title: Meta-analysis of the efficacy and safety of Ginkgo biloba extract for the treatment of dementia.
abstract: BACKGROUND
  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.
  
  
  METHODS
  We 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.
  
  
  RESULTS
  Thirteen 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]).
  
  
  CONCLUSIONS
  Taking a 240-mg daily dose of Ginkgo biloba extract is effective and safe in the treatment of dementia.
authors.affiliation: Division for Evaluation and Analysis of Drug Information, Faculty of Pharmacy, Keio University, 1-5-30 Shibakoen, Minato-ku, Tokyo 105-8512 Japan.
authors.forename: Masayuki
authors.initials: M
authors.lastname: Hashiguchi
authors.affiliation: Division for Evaluation and Analysis of Drug Information, Faculty of Pharmacy, Keio University, 1-5-30 Shibakoen, Minato-ku, Tokyo 105-8512 Japan.
authors.forename: Yuriko
authors.initials: Y
authors.lastname: Ohta
authors.affiliation: Department of Hygienic Chemistry, Faculty of Pharmacy, Keio University, 1-5-30 Shibakoen, Minato-ku, Tokyo 105-8512 Japan.
authors.forename: Mikiko
authors.initials: M
authors.lastname: Shimizu
authors.affiliation: Division for Evaluation and Analysis of Drug Information, Faculty of Pharmacy, Keio University, 1-5-30 Shibakoen, Minato-ku, Tokyo 105-8512 Japan.
authors.forename: Junya
authors.initials: J
authors.lastname: Maruyama
authors.affiliation: Division for Evaluation and Analysis of Drug Information, Faculty of Pharmacy, Keio University, 1-5-30 Shibakoen, Minato-ku, Tokyo 105-8512 Japan.
authors.forename: Mayumi
authors.initials: M
authors.lastname: Mochizuki
keywords: Dementia; Efficacy; Ginkgo biloba extract; Meta-analysis; Safety
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