Skip navigation

Ginkgo biloba for intermittent claudication

 

Clinical bottom line

Ginkgo biloba extracts at doses of 120-160 mg over 12-24 weeks increased mean pain free walking distance by an average of 33 metres (95% confidence interval 22 to 43 metres) compared with placebo in high quality randomised trials.


Reference

MH Pittler, E Ernst. Ginkgo biloba extract for the treatment of intermittent claudication: a meta-analysis of randomized trials. American Journal of Medicine 2000 108: 276-281.

Systematic review

Date review completed: 1998
Number of trials included: 8
Number of patients: 385 total
Control groups: placebo.
Main outcomes: Pain free walking distance an maximal walking distance

Inclusion criteria were randomised double blind comparisons of ginkgo versus placebo. Authors sought data from original trials to be able to obtain it in a form suitable for pooling, and to verify important study details. Studies using ginkgo in combination with other therapies were not included, nor those not assessing walking distance.

Medline, Embase, Biosis, Amed and CISCOM were searched to June 1998 for published reports. Bibliographies of retrieved reports were checked for additional citations and no language restrictions were made. Manufacturers of ginkgo preparations were contacted for published and unpublished information. Data were extracted in a standardised, predefined manner by the two reviewers.

Findings

There were eight studies with pain free walking distance, defined using devices that forced patients to walk at a set speed. Intermittent claudication was according to predefined criteria. The quality scores were 3 (out of 5) or better for all trials, ensuring that bias was minimised.

Ginkgo biloba extracts at doses of 120-160 mg over 12-24 weeks increased mean pain free walking distance by an average of 33 metres (95% confidence interval 22 to 43 metres) compared with placebo in high quality randomised trials (Figure 1).

Figure 1: Pain free walking distance with ginkgo biloba and placebo


Some trials reported no adverse events, but when they were reported they comprised abdominal complaints, nausea and dyspepsia.

Comment

What we have here is good evidence, but limited in size with under 400 patients. The results, though, show a useful increase in mean pain-free walking distance, and significantly better than placebo, with about 120 mg of ginkgo extract every day.