학술논문
Treatment of dementia and mild cognitive impairment with or without cerebrovascular disease: Expert consensus on the use of Ginkgo biloba extract, EGb 761® .
Document Type
Article
Author
Kandiah, Nagaendran; Ong, Paulus Anam; Yuda, Turana; Ng, Li‐Ling; Mamun, Kaysar; Merchant, Reshma Aziz; Chen, Christopher; Dominguez, Jacqueline; Marasigan, Simeon; Ampil, Encarnita; Nguyen, Van Thong; Yusoff, Suraya; Chan, Yee Fai; Yong, Fee Mann; Krairit, Orapitchaya; Suthisisang, Chuthamanee; Senanarong, Vorapun; Ji, Yong; Thukral, Ramesh; Ihl, Ralf
Source
Subject
*CEREBROVASCULAR disease
*MILD cognitive impairment
*VASCULAR dementia
*GINKGO
*NEUROBEHAVIORAL disorders
*DEMENTIA
*PLANT extracts
*TREATMENT effectiveness
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Language
ISSN
1755-5930
Abstract
Background: The Ginkgo biloba special extract, EGb 761® has been widely used in the treatment of neuropsychiatric disorders, including Alzheimer's disease (AD). Methods: To guide clinical practice in the Asian region, the Asian Clinical Expert Group on Neurocognitive Disorders compiled evidence‐based consensus recommendations regarding the use of EGb 761® in neurocognitive disorders with/without cerebrovascular disease. Results: Key randomized trials and robust meta‐analyses have demonstrated significant improvement in cognitive function, neuropsychiatric symptoms, activities of daily living (ADL) and quality of life with EGb 761®versus placebo in patients with mild‐to‐moderate dementia. In those with mild cognitive impairment (MCI), EGb 761® has also demonstrated significant symptomatic improvement versus placebo. World Federation of Societies of Biological Psychiatry guidelines list EGb 761® with the same strength of evidence as acetylcholinesterase inhibitors and N‐methyl‐D‐aspartate (NMDA) antagonists e.g. memantine (Grade 3 recommendation; Level B evidence). Only EGb 761® had Level B evidence in improving cognition, behaviour, and ADL in both AD and vascular dementia patients. Safety analyses show EGb 761® to have a positive risk‐benefit profile. While concerns have been raised regarding a possible increased bleeding risk, several randomized trials and two meta‐analyses have not supported this association. Conclusions: The Expert Group foresee an important role for EGb 761®, used alone or as an add‐on therapy, in the treatment of MCI and dementias, particularly when patients do not derive benefit from acetylcholinesterase inhibitors or NMDA antagonists. EGb 761® should be used in alignment with local clinical practice guidelines. [ABSTRACT FROM AUTHOR]