Publication: Treatment of dementia and mild cognitive impairment with or without cerebrovascular disease: Expert consensus on the use of Ginkgo biloba extract, EGb 761 <sup>®</sup>
Issued Date
2019-02-01
Resource Type
ISSN
17555949
17555930
17555930
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2-s2.0-85060064520
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Mahidol University
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SCOPUS
Bibliographic Citation
CNS Neuroscience and Therapeutics. Vol.25, No.2 (2019), 288-298
Suggested Citation
Nagaendran Kandiah, Paulus Anam Ong, Turana Yuda, Li Ling Ng, Kaysar Mamun, Reshma Aziz Merchant, Christopher Chen, Jacqueline Dominguez, Simeon Marasigan, Encarnita Ampil, Van Thong Nguyen, Suraya Yusoff, Yee Fai Chan, Fee Mann Yong, Orapitchaya Krairit, Chuthamanee Suthisisang, Vorapun Senanarong, Yong Ji, Ramesh Thukral, Ralf Ihl Treatment of dementia and mild cognitive impairment with or without cerebrovascular disease: Expert consensus on the use of Ginkgo biloba extract, EGb 761 <sup>®</sup>. CNS Neuroscience and Therapeutics. Vol.25, No.2 (2019), 288-298. doi:10.1111/cns.13095 Retrieved from: https://repository.li.mahidol.ac.th/handle/20.500.14594/51940
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Title
Treatment of dementia and mild cognitive impairment with or without cerebrovascular disease: Expert consensus on the use of Ginkgo biloba extract, EGb 761 <sup>®</sup>
Author(s)
Nagaendran Kandiah
Paulus Anam Ong
Turana Yuda
Li Ling Ng
Kaysar Mamun
Reshma Aziz Merchant
Christopher Chen
Jacqueline Dominguez
Simeon Marasigan
Encarnita Ampil
Van Thong Nguyen
Suraya Yusoff
Yee Fai Chan
Fee Mann Yong
Orapitchaya Krairit
Chuthamanee Suthisisang
Vorapun Senanarong
Yong Ji
Ramesh Thukral
Ralf Ihl
Paulus Anam Ong
Turana Yuda
Li Ling Ng
Kaysar Mamun
Reshma Aziz Merchant
Christopher Chen
Jacqueline Dominguez
Simeon Marasigan
Encarnita Ampil
Van Thong Nguyen
Suraya Yusoff
Yee Fai Chan
Fee Mann Yong
Orapitchaya Krairit
Chuthamanee Suthisisang
Vorapun Senanarong
Yong Ji
Ramesh Thukral
Ralf Ihl
Other Contributor(s)
Can Tho University of Medicine and Pharmacy
Subang Jaya Medical Centre
Beijing Tiantan Hospital, Capital Medical University
University of Santo Tomas, Manila
St. Luke's Medical Center Quezon City
Hasan Sadikin Hospital
Universitas Katolik Indonesia Atma Jaya
Alexianer Krefeld GmbH
Kuala Lumpur Hospital
National Neuroscience Institute of Singapore
Singapore General Hospital
National University of Singapore
Faculty of Medicine, Ramathibodi Hospital, Mahidol University
Changi General Hospital
Mahidol University
Faculty of Medicine, Siriraj Hospital, Mahidol University
Sahara Hospital
Hospital Sultan Ismail
Subang Jaya Medical Centre
Beijing Tiantan Hospital, Capital Medical University
University of Santo Tomas, Manila
St. Luke's Medical Center Quezon City
Hasan Sadikin Hospital
Universitas Katolik Indonesia Atma Jaya
Alexianer Krefeld GmbH
Kuala Lumpur Hospital
National Neuroscience Institute of Singapore
Singapore General Hospital
National University of Singapore
Faculty of Medicine, Ramathibodi Hospital, Mahidol University
Changi General Hospital
Mahidol University
Faculty of Medicine, Siriraj Hospital, Mahidol University
Sahara Hospital
Hospital Sultan Ismail
Abstract
© 2018 The Authors. CNS Neuroscience & Therapeutics Published by John Wiley & Sons Ltd 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.