Efficacy of<i>Ginkgo biloba</i>extract EGb 761<sup>®</sup>in dementia with behavioural and psychological symptoms: A systematic review

Gunten, Armin von; Schlaefke, Sandra; Überla, K

doi:10.3109/15622975.2015.1066513

Cited by 58 publications

(39 citation statements)

References 49 publications

(60 reference statements)

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“…While most of the earlier studies accepted patients with BPSD, only the later studies required clinically significant BPSD as assessed by the Neuropsychiatric Inventory (NPI). Therefore, a second meta‐analysis by von Gunten et al (2016) specifically analyzed the trials in patients with clinically significant BPSD. In a pooled analysis, EGb 761 ® at daily dose of 240 mg was efficacious in outpatients suffering from AD, VaD, and AD + CVD.…”

Section: Resultsmentioning

confidence: 99%

Treatment of dementia and mild cognitive impairment with or without cerebrovascular disease: Expert consensus on the use of Ginkgo biloba extract, EGb 761^®

et al. 2019

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Background The Ginkgo biloba special extract, EGb 761 ® has been widely used in the treatment of neuropsychiatric disorders, including Alzheimer’s disease (AD). Methods To guide clinical practice in the Asian region, the Asian Clinical Expert Group on Neurocognitive Disorders compiled evidence‐based consensus recommendations regarding the use of EGb 761 ® in neurocognitive disorders with/without cerebrovascular disease. Results Key randomized trials and robust meta‐analyses have demonstrated significant improvement in cognitive function, neuropsychiatric symptoms, activities of daily living (ADL) and quality of life with EGb 761 ® versus placebo in patients with mild‐to‐moderate dementia. In those with mild cognitive impairment (MCI), EGb 761 ® has also demonstrated significant symptomatic improvement versus placebo. World Federation of Societies of Biological Psychiatry guidelines list EGb 761 ® with the same strength of evidence as acetylcholinesterase inhibitors and N‐methyl‐D‐aspartate (NMDA) antagonists e.g. memantine (Grade 3 recommendation; Level B evidence). Only EGb 761 ® had Level B evidence in improving cognition, behaviour, and ADL in both AD and vascular dementia patients. Safety analyses show EGb 761 ® to have a positive risk‐benefit profile. While concerns have been raised regarding a possible increased bleeding risk, several randomized trials and two meta‐analyses have not supported this association. Conclusions The Expert Group foresee an important role for EGb 761 ® , used alone or as an add‐on therapy, in the treatment of MCI and dementias, particularly when patients do not derive benefit from acetylcholinesterase inhibitors or NMDA antagonists. EGb 761 ® should be used in alignment with local clinical practice guidelines.

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Section: Resultsmentioning

confidence: 99%

Treatment of dementia and mild cognitive impairment with or without cerebrovascular disease: Expert consensus on the use of Ginkgo biloba extract, EGb 761^®

et al. 2019

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“…There are also data that provide some evidence for the preventive efficacy of Ginkgo biloba extract EGb 761® in the treatment of dementia patients with clinically relevant BPSD. 105 …”

Section: Treatmentmentioning

confidence: 99%

Best practice in the management of behavioural and psychological symptoms of dementia

Tible¹,

Riese

Savaskan

et al. 2017

Ther Adv Neurol Disord

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235

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Behavioural and psychological symptoms of dementia (BPSD) occur in most patients with dementia. They cause great suffering in patients and caregivers, sometimes more so than the cognitive and functional decline inherent to dementia. The clinical features of BPSD include a wide variety of affective, psychotic and behavioural symptoms and signs. The causes and risk factors for BPSD are multiple and include biological, psychological and environmental variables. Frequently, their combination, rather than any specific factor, explains the occurrence of BPSD in an individual patient. Thus, a sound etiopathogenetic investigation including the patient and the family or care team is essential. The aim is to develop an individualized treatment plan using a therapeutic decision tree modified by the individual and environmental risk profile. Still, treatment may be difficult and challenging. Clinical empiricism often steps in where evidence from controlled studies is lacking. Psychosocial treatment approaches are pivotal for successful treatment of BPSD. Often a combination of different non-pharmacological approaches precedes drug treatment (most of which is off-label). Regular assessments of the treatment plan and any prescriptions must be carried out to detect signs of relapse and to stop any medicines that may have become inappropriate. Even with optimal management, BPSD will not disappear completely in some cases and will remain challenging for all involved parties. This article is a narrative review based closely on the interprofessional Swiss recommendations for the treatment of BPSD. To establish the recommendations, a thorough research of the literature has been carried out. Evidence-based data were provided through searches of Medline, Embase, ISI and Cochrane-Database research. Evidence categories of the World Federation of Biological Societies were used. Additionally, the clinical experience of Swiss medical experts was considered.

