The article below is extracted from Medical Tribune dated 15 - 31 Dec 2006. You can download the issue from Medical Tribune website at http://www.medicaltribune.com/
The Role of EGb 761® in Cognitive Disorders & Pre-Dementia in the Elderly
by Helene-Mathiex Fortunet, MDAssociate Professor
Medical Affairs Director (Primary Care Products)
IPSEN
EGb 761® has been studied widely on all biological levels. A comparison of EGb 761® to other Ginkgo biloba extracts available in the US shows that EGb 761® contains a safe level of ginkgolic acid <5 ppm.1
Pharmacological properties of EGb 761®
Current pathological and biological data on EGb 761® suggest that it may play a role in the prevention of dementia/Alzheimer’s disease (AD) due to its anti-radical properties, and neuroprotective effects that may protect against neurodegenerative processes.2-4 More recent studies demonstrated that EGb 761® reduced the aggregation of beta-amyloid fibrilspaques,5 which are the diagnostic, and possibly causative, feature of AD. Additionally, EGb 761® has been shown to significantly decrease the activity of caspase-3, a key enzyme in the apoptosis cell-signaling cascade.5
Clinical data
The Cochrane analysis suggests that there is promising evidence of improvement in cognition and function associated with EGb 761®.6 2 recent epidemiological studies – EPIDOS7 and PAQUID8 – further support the role of EGb 761® in the prevention of dementia and AD.
EPIDOS (Epidemiology of Osteoporosis)7A follow-up of the EPIDOS cohort (i.e. 1462 women aged over 75 years) assessed the correlation between the intake of vasoactive substances, particularly EGb 761®, and onset of Alzheimer-type dementia. After 7 years, comparison between 69 women who developed Alzheimer-type dementia with 345 paired women whose cognitive function remained normal showed that, regular intake of EGb 761® for at least 3 years was associated with a lower risk for Alzheimer-type dementia compared to those who had not received EGb 761® (odds ration=0.31; P=.018).
PAQUID (Personnes Agées Quid)8PAQUID is a prospective epidemiological cohort study on cognitive and functional aging, particularly focusing on dementia risk factors. A total of 3,777 subjects aged 65 years and above were recruited into study and followed up for 10 years with active screening of dementia. Results showed that EGb 761® was associated with a decreased risk of dementia or death compared to treatment with other vasodilators or without vasodilators.
Ongoing trials
Currently, there are many trials conducted worldwide to further assess the therapeutic role of EGb 761® in cognitive disorders, to delay or prevent Alzheimer’s disease in mild cognitive impairment, including:
- The Ginkgo Evaluation of Memory (GEM) study sponsored by the National Institues of Health in the US, 9 (3,000 patients with or without memory complaints, 5 years treatment with EGb 761® or placebo and follow up)
- The Ginkgo biloba: Usefulness upon Incidence of Dementia with Age (GuidAge™) study.10 (2,800 patients with memory complaints, 5 years treatment with EGb 761® or placebo 5 years treatment and follow up)
References:
1. Kressmann S, et al. J Pharm Pharmacol 2002;54:661-669.
2. Madruga MH, et al. Elsevier 1995.
3. Pietri S, et al. J Mol Cell Cardiol 1997;29:733-742.
4. Chandrasekaran K, et al. Brain Res 2001;922:282-282.
5. Luo Y, et al. Proc Natl Acad Sci USA 2002;99:12197-12202.
6. Birks J, et al. Cochrane Databse Syst Rev 2002;4:CD003120.
7. Andrieu S, et al. J Gerontol A Biol Sci Med Sci 2003;58A:372-377.
8. Ramaroson H, et al. Rev Neurol 2003;159:405-411.
9. DeKosky ST, et al. Contemp Clin Trials 2006;27:238-253.
10. GuidAge Trial. Data on file. Ipsen 2006.
