Medizinonline Medizinonline
  • News
    • News
    • Market & Medicine
  • Patients
    • Disease patterns
    • Diagnostics
    • Therapy
  • Partner Content
    • Dermatology
      • Atopic dermatitis and psoriasis news
      • Dermatology News
    • Diabetes
      • Dia-Month Club – Type 2 Diabetes
      • Diabetes in Motion
      • Diabetes Podcasts
    • Gastroenterology
      • IBD matters
      • Forum Gastroenterology
      • Ozanimod: ulcerative colitis
      • Reflux Update
    • Immunology
      • Primary immunodeficiency – exchange of experience
    • Vaccinate
      • Herpes zoster
    • Infektiologie
    • Neurology
      • EXPERT ULTRASONIC: Introduction to ultrasound-guided injection
      • MS News
      • MS Therapy in Transition
    • Oncology
      • Swiss Oncology in motion
    • Orthopedics
      • Osteoporosis in motion
    • Phytotherapie
    • Practice Management
      • Aargau Cantonal Bank
      • Claraspital
    • Psychiatry
      • Geriatric Psychiatry
    • Rheumatology
  • Departments
    • Allergology and clinical immunology
    • General Internal Medicine
    • Anesthesiology
    • Angiology
    • Surgery
    • Dermatology and venereology
    • Endocrinology and Diabetology
    • Nutrition
    • Gastroenterology and Hepatology
    • Genetics
    • Geriatrics
    • Gynecology
    • Hematology
    • Infectiology
    • Cardiology
    • Nephrology
    • Neurology
    • Emergency and intensive care medicine
    • Nuclear Medicine
    • Oncology
    • Ophthalmology
    • ORL
    • Orthopedics
    • Pediatrics
    • Pharmacology and toxicology
    • Pharmaceutical medicine
    • Phlebology
    • Physical medicine and rehabilitation
    • Pneumology
    • Prevention and health care
    • Psychiatry and psychotherapy
    • Radiology
    • Forensic Medicine
    • Rheumatology
    • Sports Medicine
    • Traumatology and trauma surgery
    • Tropical and travel medicine
    • Urology
    • Dentistry
  • CME & Congresses
    • CME continuing education
    • Congress Reports
    • Congress calendar
  • Practice
    • Noctimed
    • Practice Management
    • Jobs
    • Interviews
  • Log In
  • Register
  • My account
  • Contact
  • English
    • Deutsch
    • Français
    • Italiano
    • Português
    • Español
  • Publications
  • Contact
  • Deutsch
  • English
  • Français
  • Italiano
  • Português
  • Español
Subscribe
Medizinonline Medizinonline
Medizinonline Medizinonline
  • News
    • News
    • Market & Medicine
  • Patienten
    • Krankheitsbilder
    • Diagnostik
    • Therapie
  • Partner Content
    • Dermatology
      • Atopic dermatitis and psoriasis news
      • Dermatology News
    • Diabetes
      • Dia-Month Club – Type 2 Diabetes
      • Diabetes in Motion
      • Diabetes Podcasts
    • Gastroenterology
      • IBD matters
      • Forum Gastroenterology
      • Ozanimod: ulcerative colitis
      • Reflux Update
    • Immunology
      • Primary immunodeficiency – exchange of experience
    • Vaccinate
      • Herpes zoster
    • Infektiologie
    • Neurology
      • EXPERT ULTRASONIC: Introduction to ultrasound-guided injection
      • MS News
      • MS Therapy in Transition
    • Oncology
      • Swiss Oncology in motion
    • Orthopedics
      • Osteoporosis in motion
    • Phytotherapie
    • Practice Management
      • Aargau Cantonal Bank
      • Claraspital
    • Psychiatry
      • Geriatric Psychiatry
    • Rheumatology
  • Departments
    • Fachbereiche 1-13
      • Allergology and clinical immunology
      • General Internal Medicine
      • Anesthesiology
      • Angiology
      • Surgery
      • Dermatology and venereology
      • Endocrinology and Diabetology
      • Nutrition
      • Gastroenterology and Hepatology
      • Genetics
      • Geriatrics
      • Gynecology
      • Hematology
    • Fachbereiche 14-26
      • Infectiology
      • Cardiology
      • Nephrology
      • Neurology
      • Emergency and intensive care medicine
      • Nuclear Medicine
      • Oncology
      • Ophthalmology
      • ORL
      • Orthopedics
      • Pediatrics
      • Pharmacology and toxicology
      • Pharmaceutical medicine
    • Fachbereiche 26-38
      • Phlebology
      • Physical medicine and rehabilitation
      • Phytotherapy
      • Pneumology
      • Prevention and health care
      • Psychiatry and psychotherapy
      • Radiology
      • Forensic Medicine
      • Rheumatology
      • Sports Medicine
      • Traumatology and trauma surgery
      • Tropical and travel medicine
      • Urology
      • Dentistry
  • CME & Congresses
    • CME continuing education
    • Congress Reports
    • Congress calendar
  • Practice
    • Noctimed
    • Practice Management
    • Jobs
    • Interviews
Login

Sie haben noch keinen Account? Registrieren

  • EGb 761 for dementia with neuropsychiatric problems

Evaluation of new studies shows effectiveness

    • General Internal Medicine
    • Geriatrics
    • Neurology
    • News
    • Pharmacology and toxicology
    • Psychiatry and psychotherapy
    • RX
    • Studies
  • 4 minute read

For years, Ginkgo biloba research focused on improving cognitive abilities or prevention. In this context, many studies with the Ginkgo biloba extract EGb 761 have shown positive results. Recently, mental disorders and behavioral problems have also been included.

