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

Masayuki Hashiguchi,Mayumi Mochizuki,Mikiko Shimizu,Junya Maruyama,Yuriko Ohta

doi:10.1186/s40780-015-0014-7

Masayuki Hashiguchi, Mayumi Mochizuki + Show 3 more

Open Access

https://doi.org/10.1186/s40780-015-0014-7

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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.

Highlights

The benefit of Ginkgo biloba for the treatment of dementia remains controversial
Among the 298 studies retrieved from the electronic databases and those retrieved from their references by manual search, we identified 13 clinical studies that satisfied the predetermined inclusion criteria for our study (Figure 1, Table 1) [16,17,18,19,20,21,22,23,24,25,26,27,28]
Because a higher Syndrome Kurztest (SKT) score indicates a more severe level of dementia [29], these results suggest that Ginkgo biloba can improve the symptoms of Alzheimer’s disease (AD) and/or vascular dementia (VaD)

Summary

Introduction

The 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. There are a few meta-analyses [7,8,9,10] and a Cochran review [11] in the literature, they mainly focused on the efficacy of Ginkgo biloba rather than safety, except for the reviews by Jiang et al [10] and Birks and Evans [11] They evaluated multiple measures of cognitive outcome by extracting the results of the ADAS-Cog, SKT, etc. The aim of this study was to evaluate both the efficacy based on a single measure of cognitive outcome and safety based on various outcomes of Ginkgo biloba in the treatment of dementia using the meta-analysis approach

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