From the Cochrane library: Ginkgo biloba for intermittent claudication.
BACKGROUND
Patients with intermittent claudication suffer from pain in the muscles of the legs during exercise that is relieved by a short rest. Ginkgo biloba extract is a vasoactive agent used for symptomatic relief in intermittent claudication. In this article a meta-analysis is discussed that assessed the effect of Ginkgo biloba on walking capacity in patients with intermittent claudication.


METHODS
The Cochrane Peripheral Vascular Diseases Group searched their Trials Register and the Cochrane Central Register of Controlled Trials in The Cochrane Library. Furthermore MEDLINE/PUBMED (until May 2008) and EMBASE (until May 2008) were searched and manufacturers of Ginkgo biloba extract were contacted. Randomized controlled trials of Ginkgo biloba extract versus placebo in people with intermittent claudication were included. Two authors independently assessed trials for selection, assessed study quality and extracted data. To standardize walking distance or time, caloric expenditures were used to correct for the different treadmill protocols.


RESULTS
Eleven trials involving 477 participants compared Ginkgo biloba with placebo and assessed the absolute claudication distance (maximal walking distance). At the end of the study the absolute claudication distance increased with an overall effect size of 3.57 kilocalories ( p = 0.06), for treatment with Ginkgo biloba, compared to placebo. This translates to an increase of 64.5 meters (confidence interval -1.8 to 130.7) on a flat treadmill with an average speed of 3.2 km/h.


CONCLUSIONS
There is no evidence that Ginkgo biloba has a clinically significant benefit for patients with intermittent claudication.
Nicolaï
S P
SP
Catharina Hospital Eindhoven, Eindhoven, The Netherlands.
Gerardu
V C
VC
Kruidenier
L M
LM
Prins
M H
MH
Teijink
J A
JA
D002317:Cardiovascular Agents / Q000627:therapeutic use*; D004734:Energy Metabolism; D019317:Evidence-Based Medicine; D005080:Exercise Test; D017079:Exercise Tolerance / Q000187:drug effects*; D020441:Ginkgo biloba; D006801:Humans; D007383:Intermittent Claudication / Q000188:drug therapy* / Q000503:physiopathology; D028321:Plant Preparations / Q000627:therapeutic use*; D016032:Randomized Controlled Trials as Topic; D020127:Recovery of Function; D016896:Treatment Outcome; D016138:Walking
D002317:Cardiovascular Agents; D028321:Plant Preparations