The following article summarizes a recently published systematic review that investigated the efficacy of the Ginkgo biloba extract EGb 761 in dementia with psychological and behavioral symptoms of dementia (BPSD) [1]. These are also known as neuropsychiatric symptoms and are present in 80 to nearly 100% of patients affected by dementia.

Method

Studies that met the following criteria were sought for the review:

  • randomized, placebo-controlled clinical trials
  • Patients with a diagnosis of Alzheimer’s disease, vascular dementia, or mixed forms (present for at least 22 weeks at recruitment).
  • Patients with BPSD according to the Neuropsychiatric Inventory (NPI) or another recognized standard test.
  • At least two of the following three parameters had to be included in the assessment: Cognitive functions, Activities of Daily Living (ADL), overall clinical assessment.

The methodological quality of the studies was considered sufficient if it met the standard for the following factors:

  • Randomization, assignment, and blinding
  • Sample size
  • Number of patients who dropped out of the study early, and the rationale for this
  • statistical analysis and evaluation.
     

Studies

Four studies met the criteria (Table 1) [2–5]. All patients in these four studies were diagnosed with mild to moderate dementia according to TE4D-Cog (Test for the Early Detection of Dementia from Depression) and SKT (Short Cognitive Performance Test). The characteristics were:

  • TE4D-Cog ≤35
  • SKT between 9 and 12
  • No major depression (HAMD ≤20).
  • Age ≥50 years.

Results

The following dimensions were assessed:

  • Cognitive functions
  • BPSD
  • ADL
  • Overall assessment
  • Quality of Life (QoL).

Cognitive functions: Results pooled with all four studies showed an improvement of 2.26 ± 3.15 scale points for the verum group versus 0.20 ± 3.48 for placebo. This indicates significant superiority of EGb 761 over placebo (p<0.001).

Neuropsychiatric symptoms (BPSD): All studies reviewed neuropsychiatric symptoms using the NPI or NPI caregiver distress (method for assessing caregiver stress symptoms). In all four studies, patients in the EGb 761 group showed an improvement of at least three scale points. In three of the four studies [2–4] this meant a significant improvement over placebo.

Pooled results from all studies showed significant improvement in both patients and caregivers (p<0.001) with EGb 761 versus placebo (patients: EGb 761 4.52 ± 6.56, placebo 0.71 ± 6.94; nurses: EGb 761 2.64 ± 4.44, placebo 0.33 ± 3.98).

Activities of daily living (ADL): Two studies [2,5] used the ADL subscale of the Gottfries-Bråne scale to assess activities of daily living, and the other two [3,4] used the ADL International Scale (ADL-IS). In all studies, competence for activities of daily living improved more in EGb 761 patients than in placebo patients. Pooling the results of the four studies showed a significant improvement with EGb 761 over placebo (p<0.001).

Overall Assessment: Overall assessment was performed using either the GBS [2,5] or the Alzheimer Disease Cooperative Study Clinical Impression of Change (ADCS-CGIC) [3,4]. In all four studies, EGb 761 patients performed better than placebo patients. In three studies, these values reached significance [2–4]. Pooling of all four studies showed significance for the EGb 761 groups (p<0.001).

Quality of life: Two studies determined health-related quality of life (DEMQOL-PROXY mean score) [3,4]. Significant improvements were found for the EGb 761 groups in both studies, which of course confirmed the pooling of the results of the two groups (p<0.001).

Subgroup evaluation: A subgroup evaluation with respect to the different dementia groups showed a significant improvement with EGb 761 in all three groups (AD, VaD, mixed form), except for the parameter QoL in the very small subgroup VaD.
Responder analyses: Responders were defined as patients with the following improvements in accordance with international standards (Table 2):

  • Cognitive functions: 4 points on the ADAS-cog scale.
  • NPI: 4 points
  • ADL: any improvement observed within five to six months by an independent physician.
  • Global assessment: 8 points.
     

Safety and compatibility

Adverse events documented in the placebo groups were more numerous than in the EGb 761 groups, and none of these events could be linked to EGb 761.

Summary

The pooled results of the review illustrate the evidence-based efficacy of Ginkgo biloba extract EGb 761 in the treatment of dementia patients with BPSD. Compared with placebo, EGb 761 was found to be statistically and clinically significantly superior in terms of improvement in cognitive function, BPSD, activities of daily living, quality of life, and in terms of global assessment. This significant superiority of EGb 761 was also evident in the individual analysis of three of the four studies [2–4].