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“…Moracenin D, an extract from Mori Cortex radices, significantly up-regulates Nurr1 expression and down-regulates α-synuclein expression [70]. EGb 761, extracted from Ginkgo biloba leaves, has been applied in clinical trials of treating several neuropsychiatric diseases [74,75]. It also exerts neuroprotective effect in MPTP-lesioned mice via increasing the expression of a series of DA-related genes, of which Nurr1 is increased by 148% in SN [71].…”

Section: Nurr1 Modulatorsmentioning

confidence: 99%

Nurr1‐Based Therapies for Parkinson's Disease

Dong

et al. 2016

CNS Neurosci Ther

101

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Previous studies have documented that orphan nuclear receptor Nurr1 (also known as NR4A2) plays important roles in the midbrain dopamine (DA) neuron development, differentiation and survival. Furthermore, it has been reported that the defects in Nurr1 are associated with Parkinson’s disease (PD). Thus, Nurr1 might be a potential therapeutic target for PD. Emerging evidence from in vitro and in vivo studies has recently demonstrated that Nurr1-activating compounds and Nurr1 gene therapy are able not only to enhance DA neurotransmission but also to protect DA neurons from cell injury induced by environmental toxin or microglia-mediated neuroinflammation. Moreover, modulators that interact with Nurr1 or regulate its function, such as retinoid X receptor, cyclic AMP-responsive element-binding protein, glial cell line-derived neurotrophic factor and Wnt/β-catenin pathway have the potential to enhance the effects of Nurr1-based therapies in PD. This review highlights the recent progress in preclinical studies of Nurr1-based therapies and discusses the outlook of this emerging therapy as a promising new generation of PD medication.

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Efficacy ofGinkgo bilobaextract EGb 761^®in dementia with behavioural and psychological symptoms: A systematic review

Abstract: The pooled analyses provide evidence of efficacy of EGb 761 at a daily dose of 240 mg in the treatment of out-patients suffering from Alzheimer's, vascular or mixed dementia with BPSD.

Cited by 58 publications

References 49 publications

Treatment of dementia and mild cognitive impairment with or without cerebrovascular disease: Expert consensus on the use of Ginkgo biloba extract, EGb 761^®

Treatment of dementia and mild cognitive impairment with or without cerebrovascular disease: Expert consensus on the use of Ginkgo biloba extract, EGb 761^®

Best practice in the management of behavioural and psychological symptoms of dementia

Nurr1‐Based Therapies for Parkinson's Disease

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Efficacy ofGinkgo bilobaextract EGb 761®in dementia with behavioural and psychological symptoms: A systematic review

Abstract: The pooled analyses provide evidence of efficacy of EGb 761 at a daily dose of 240 mg in the treatment of out-patients suffering from Alzheimer's, vascular or mixed dementia with BPSD.

Cited by 58 publications

References 49 publications

Treatment of dementia and mild cognitive impairment with or without cerebrovascular disease: Expert consensus on the use of Ginkgo biloba extract, EGb 761®

Treatment of dementia and mild cognitive impairment with or without cerebrovascular disease: Expert consensus on the use of Ginkgo biloba extract, EGb 761®

Best practice in the management of behavioural and psychological symptoms of dementia

Nurr1‐Based Therapies for Parkinson's Disease

Contact Info

Product

Resources

About

Efficacy ofGinkgo bilobaextract EGb 761^®in dementia with behavioural and psychological symptoms: A systematic review

Treatment of dementia and mild cognitive impairment with or without cerebrovascular disease: Expert consensus on the use of Ginkgo biloba extract, EGb 761^®

Treatment of dementia and mild cognitive impairment with or without cerebrovascular disease: Expert consensus on the use of Ginkgo biloba extract, EGb 761^®