Key Message

• We did not find any evidence regarding the clinical effectiveness and safety of alternative treatments to IV immunoglobulin (IVIg) compared to IVIg or placebo for bullous pemphigoid (BP) or pemphigus vulgaris (PV) and pemphigus foliaceus (PF) that met our inclusion criteria for this review.
• We identified 6 consensus guidelines presenting treatment algorithms for BP (3 guidelines) or PV and PF (3 guidelines). All guidelines recommend that IVIg may be used as a third-line treatment for severe or refractory cases.
• For severe or refractory BP, other therapeutic options than IVIg include monoclonal antibodies, immunosuppressive drugs, immunoadsorption, and plasma exchange (3 guidelines).
• For severe or refractory PV and PF, other therapeutic options than IVIg include immunosuppressive drugs, dapsone, immunoadsorption, plasma exchange, and IV corticosteroid pulse therapy (3 guidelines).
• The evidence base supporting these guidelines was unclear; recommendations should be interpreted with caution.

Key Message

Compared to alternative local anesthetic drugs, chloroprocaine may result in a shorter or equal onset of sensory and motor blocks and recovery from sensory and motor blocks.

Compared to alternative local anesthetic drugs, chloroprocaine has a shorter time to unaided ambulation, time to independent urination, and time to discharge.

Chloroprocaine may have better or equal clinical effectiveness than alternative drugs for spinal or epidural local anesthesia.

Compared to alternative local anesthetic drugs, chloroprocaine may cause higher rates of adverse events. However, due to inconsistency in evidence, it was difficult to draw any firm conclusions in this regard, suggesting further investigation for decision-making.

We did not find any evidence regarding the cost-effectiveness of chloroprocaine compared to other local anesthetic drugs and evidence-based guidelines for using chloroprocaine for patients requiring spinal or epidural anesthesia that met the inclusion criteria for the present review.

Key Message

It was not clear from the studies in this review whether bevacizumab plus chemotherapy does or does not improve overall survival compared to chemotherapy alone (or with placebo) for recurrent platinum-sensitive ovarian cancer.

Most studies in this review found that bevacizumab plus chemotherapy results in longer progression-free survival than chemotherapy alone (or with placebo) for recurrent platinum-sensitive ovarian cancer.

Most studies in this review found that bevacizumab plus chemotherapy had a more beneficial effect on treatment response than chemotherapy alone (or with placebo) for recurrent platinum-sensitive ovarian cancer.

There was no difference in quality of life, based on 1 randomized controlled trial, and no clear differences in adverse events reported between bevacizumab plus chemotherapy or chemotherapy alone (or with placebo).

Key Message

Plasma exchange may be more effective than placebo in reducing disability scale scores and improving the likelihood of disability improvement in patients with Guillain-Barré syndrome.

Plasma exchange showed similar effectiveness as IV immunoglobulin on disability outcomes in treating Guillain-Barré syndrome.

Limited evidence from a health technology assessment subsection suggests that plasma exchange may have a similar safety profile as IV immunoglobulin.

An evidence-based guideline suggests that plasma exchange can be used as 1 of the immune therapies (IV immunoglobulin alternatives) for children with Guillain-Barré syndrome who have contraindications for IV immunoglobulin or when IV immunoglobulin is ineffective. However, most supporting evidence was from adults.

We did not find any study reporting on the rate of recovery, duration of hospitalization, or cost-effectiveness of plasma exchange for treating Guillain-Barré syndrome that met the inclusion criteria for this report.