Similarly, EGb 761 proved significantly superior in all but one of the subgroup evaluations.

For the treatment of dementia associated with neuropsychiatric symptoms (BPSD), Ginkgo biloba extract EGb 761 is not only an effective therapy, but is also characterized by its great safety and tolerability.

 

Literature:

  1. von Gunten A, Schlaefke S, Überla K: Efficacy of Ginkgo biloba extract EGb 761 in dementia with behavioral and psychological symptoms: a systematic review. The World Journal of Biological Psychiatry 2015; 1-12. Doi:10.3109/156229975.1066513.
  2. Napryeyenko O, Borzenko I: Ginkgo biloba special extract in dementia with neuropsychatric features. A randomized, placebo-controlled, double-blind clinical trial. Drug Research 2007; 57: 4-11.
  3. Ihl R, et al.: Efficacy and safety of a once-daily formulation of Ginkgo biloba extract EGb 761in dementia with neuropsychiatric features. A randomized controlled trial. Int J Geriatr Psychiatry 2011a; 26: 1186-1194.
  4. Herrschaft H, et al: Ginkgo biloba extract EGb 761 in dementia with neuropsychiatric features: a randomized, placebo-controlled trial to confirm the efficacy and safety of a daily dose of 240 mg. J Psychiatr Res 2012; 46: 716-723.
  5. Nikolova G, et al: Ginkgo biloba extract in dementia: a 22-week randomized, placebo-controlled, double-blind trial. Bulgarian Neurology 2013; 14: 139-143.

HAUSARZT PRAXIS 2016; 11(6): 2-3

Autoren
  • Dr. pharm. Christoph Bachmann
Publikation
  • HAUSARZT PRAXIS
Related Topics
  • Dementia
  • egb 761
  • Ginkgo
  • VaD
Previous Article
  • AAD Congress in Washington

Vaccination against herpes and social impact of acne

  • Congress Reports
  • Dermatology and venereology
  • Infectiology
  • RX
  • Studies
View Post
Next Article
  • Diagnostics, therapy and aftercare

Community-acquired pneumonia

  • Education
  • General Internal Medicine
  • Infectiology
  • Pneumology
  • RX
View Post
You May Also Like
View Post
  • 4 min
  • Circadian rhythm during Ramadan

Disturbed sleep patterns lead to metabolic stress

    • Education
    • Endocrinology and Diabetology
    • General Internal Medicine
    • Nutrition
    • RX
    • Studies
View Post
  • 6 min
  • Case Report

Breast cancer metastases in the bladder

    • Cases
    • Education
    • Gynecology
    • Oncology
    • RX
    • Urology
View Post
  • 11 min
  • Findings from the ALS Symposium 2024 in Montreal

Current and future approaches in the treatment of amyotrophic lateral sclerosis (ALS)

    • Congress Reports
    • Interviews
    • Neurology
    • RX
    • Studies
View Post
  • 8 min
  • Efficacy, mechanism of action and clinical effects

Garlic and high blood pressure

    • Cardiology
    • Education
    • General Internal Medicine
    • Pharmaceutical medicine
    • Phytotherapy
    • RX
    • Studies
View Post
  • 7 min
  • Moderate to severe chronic hand eczema

Delgocitinib cream – first topical pan-JAK inhibitor approved in Switzerland

    • Allergology and clinical immunology
    • Dermatology and venereology
    • Education
    • Infectiology
    • Market & Medicine
    • Pharmacology and toxicology
    • RX
View Post
  • 9 min
  • Wild-type transthyretin amyloid cardiomyopathy (ATTRwt-CA)

Diagnosis at an early stage, prognostic classifications and outlook

    • Cardiology
    • Education
    • RX
    • Studies
View Post
  • 4 min
  • Case report: Drug-induced hepatitis

Rare side effect of tirzepatide therapy

    • Cases
    • Education
    • Endocrinology and Diabetology
    • Gastroenterology and Hepatology
    • Pharmacology and toxicology
    • RX
    • Studies
View Post
  • 4 min
  • Plea for sex-specific neurology

Migraine in men: underdiagnosed, underestimated, under-researched

    • Education
    • Neurology
    • RX
    • Studies
Top Partner Content
  • Forum Gastroenterology

    Zum Thema
  • Herpes zoster

    Zum Thema
  • Dermatology News

    Zum Thema
Top CME content
  • 1
    Patience, knowledge and persistence in therapy
  • 2
    Sarcopenia and malnutrition in the context of pneumological rehabilitation
  • 3
    Medical and psychosocial perspectives
  • 4
    New nomenclature for non-alcoholic fatty liver disease
  • 5
    Examinations and considerations before therapy

Newsletter

Sign up and stay up to date

Subscribe
Medizinonline
  • Contact
  • General terms and conditions
  • Imprint

Input your search keywords and press Enter.