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. 2021 Feb;27(2):149-162.
doi: 10.1111/cns.13536. Epub 2020 Dec 22.

Strategies for the use of Ginkgo biloba extract, EGb 761® , in the treatment and management of mild cognitive impairment in Asia: Expert consensus

Nagaendran Kandiah  1   2   3 , Yee Fai Chan  4 , Christopher Chen  5 , Darwin Dasig  6 , Jacqueline Dominguez  7 , Seol-Heui Han  8 , Jianping Jia  9 , SangYun Kim  10 , Panita Limpawattana  11 , Li-Ling Ng  12 , Dinh Toan Nguyen  13 , Paulus Anam Ong  14 , Encarnita Raya-Ampil  15 , Nor'izzati Saedon  16 , Vorapun Senanarong  17 , Siti Setiati  18 , Harjot Singh  19 , Chuthamanee Suthisisang  20 , Tong Mai Trang  21 , Yuda Turana  22 , Narayanaswamy Venketasubramanian  23 , Fee Mann Yong  24 , Yong Chul Youn  25 , Ralf Ihl  26
Affiliations

Strategies for the use of Ginkgo biloba extract, EGb 761® , in the treatment and management of mild cognitive impairment in Asia: Expert consensus

Nagaendran Kandiah et al. CNS Neurosci Ther. 2021 Feb.

Abstract

Background: Mild cognitive impairment (MCI) is a neurocognitive state between normal cognitive aging and dementia, with evidence of neuropsychological changes but insufficient functional decline to warrant a diagnosis of dementia. Individuals with MCI are at increased risk for progression to dementia; and an appreciable proportion display neuropsychiatric symptoms (NPS), also a known risk factor for dementia. Cerebrovascular disease (CVD) is thought to be an underdiagnosed contributor to MCI/dementia. The Ginkgo biloba extract, EGb 761® , is increasingly being used for the symptomatic treatment of cognitive disorders with/without CVD, due to its known neuroprotective effects and cerebrovascular benefits.

Aims: To present consensus opinion from the ASian Clinical Expert group on Neurocognitive Disorders (ASCEND) regarding the role of EGb 761® in MCI.

Materials & methods: The ASCEND Group reconvened in September 2019 to present and critically assess the current evidence on the general management of MCI, including the efficacy and safety of EGb 761® as a treatment option.

Results: EGb 761® has demonstrated symptomatic improvement in at least four randomized trials, in terms of cognitive performance, memory, recall and recognition, attention and concentration, anxiety, and NPS. There is also evidence that EGb 761® may help delay progression from MCI to dementia in some individuals.

Discussion: EGb 761® is currently recommended in multiple guidelines for the symptomatic treatment of MCI. Due to its beneficial effects on cerebrovascular blood flow, it is reasonable to expect that EGb 761® may benefit MCI patients with underlying CVD.

Conclusion: As an expert group, we suggest it is clinically appropriate to incorporate EGb 761® as part of the multidomain intervention for MCI.

Keywords: Ginkgo biloba; EGb 761®; cerebrovascular disease; dementia; mild cognitive impairment; neuropsychiatric symptoms.

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Conflict of interest statement

All authors participated in the ASCEND expert meeting from which this document was drafted, and contributed to or critically reviewed the manuscript. The final manuscript was approved by all authors prior to publication. The following authors declare no conflict of interest: Yuda Turana, Saedon Nor'izzati, Christopher Chen, Narayanaswamy Venketasubramanian, Young Chul Youn, Harjot Singh, Siti Setiati, SangYun Kim, Seol‐Heui Han, Ralf Ihl, Jianping Jia, Trang Tong Mai, and Fee Mann Yong. During the last three years: Nagaendran Kandiah has received grant funding and honorarium payments from Novartis Pharmaceuticals, Eisai Pharmaceuticals, Lundbeck, Schwabe Pharma. Chan Yee Fai has received honoraria and CME sponsorship from DCH Auriga, Eisai, Johnson & Johnson, Lundbeck and Novartis as well as involvement in Industry Sponsored Research. Encarnita Ampil has received honoraria from the Lundbeck, Menarini, Medichem, Torrent, Novartis, Kusum Pharma for CME sponsorship, lecture fees and/or module development. D. Darwin A. Dasig. MD has received honoraria, CME sponsorship, lecture fees and/or speaker fees from Hi‐Eisai, Lundbeck, Medichem, and Menarini. Ng Li‐Ling has received honoraria from Novartis, Eisai, MIMS, Schwabe Pharma, and Danone Dumex, and was involved as a consultant, speaker, or in advisory boards for Novartis, Eisai, MIMS, Schwabe Pharma, and Danone Dumex. Paulus Anam Ong has received CME lecture fees from Lundbeck Indonesia, and a grant from Universitas Padjadjaran Bandung Indonesia. Jacqueline Dominguez has received honoraria and CME sponsorship from HI‐Eisai Pharmaceutical Phil., Inc, Menarini Inc Philippines, and Schwabe Pharma; was involved as a consultant, speaker, or in advisory boards for HI‐Eisai Pharmaceutical Phil., Inc, and Menarini Inc Philippines, and EVER Pharma; and received a research grant from the Philippine Institute for Traditional and Alternative Healthcare‐Department of Health. Nguyen Dinh Toan has received honoraria from Eisai pharmaceutical company. Panita Limpawattana has received CME sponsorship from A. Menarini (Thailand) Limited. Chuthamanee Suthisisang has received CME sponsorship from A. Menarini (Thailand) Limited. Vorapun Senanarong has received lecture fees from Eisai Thailand, Lundbeck Thailand; was involved as a consultant, speaker, or in advisory boards with Menarini Thailand; and has received a research grant from the Faculty of Medicine in Siriraj Hospital, Thailand Research Fund, and SCB Corporate Social Responsibility (CSR) project.

Figures

FIGURE 1
FIGURE 1
Key trials of EGb 761® indicating cognitive benefits in healthy individuals and MCI patients, and effects on dementia prevention
See this image and copyright information in PMC

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