Efgartigimod Shows Comparable Efficacy to IVIG in Guillain-Barre Syndrome with Faster Neurological Recovery
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A 2026 retrospective study found that efgartigimod, a neonatal Fc receptor (FcRn) inhibitor, achieved recovery outcomes in Guillain-Barre syndrome comparable to intravenous immunoglobulin (IVIG) while enabling faster neurological improvement in some patients. The study is among the first to evaluate efgartigimod as a standalone treatment for GBS and suggests it may be a viable alternative for patients who cannot receive or tolerate IVIG. These findings add to a growing body of evidence supporting FcRn inhibition as a promising approach for antibody-mediated neurological diseases.
Abstract
Guillain-Barre syndrome (GBS) is an acute immune-mediated polyneuropathy in which autoantibodies attack peripheral nerve components, leading to rapidly progressive weakness, sensory changes, and in severe cases, respiratory failure. Standard treatments include intravenous immunoglobulin (IVIG) and plasma exchange (PE), both of which modulate the immune response but leave a significant proportion of patients with residual disability.
Efgartigimod is an FcRn inhibitor that accelerates the degradation of circulating IgG, including the pathogenic autoantibodies implicated in GBS. This single-center retrospective study included 34 GBS patients with disability, divided into an efgartigimod group (n=12) and an IVIG group (n=22). The primary outcome was improvement on the GBS Disability Scale (GBS-DS).
Patients treated with efgartigimod demonstrated notably faster improvement in GBS-DS score compared to the IVIG group, with particular clinical benefit observed in patients presenting with ophthalmoplegia and respiratory insufficiency. Efgartigimod showed a favorable safety profile in this cohort. The authors concluded that efgartigimod represents a promising and potentially faster-acting alternative to IVIG for GBS, particularly in patients with severe or atypical presentations, and supports the rationale for prospective randomized trials to confirm these findings.