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Efgartigimod as Add‐On Treatment in Refractory Guillain–Barré Syndrome: A Case Report

Year: 2025

Type: article

Abstract: BACKGROUND AND AIMS: Guillain-Barré Syndrome (GBS) is an autoimmune disease that can cause flaccid tetraplegia. Efgartigimod, a monoclonal antibody that inhibits the neonatal receptor (FcRn), increases IgG degradation. METHODS: A 60-year-old lady was admitted with acute flaccid tetraparesis, requiring mechanical ventilation within 12 h. Nerve conduction studies were compatible with acute inflammatory demyelinating polyneuropathy (AIDP). No anti-ganglioside or anti-nodal/paranodal antibody could be identified in serum. Despite receiving standard treatment with plasma exchange (PLEX), the patient remained severely tetraparetic, bedridden, and mechanically ventilated. Human immunoglobulin 2 g/kg was given, without obtaining significant improvement. One month after disease onset, the patient received efgartigimod (10 mg/kg intravenously) weekly for four doses. RESULTS: We report the results of this treatment on muscle strength, patient disability, and nerve conduction studies. The tolerability profile was satisfactory, and the patient was able to walk alone after 4 months from disease onset. INTERPRETATION: The potential role of efgartigmod in GBS should be explored in future clinical trials.

Source: European Journal of Neurology

DOI: 10.1111/ene.70308