Systematic Review on the Efficacy and Safety of Herbal Medicines for Alzheimer's Disease

Man, Sui Cheung; Durairajan, Siva Sundara Kumar; Kum, Wan Fung; Lu, Jiahong; Huang, Jinkun; Cheng, Chung Wah; Chung, Vincent C.H.; Xu, Min; Li, Min

doi:10.3233/jad-2008-14209

Cited by 43 publications

(30 citation statements)

References 46 publications

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“…There are limited systematic reviews published before in assessing the efficacy of natural medicines on AD. Heterogeneity in types of natural medicines, diagnostic criteria, and outcome measures hindered comprehensive data analysis for natural medicines (Dos Santos-Neto et al, 2006;Man et al, 2008). This analysis is consistent with the results of another meta-analysis, which draws the conclusion that Ginkgo has a beneficial effect on the outcome of activities of daily living, but the potential effect size cannot be confirmed because of significant heterogeneity across included RCTs (Janssen et al, 2010).…”

Section: Discussionsupporting

confidence: 86%

A Systematic Review on Natural Medicines for the Prevention and Treatment of Alzheimer's Disease with Meta-Analyses of Intervention Effect of Ginkgo

Zhang

Liu

et al. 2014

Am. J. Chin. Med.

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We performed a systematic review to evaluate the efficacy of natural medicines for the treatment of Alzheimer's disease (AD) in randomized controlled trials (RCTs). Disease-specific and intervention terms were searched in MEDLINE, EMBASE, the Cochrane Library and PsycINFO to identify RCTs for the AD intervention of natural medicines, and searched for literatures in English language. The RCTs compared natural medicines and either placebo or orthodox medication in AD patients. The quality of literature was evaluated by Jadad's score and the Cochrane assessing tool to reduce the risk of bias. Meta-analysis and the heterogeneity of results across the trials were performed. Out of the literatures, 21 clinical reports were included in this review that satisfied the particular selection criteria. Apart from Ginkgo, other treatments we came across had minimal benefits and/or the methodological quality of the available trials was poor. The meta-analyses showed that Ginkgo had better outcomes than the placebo, with the standardized mean difference (SMD) between Ginkgo and the placebo on cognition being -1.62 (95% CI: -2.69 to -0.56) and on activities of daily living being -1.55 (95% CI: -2.55 to -0.55), with the existence of significant heterogeneity across studies. The meta-analysis for assessing the prevention effect of Ginkgo against AD suggested that risk ratio (RR) is 1.06 (95% CI: 0.92 to 1.22) between Gingko and the placebo, with no significant heterogeneity across studies (test for heterogeneity, p = 0.49). Our results suggest that Ginkgo may help established AD patients with cognitive symptoms but cannot prevent the neurodegenerative progression of the disease.

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Section: Discussionsupporting

confidence: 86%

A Systematic Review on Natural Medicines for the Prevention and Treatment of Alzheimer's Disease with Meta-Analyses of Intervention Effect of Ginkgo

Zhang

Liu

et al. 2014

Am. J. Chin. Med.

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“…Although natural products are not discussed in this review, however, there is a plethora of compounds which may be important in multitarget drug design. These can also serve as templates to achieve new biological activities, which medicinal chemists should have in mind, during the discovery process . Recent multitarget drugs have mainly been designed by studying the 3D structure of previous molecules with known activities and crystal structures of target proteins.…”

Section: Discussionmentioning

confidence: 99%

Recent advances in the multitarget‐directed ligands approach for the treatment of Alzheimer's disease

León

Garcı́a

Marco‐Contelles

2011

Medicinal Research Reviews

409

256

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With 27 million cases worldwide documented in 2006, Alzheimer's disease (AD) constitutes an overwhelming health, social, economic, and political problem to nations. Unless a new medicine capable to delay disease progression is found, the number of cases will reach 107 million in 2050. So far, the therapeutic paradigm one‐compound‐one‐target has failed. This could be due to the multiple pathogenic mechanisms involved in AD including amyloid β (Aβ) aggregation to form plaques, τ hyperphosphorylation to disrupt microtubule to form neurofibrillary tangles, calcium imbalance, enhanced oxidative stress, impaired mitochondrial function, apoptotic neuronal death, and deterioration of synaptic transmission, particularly at cholinergic neurons. Approximately 100 compounds are presently been investigated directed to single targets, namely inhibitors of β and γ secretase, vaccines or antibodies that clear Aβ, metal chelators to inhibit Aβ aggregation, blockers of glycogen synthase kinase 3β, enhancers of mitochondrial function, antioxidants, modulators of calcium‐permeable channels such as voltage‐dependent calcium channels, N‐methyl‐D‐aspartate receptors for glutamate, or enhancers of cholinergic neurotransmission such as inhibitors of acetylcholinesterase or butyrylcholinesterase. In view of this complex pathogenic mechanisms, and the successful treatment of chronic diseases such as HIV or cancer, with multiple drugs having complementary mechanisms of action, the concern is growing that AD could better be treated with a single compound targeting two or more of the pathogenic mechanisms leading to neuronal death. This review summarizes the current therapeutic strategies based on the paradigm one‐compound‐various targets to treat AD. A treatment that delays disease onset and/or progression by 5 years could halve the number of people requiring institutionalization and/or dying from AD. © 2011 Wiley Periodicals, Inc. Med Res Rev

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“…The search identified 225 articles, of which 219 were excluded (Figure ). Six SRs met the inclusion criteria . Most reviews were of herbal medicines; one was of acupuncture (Table ).…”

Section: Resultsmentioning

confidence: 99%

Complementary and alternative medicine for Alzheimer's disease: an overview of systematic reviews

Posadzki

Ernst

Lee

2012

Focus on Alt & Comp Therapy

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Aim The aim of this overview was to critically evaluate the literature on complementary and alternative medicine (CAM) for Alzheimer's disease. Method Four electronic databases were searched to identify all relevant systematic reviews of effectiveness of CAM for Alzheimer's disease. Reviews were defined as systematic if they included explicit and repeatable criteria for the selection of primary studies. The methodological quality of reviews was assessed using the Oxman criteria for systematic reviews. Results Six systematic reviews met the inclusion criteria. Most reviews were of high quality. Three reviews arrived at ambiguous conclusions, two arrived at positive conclusions and one reached a negative conclusion. Conclusions Evidence supporting the effectiveness of CAM for the treatment of Alzheimer's disease is ambiguous. Since some herbal medicines show promise in the management of Alzheimer's disease, future research seems justified.

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Systematic Review on the Efficacy and Safety of Herbal Medicines for Alzheimer's Disease

Cited by 43 publications

References 46 publications

A Systematic Review on Natural Medicines for the Prevention and Treatment of Alzheimer's Disease with Meta-Analyses of Intervention Effect of Ginkgo

A Systematic Review on Natural Medicines for the Prevention and Treatment of Alzheimer's Disease with Meta-Analyses of Intervention Effect of Ginkgo

Recent advances in the multitarget‐directed ligands approach for the treatment of Alzheimer's disease

Complementary and alternative medicine for Alzheimer's disease: an overview of systematic reviews

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