Efficacy of Ginkgo biloba extract EGb 761® in dementia with behavioural and psychological symptoms: A systematic review

Objectives. To review current evidence of efficacy of Ginkgo biloba extract EGb 761((R)) in dementia with behavioural and psychological symptoms (BPSD). Methods. Randomized, placebo-controlled trials assessing the effects of EGb 761((R)) in dementia patients with BPSD were included if the diagnosis was made in accordance with internationally accepted criteria, the treatment period was at least 22 weeks, outcome measures covered BPSD and at least two of the following domains of assessment, i.e. cognition, activities of daily living and clinical global assessment, and methodological quality was adequate. An analysis of covariance (ANCOVA) model was used to calculate the pooled effect estimates and to compare effects of EGb 761((R)) and placebo; furthermore, combined risk differences of response rates were calculated. Results. Four published trials were identified, involving altogether 1,628 outpatients with mild to moderate dementia. Least-square mean differences for change from baseline in cognition, BPSD (including caregiver distress rating), activities of daily living, clinical global impression, and quality of life favoured EGb 761((R)) (P < 0.001 for all comparisons). Conclusions. The pooled analyses provide evidence of efficacy of EGb 761((R)) at a daily dose of 240 mg in the treatment of out-patients suffering from Alzheimer's, vascular or mixed dementia with BPSD.