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EGb in the Treatment for Patients with VCI: A Systematic Review and Meta-Analysis
BACKGROUND: Ginkgo biloba extract (EGb) is widely used to treat impairments in memory, cognition, activities of daily living, inflammation, edema, stroke, Alzheimer's dementia, and aging. AIM: We aimed to evaluate the safety and efficacy of EGb in treating vascular cognitive impairment (VCI). M...
Autores principales: | , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Hindawi
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8422158/ https://www.ncbi.nlm.nih.gov/pubmed/34504643 http://dx.doi.org/10.1155/2021/8787684 |
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author | Zhan, Min Sun, Linjuan Liu, Jianxun Zeng, Zixiu Shen, Wei Li, Huimin Wang, Ying Han, Fuhua Shi, Jingzi Zeng, Xinyun Lu, Xiyue Zhang, Yunling Liao, Xing |
author_facet | Zhan, Min Sun, Linjuan Liu, Jianxun Zeng, Zixiu Shen, Wei Li, Huimin Wang, Ying Han, Fuhua Shi, Jingzi Zeng, Xinyun Lu, Xiyue Zhang, Yunling Liao, Xing |
author_sort | Zhan, Min |
collection | PubMed |
description | BACKGROUND: Ginkgo biloba extract (EGb) is widely used to treat impairments in memory, cognition, activities of daily living, inflammation, edema, stroke, Alzheimer's dementia, and aging. AIM: We aimed to evaluate the safety and efficacy of EGb in treating vascular cognitive impairment (VCI). METHODS: The systematic review was performed using the latest guidelines. We searched for EGb-related trials up to March 1, 2021, in four Chinese databases, three English databases, and clinical trial registry platforms. Randomized controlled trials (RCTs) were included if the study enrolled participants with VCI. Two reviewers independently extracted the data and critically appraised the study quality. Heterogeneity was quantified with I(2). Both sensitivity and subgroup analyses were used to identify the sources of heterogeneity. Publication bias was assessed with funnel plots. We used the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) approach to rate the evidence quality. Outcomes included assessments using the Activities of Daily Living (ADL), Montreal Cognitive Assessment (MoCA), Mini-Mental State Examination (MMSE), Hasegawa Dementia Scale (HDS), Barthel Index (BI), Functional Activity Questionnaire (FAQ), and adverse events. RESULTS: In this study, a total of 2019 patients in 23 RCTs were included. EGb appeared to be more effective than control conditions as assessed by the results of cognitive function evaluation, including MMSE (MD(MMSE,EGb vs.blank) = 3.04, 95% CI: 0.10-5.98; MD(MMSE,EGb vs.drugs for VCI) = 2.70, 95% CI: 1.39-4.01; MD(MMSE,EGb+drugs for VCI vs.blank) = 5.90, 95% CI: 4.21-7.59; and MD(MMSE,EGb+drugs for VCI vs.drugs for VCI) = 3.14, 95% CI: 2.14-4.15), MoCA (MD(MoCA,EGb vs.blank) = 5.30, 95% CI: 2.15-8.46; MD(MoCA,EGb+drugs for VCI vs.blank) = 2.66, 95% CI: 1.82-3.50; and MD(MoCA,EGb+drugs for VCI vs.drugs for VCI) = 2.56, 95% CI: 1.85-3.27), HDS (MD(HDS,EGb vs.blank) = 6.50; 95% CI: 4.86-8.14; MD(HDS,EGb+drugs for VCI vs.drugs for VCI) = 3.60, 95% CI: 2.50-4.70), ADL (MD(ADL,EGb vs.blank) = 7.20, 95% CI: 3.28-11.12; MD(ADL,EGb+drugs for VCI vs.blank) = 10.00, 95% CI: 7.51-12.49; and MD(ADL,EGb+drugs for VCI vs.drugs for VCI) = 9.20, 95% CI: 7.26-11.14), BI (MD(BI,EGb+drugs for VCI vs.drugs for VCI) = 5.71, 95% CI: 2.99-8.43; MD(FAQ,EGb vs.drugs for VCI) = −1.43, 95% CI: -2.78 to 0.08), and FAQ (MD(FAQ,EGb+drugs for VCI vs.drugs for VCI) = −2.17, 95% CI: -4.13 to 0.21). Evidence of certainty ranged from medium certainty to very low certainty. CONCLUSION: This meta-analysis showed that EGb may be an effective and safe treatment in improving MMSE, MOCA, ADL, and BI for VCI patients within three months of diagnosis. However, given the quality of the included RCTs, more preregistered trials are needed that explicitly examine the efficacy of EGb. This systematic review has been registered on PROSPERO, with the registration number CRD42021232967. |
format | Online Article Text |
id | pubmed-8422158 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | Hindawi |
record_format | MEDLINE/PubMed |
