) followed by IVIG (combination therapy) have no additional therapeutic benefit in Guillain\u2010Barre Syndrome (GBS) non\u2010responders. Furthermore, the delineation between GBS and Acute Onset CIDP (A\u2010CIDP) can be particularly challenging and carries therapeutic implications. We aimed to evaluate the presence of repeat IVIG, combination therapy, and diagnostic reclassification from GBS to CIDP.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We performed a retrospective study of a large healthcare database for patients with GBS in the US from 2001 to 2018. We identified individuals initially diagnosed with GBS and later re\u2010classified as CIDP. Multivariable logistic regression models were developed to determine associations between patient factors and repeat IVIG dosing, combination therapy, and diagnostic re\u2010classification from GBS to CIDP.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>We identified 2325 patients with GBS. A total of 39.7% received repeat IVIG and 6.1% received combination therapy. The proportion of individuals initially diagnosed with GBS and then re\u2010classified as CIDP was 32.0%. Repeat IVIG, combination therapy, and diagnostic reclassification remained stable over time. Female sex (OR 0.79, 95% CI 0.65\u20130.96) and medium\u2010high net worth (OR 0.64, 95% CI 0.45\u20130.90) associated with repeat IVIG therapy, while Asian ethnicity associated with diagnostic re\u2010classification from GBS to CIDP (OR 1.77, 95% CI 1.09\u20132.86).<\/jats:p><\/jats:sec><jats:sec><jats:title>Discussion<\/jats:title><jats:p>Repeat IVIG dosing was quite common in GBS before newer trials suggesting harm in non\u2010responders, and IVIG\/PLEX combination therapy continues to persist despite strong evidence against use in non\u2010responders. Further, nearly one in three patients initially diagnosed with GBS is subsequently diagnosed with CIDP, but the reasons are unclear.<\/jats:p><\/jats:sec>","DOI":"10.1002\/mus.28265","type":"journal-article","created":{"date-parts":[[2024,9,26]],"date-time":"2024-09-26T08:18:48Z","timestamp":1727338728000},"page":"1192-1199","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Intravenous immunoglobulin and plasma exchange prescribing patterns for Guillain\u2010Barre Syndrome in the United States\u20142001 to 2018"],"prefix":"10.1002","volume":"70","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7793-6662","authenticated-orcid":false,"given":"Amro M.","family":"Stino","sequence":"first","affiliation":[{"name":"Department of Neurology University of Michigan  Ann Arbor Michigan USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0138-8436","authenticated-orcid":false,"given":"Evan L.","family":"Reynolds","sequence":"additional","affiliation":[{"name":"Department of Neurology University of Michigan  Ann Arbor Michigan USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maya","family":"Watanabe","sequence":"additional","affiliation":[{"name":"Department of Biostatistics University of Michigan  Ann Arbor Michigan USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brian C.","family":"Callaghan","sequence":"additional","affiliation":[{"name":"Department of Neurology University of Michigan  Ann Arbor Michigan USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2024,9,26]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1159\/000324710"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1038\/nrneurol.2014.121"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(96)09095-2"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1474-4422(20)30494-4"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1097\/CND.0b013e318182b5ce"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.61.6.736"},{"issue":"9","key":"e_1_2_10_8_1","article-title":"Intravenous immunoglobulin for Guillain\u2010Barre syndrome","volume":"2014","author":"Hughes RA","year":"2014","journal-title":"Cochrane Database Syst Rev"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41582-019-0250-9"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.1111\/ene.16073"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.1177\/1756285616659978"},{"key":"e_1_2_10_12_1","doi-asserted-by":"publisher","DOI":"10.1111\/jns.12266"},{"key":"e_1_2_10_13_1","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0b013e3181e07d14"},{"key":"e_1_2_10_14_1","doi-asserted-by":"publisher","DOI":"10.1093\/brain\/110.6.1617"},{"key":"e_1_2_10_15_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00415-003-1096-y"},{"key":"e_1_2_10_16_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00415-020-10287-7"},{"key":"e_1_2_10_17_1","doi-asserted-by":"publisher","DOI":"10.1111\/trf.17261"},{"issue":"2","key":"e_1_2_10_18_1","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0143837","article-title":"Hospital admissions, transfers and costs of Guillain\u2010Barre syndrome","volume":"11","author":"Leeuwen N","year":"2016","journal-title":"PLoS One"},{"key":"e_1_2_10_19_1","doi-asserted-by":"publisher","DOI":"10.1136\/jnnp-2019-321496"},{"key":"e_1_2_10_20_1","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0000000000007719"},{"key":"e_1_2_10_21_1","doi-asserted-by":"publisher","DOI":"10.1093\/brain\/awm004"},{"key":"e_1_2_10_22_1","doi-asserted-by":"publisher","DOI":"10.1136\/jnnp.54.11.957"},{"key":"e_1_2_10_23_1","doi-asserted-by":"publisher","DOI":"10.1111\/jns.12412"},{"key":"e_1_2_10_24_1","doi-asserted-by":"publisher","DOI":"10.1111\/imj.14705"},{"key":"e_1_2_10_25_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12883-021-02314-5"},{"key":"e_1_2_10_26_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.lpm.2013.02.328"},{"key":"e_1_2_10_27_1","doi-asserted-by":"publisher","DOI":"10.2147\/CLEP.S199839"}],"container-title":["Muscle &amp; 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