Ginkgo biloba special extract EGb 761 in the treatment of peripheral arterial occlusive disease (PAOD)--a review based on randomized, controlled studies.
OBJECTIVE
The present review gives an overview and evaluation of clinical studies proving the efficacy of EGb 761 in patients with PAOD.


METHODS
Relevant original papers and reports on this topic were identified by means of a literature search. Only randomized, double-blind, placebo-controlled clinical trials in patients with the indication peripheral arterial occlusive disease in stage II according to Fontaine were included (only treatment with the oral form of EGb 761). For the selected studies the ratio theta of the walking distance between EGb 761 and placebo was calculated and a test for relevant superiority of EGb 761 was performed (according to the guidelines of the Deutsche Gesellschaft für Angiologie (German Society of Angiology) [Heidrich et al. 1996]). Furthermore, a pooled estimation of the ratio was carried out.


RESULTS
Nine studies complied with the criteria. The methodological quality and design of the trials were heterogeneous. In the majority of the studies, there was an advantage of EGb 761 in the increase of pain-free walking distance compared to placebo. For 7 studies, the advantage was found to be statistically significant. Testing the relevant superiority showed a significant result in 6 of the selected studies. The pooled estimator of the ratio amounts to theta = 1.23 (95% CI: 1.16, 1.31) and demonstrates the efficacy of EGb 761 over placebo as well.


CONCLUSIONS
This review confirms the efficacy of Ginkgo biloba special extract EGb 761. It demonstrates not only the statistical significance of the difference with respect to placebo but also the clinical relevance for the treatment of patients with PAOD.
Horsch
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Surgical Department, Hospital Porz/Rhein, Köln, Germany.
Walther
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D001157:Arterial Occlusive Diseases / Q000188:drug therapy* / Q000473:pathology; D020441:Ginkgo biloba; D006801:Humans; D008517:Phytotherapy; D010936:Plant Extracts / Q000627:therapeutic use*; D016032:Randomized Controlled Trials as Topic; D014665:Vasodilator Agents / Q000627:therapeutic use*; D000096983:Ginkgo Extract
D010936:Plant Extracts; D014665:Vasodilator Agents; C063170:Ginkgo biloba extract; D000096983:Ginkgo Extract