Ginkgo biloba extract for the treatment of intermittent claudication: A meta-analysis of randomized trials

PURPOSE: The optimal treatment of intermittent claudication has not yet bee n identified. Ginkgo biloba extract has been reported to have beneficial ef fects. We performed a metaanalysis of the efficacy of Ginkgo biloba extract for intermittent claudication based on the results of randomized, placebo- controlled, double-blind trials. METHODS: Literature searches of MEDLINE, EMBASE, BIOSIS, AMED, CISCOM, and the Cochrane Library were performed to identify studies on the topic. Manuf acturers of commercial Ginkgo biloba products and authors of original publi cations and reviews were contacted to provide additional information. No la nguage restrictions were imposed. RESULTS: Eight randomized, placebo-controlled, double-blind trials were inc luded. Meta-analysis found a significant difference in the increase in pain -free walking distance in favor of Ginkgo biloba (weighted mean difference: 34 meters, 95% confidence interval [CI]: 26 to 43 meters). In studies usin g similar methodological features (ergometer speed: 3 km/h, inclination: 12 %) this difference was 33 meters in favor of Ginkgo biloba (95% CT: 22 to 4 3 meters). Adverse effects were rare, mild, and transient. CONCLUSIONS: These results suggest that Ginkgo biloba extract is superior t o placebo in the symptomatic treatment of intermittent claudication. Howeve r, the size of the overall treatment effect is modest and of uncertain clin ical relevance. Am J Med. 2000;108:276-281. (C) 2000 by Excerpta Medica, In c.