spelling | pubmed-84221582021-09-08 EGb in the Treatment for Patients with VCI: A Systematic Review and Meta-Analysis Zhan, Min Sun, Linjuan Liu, Jianxun Zeng, Zixiu Shen, Wei Li, Huimin Wang, Ying Han, Fuhua Shi, Jingzi Zeng, Xinyun Lu, Xiyue Zhang, Yunling Liao, Xing Oxid Med Cell Longev Review Article BACKGROUND: Ginkgo biloba extract (EGb) is widely used to treat impairments in memory, cognition, activities of daily living, inflammation, edema, stroke, Alzheimer's dementia, and aging. AIM: We aimed to evaluate the safety and efficacy of EGb in treating vascular cognitive impairment (VCI). METHODS: The systematic review was performed using the latest guidelines. We searched for EGb-related trials up to March 1, 2021, in four Chinese databases, three English databases, and clinical trial registry platforms. Randomized controlled trials (RCTs) were included if the study enrolled participants with VCI. Two reviewers independently extracted the data and critically appraised the study quality. Heterogeneity was quantified with I(2). Both sensitivity and subgroup analyses were used to identify the sources of heterogeneity. Publication bias was assessed with funnel plots. We used the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) approach to rate the evidence quality. Outcomes included assessments using the Activities of Daily Living (ADL), Montreal Cognitive Assessment (MoCA), Mini-Mental State Examination (MMSE), Hasegawa Dementia Scale (HDS), Barthel Index (BI), Functional Activity Questionnaire (FAQ), and adverse events. RESULTS: In this study, a total of 2019 patients in 23 RCTs were included. EGb appeared to be more effective than control conditions as assessed by the results of cognitive function evaluation, including MMSE (MD(MMSE,EGb vs.blank) = 3.04, 95% CI: 0.10-5.98; MD(MMSE,EGb vs.drugs for VCI) = 2.70, 95% CI: 1.39-4.01; MD(MMSE,EGb+drugs for VCI vs.blank) = 5.90, 95% CI: 4.21-7.59; and MD(MMSE,EGb+drugs for VCI vs.drugs for VCI) = 3.14, 95% CI: 2.14-4.15), MoCA (MD(MoCA,EGb vs.blank) = 5.30, 95% CI: 2.15-8.46; MD(MoCA,EGb+drugs for VCI vs.blank) = 2.66, 95% CI: 1.82-3.50; and MD(MoCA,EGb+drugs for VCI vs.drugs for VCI) = 2.56, 95% CI: 1.85-3.27), HDS (MD(HDS,EGb vs.blank) = 6.50; 95% CI: 4.86-8.14; MD(HDS,EGb+drugs for VCI vs.drugs for VCI) = 3.60, 95% CI: 2.50-4.70), ADL (MD(ADL,EGb vs.blank) = 7.20, 95% CI: 3.28-11.12; MD(ADL,EGb+drugs for VCI vs.blank) = 10.00, 95% CI: 7.51-12.49; and MD(ADL,EGb+drugs for VCI vs.drugs for VCI) = 9.20, 95% CI: 7.26-11.14), BI (MD(BI,EGb+drugs for VCI vs.drugs for VCI) = 5.71, 95% CI: 2.99-8.43; MD(FAQ,EGb vs.drugs for VCI) = −1.43, 95% CI: -2.78 to 0.08), and FAQ (MD(FAQ,EGb+drugs for VCI vs.drugs for VCI) = −2.17, 95% CI: -4.13 to 0.21). Evidence of certainty ranged from medium certainty to very low certainty. CONCLUSION: This meta-analysis showed that EGb may be an effective and safe treatment in improving MMSE, MOCA, ADL, and BI for VCI patients within three months of diagnosis. However, given the quality of the included RCTs, more preregistered trials are needed that explicitly examine the efficacy of EGb. This systematic review has been registered on PROSPERO, with the registration number CRD42021232967. Hindawi 2021-08-27 /pmc/articles/PMC8422158/ /pubmed/34504643 http://dx.doi.org/10.1155/2021/8787684 Text en Copyright © 2021 Min Zhan et al. https://creativecommons.org/licenses/by/4.0/This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Review Article Zhan, Min Sun, Linjuan Liu, Jianxun Zeng, Zixiu Shen, Wei Li, Huimin Wang, Ying Han, Fuhua Shi, Jingzi Zeng, Xinyun Lu, Xiyue Zhang, Yunling Liao, Xing EGb in the Treatment for Patients with VCI: A Systematic Review and Meta-Analysis |
title | EGb in the Treatment for Patients with VCI: A Systematic Review and Meta-Analysis |
title_full | EGb in the Treatment for Patients with VCI: A Systematic Review and Meta-Analysis |
title_fullStr | EGb in the Treatment for Patients with VCI: A Systematic Review and Meta-Analysis |
title_full_unstemmed | EGb in the Treatment for Patients with VCI: A Systematic Review and Meta-Analysis |
title_short | EGb in the Treatment for Patients with VCI: A Systematic Review and Meta-Analysis |
title_sort | egb in the treatment for patients with vci: a systematic review and meta-analysis |
topic | Review Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8422158/ https://www.ncbi.nlm.nih.gov/pubmed/34504643 http://dx.doi.org/10.1155/2021/8787684 |
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