Ginkgo biloba in Alzheimer’s disease: a systematic review

Abstract

This systematic review determines the benefit of treatment with Ginkgo biloba (Ginkgo) in Alzheimer's disease (AD) concerning patient-relevant outcomes. Bibliographic databases, clinical trial and study result registries were searched for randomized controlled trials (RCTs) in patients with AD (follow-up ≥16 weeks) comparing Ginkgo to placebo or a different treatment option. Manufacturers were asked to provide unpublished data. If feasible, data were pooled by meta-analysis. Six studies were eligible; overall, high heterogeneity was shown for most outcomes, except safety aspects. Among studies administering high-dose Ginkgo (240 mg), all studies favour treatment though effects remain heterogeneous. In this subgroup, a benefit of Ginkgo exists for activities of daily living. Cognition and accompanying psychopathological symptoms show an indication of a benefit. A harm of Ginkgo is not evident. An estimation of the effect size was not possible for any outcome. Further evidence is needed which focuses especially on subgroups of AD patients.

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

“…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). Further justification for the efficacy and dosage requires more rigorous evidence with appropriate sample sizes, clinical settings, dosage arms and experimental durations.…”

Phytopharmaceutical treatment of anxiety, depression, and dementia in the elderly: evidence from randomized, controlled clinical trials

“…Convincing evidence of efficacy is available for a daily dose of 240 mg. EGb 761 improves impaired mitochondrial function, hippocampal neurogenesis and neuroplasticity, inhibits the aggregation and toxicity of A protein, decreases blood viscosity, and enhances microperfusion [53][54][55][56][57]. The efficacy of EGb 761 in AD, VaD, and mixed-type dementia has been extensively reviewed and is supported by numerous clinical trials, with beneficial effects on cognition, neuropsychiatric features, activities of daily living, and caregiver burden (e.g., [58][59][60][61][62]). Adverse events were not noticeably different from those observed under placebo, and no specific side effects of EGb 761 have been substantiated by clinical trials.…”

Epidemiological findings of vascular risk factors in Alzheimer’s disease: implications for therapeutic and preventive intervention

“…Epidemiological findings of vascular risk factors in Alzheimer's disease found evidence of a benefit of high-dose Ginkgo biloba extract for 'activities of daily living' and 'cognitive function' in patients with AD, but argued that it was not possible to estimate the effect size owing to highly heterogeneous results [163].…”