Background
Dementia is a leading cause of disability and dependency in elderly people, generating significant physical, psychological, and financial challenges for patients, caregivers, and healthcare systems worldwide. For Alzheimer’s disease (AD), the most common form of dementia, established treatments such as Acetyl-Cholinesterase Inhibitors (AChE) have proven to be marginally beneficial, but side effects remain. Alternatively, a standardized preparation of Ginkgo Biloba Extract (EGb-761) is a popular herbal medicine used globally and widely available in Hong Kong. This paper reviews and synthesizes the effectiveness of EGb-761 in the treatment of AD compared to placebo and AChE treatments.
Methods
A systematic search was performed using PubMed, ProQuest, and Google Scholar to identify all relevant randomized controlled studies in English that examined the effectiveness of EGb-761 on individuals with AD. The studies, based on expert consensus, had to have a minimum duration of 22 weeks and one of two primary outcome measures: 1. cognitive functioning, 2. functional ability in activities-of-daily-living (ADL). A secondary outcome measure, safety (drop-out rate from adverse events), was also evaluated. Quality was assessed based on indicators derived from the CONSORT 2010 checklist.
Findings
Ten randomized controlled trials from eight countries, with participants ranging from mild to severe AD were included. Of the ten studies, eight compared EGb-761 with placebo, three compared EGb-761 head-to-head with an AChE (two with Donepezil, one with Rivastigmine), and one compared EGb-761 and AChE stand-alone treatment with combined treatments (EGb-761 + AChE). Overall results on cognitive and functional improvements were mixed. Of the studies that demonstrated a positive association, the clinical significance is questionable.
Conclusions
Although results were inconsistent, EGb-761’s safety appears to be acceptable. In Hong Kong, given the widespread availability, popularity and perceived safety of EGb-761, the population needs appropriate guidance and support from the government to safeguard quality and increase awareness of potential drug-herb interactions. Concurrently, with AChE becoming an increasingly established treatment for AD, more head-to-head studies on EGb-761 and AChE on the local population are needed to increase understanding and public awareness. / published_or_final_version / Public Health / Master / Master of Public Health
| Identifer | oai:union.ndltd.org:HKU/oai:hub.hku.hk:10722/206911 |
| Date | January 2014 |
| Creators | Chow, Wing-gee, Janet, 周詠芝 |
| Publisher | The University of Hong Kong (Pokfulam, Hong Kong) |
| Source Sets | Hong Kong University Theses |
| Language | English |
| Detected Language | English |
| Type | PG_Thesis |
| Rights | The author retains all proprietary rights, (such as patent rights) and the right to use in future works., Creative Commons: Attribution 3.0 Hong Kong License |
| Relation | HKU Theses Online (HKUTO) |
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