Meta-analysis of the efficacy and safety of Ginkgo biloba extract for the treatment of dementia

Abstract

BackgroundThe benefit of Ginkgo biloba for the treatment of dementia remains controversial. The aim of this study was to evaluate the efficacy and safety of Ginkgo biloba in patients with dementia in whom administration effects were reported using meta-analysis.MethodsWe searched MEDLINE, Embase, the Cochrane databases, and Ichushi for controlled trials of Ginkgo biloba for the treatment dementia. Clinical characteristics and outcomes were extracted. Meta-analysis results were expressed as standard mean differences (SMDs) in scores of the Syndrome Kurztest (SKT), Alzheimer’s Disease Assessment Scale Cognitive Subscale (ADAS-Cog) for cognition efficacy, or odds ratios (ORs) for dropouts and adverse drug reactions.ResultsThirteen studies using the extract EGb761 met our inclusion criteria, which were duration of 12 to 52 weeks and daily dose of more than 120 mg, and included a total of 2381 patients. Meta-analysis was performed by using 9 of 13 studies, 7 of which used the SKT and 2 ADAS-Cog (dose 120 mg, 26 weeks) scores as efficacy parameters. In meta-analysis of all patients, SMDs (95% confidence interval [CI]) in the change in SKT scores (7 studies) were in favor of Ginkgo biloba over placebo (SMD = –0.90 [–1.46, –0.34]), but 2 studies that used ADAS-Cog did not show a statistically significant difference from placebo for ADAS-Cog (–0.06 [–0.41, 0.30]). For Alzheimer’s disease (AD) and vascular dementia (VaD) subgroups, SMDs [95% CI] in SKT in the combined AD and VaD subgroup (–1.07 [–1.66, –0.47]) and AD subgroup (–1.36 [–2.27, –0.46]) were in favor of Ginkgo biloba over placebo. In terms of daily dose of Ginkgo biloba in the combined AD and VaD subgroup, SMD in SKT score in 240-mg daily dose groups was significantly greater than with placebo (–0.71 [–1.28, –0.14]). Dropout rates for any reason did not differ between two groups, but dropout rates due to side effects were significantly lower in Ginkgo biloba groups compared with placebo groups (OR = 1.72 [1.06, 2.80]).ConclusionsTaking a 240-mg daily dose of Ginkgo biloba extract is effective and safe in the treatment of dementia.

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

“…A 2015 meta‐analysis by Hashiguchi et al also demonstrated efficacy results (Syndrome Kurztest [SKT] scores) in favor of EGb 761 ® , both in the AD and AD + VaD subgroups.…”

Enhancement of cognitive performance in mice and in vitro acetyl-cholinesterase inhibitory activity of 3,3’,4’,5,7-pentahydroxyflavone isolated from <i>Cadaba indica</i>

“…Investigation on use of Ginkgo biloba extracts EGb761 outperformed in enhancing the cognitive function (Hashiguchi et al, 2015). A randomized clinical trial for huperzine A, which is a sesquiterpene alkaloid separated from Huperzia serrata exhibited potent acetylcholinesterase inhibiting activity (Yang et al, 2013).…”

Complementary and Integrative Medicine for Neurologic Conditions

“…In a rigorous meta-analysis, 240 mg/day of Ginkgo biloba extract was found to be effective and safe in the treatment of dementia. 58 Bacopa monnieri , otherwise known as water hyssop, also has evidence from a meta-analysis demonstrating improved cognition, especially speed of attention. 59 Omega-3 fatty acid therapy has positive but conflicting results on dosage and benefit so more rigorous research is recommended.…”