Ginkgo biloba effective for treatment of intermittent claudication


April 27, 2000

Am J Med 2000;108:276-281,341-342



Gingko biloba herbal extract is more effective than placebo for treating
intermittent
claudication, British researchers report in the March issue of The American
Journal of Medicine.Drs. Max H. Pittler and Edzard Ernst, of the University
of Exeter, UK, conducted a meta-analysis of eight randomized,
placebo-controlled,
double-blind studies, which investigated the use of Gingko biloba for treatment
of intermittent claudication resulting from peripheral arterial disease.While
a number of controlled, nonrandomized studies have suggested the effectiveness
of Ginkgo biloba, those studies "may have resulted in a substantial
overestimation
of the effect size," the authors note.The researchers found that pain-free
walking
distance was 34 meters greater for those taking the herb compared with control
subjects.

However, they caution that "the overall effect seems modest, and several caveats
about the available trials prevent a final judgment on the efficacy of this
treatment."While regular walking is an effective symptomatic treatment, patient
compliance is often poor, and treatment with drugs is common, the authors point
out.

"In the few studies that have been done comparing the herb with conventional
drugs, Gingko biloba has been found to be as effective as the drugs and has
fewer side effects," Dr. Ernst said in an interview with Reuters Health.The
authors are currently planning a study to investigate Gingko biloba's ability
to accelerate wound healing in patients with advanced peripheral vascular
disease,
Dr. Ernst noted.In an accompanying editorial, Drs. Bradly P. Jacobs and Warren
S. Browner, of the University of California at San Francisco, comment that even
though the herb "was well tolerated and less expensive than the two FDA-approved
drugs, clinicians will remain reluctant to recommend this herbal product to
their patients."

This is due, they note, to the modest results and the current lack of US Food
and Drug Administration regulation of herbal products."Herbal products should
be regulated for safety and product quality so that clinicians who wish to
prescribe
them will be able to apply the results of research without fear of doing harm
to patients," the editorialists conclude.A




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