<i>Ginkgo biloba </i>Compared with Cholinesterase Inhibitors in the Treatment of Dementia: A Review Based on Meta-Analyses by the Cochrane Collaboration
<i>Ginkgo biloba </i>im Vergleich zu Cholinesterase-Inhibitoren in der Behandlung von Demenz: Eine Übersichtsarbeit auf der Grundlage von Metaanalysen der Cochrane Collaboration
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Abstract
Data were derived from the Cochrane Collaboration meta-analyses of the efficacies of ginkgo, donepezil, rivastigmine and galantamine on changes in cognitive function in patients with dementia and, where necessary, were transformed to standardized mean differences. The proportion of patients discontinuing trials was used as a proxy measure of tolerability. Outcomes were assessed after 6 months of treatment. Trial data for cholinesterase inhibitors were more consistent than those for ginkgo, particularly regarding patient populations and outcome measures. Significant benefits on cognition vs. placebo were seen with donepezil, 5 and 10 mg, rivastigmine, 6–12 mg, and galantamine, 16 and 24 mg. Significant benefit vs. placebo with ginkgo was seen only when all doses were pooled. Similar proportions of patients discontinued treatment with ginkgo and placebo. Cholinesterase inhibitors were also well tolerated, although a significantly greater proportion of patients receiving active treatment discontinued vs. placebo with some doses. An evidence-based medicine approach, taking into account the quality of clinical trials, is essential when assessing the safety and efficacy of medications.
Die Daten stammten aus den Metaanalysen der Cochrane Collaboration zur Wirksamkeit von Ginkgo, Donepezil, Rivastigmin und Galantamin hinsichtlich Veränderungen der kognitiven Funktion bei Patienten mit Demenz und wurden, sofern erforderlich, in standardisierte Mittelwertdifferenzen transformiert. Der Anteil der Patienten, die die Studien abbrachen, wurde als Surrogatparameter für die Verträglichkeit herangezogen. Die Endpunkte wurden nach 6 Monaten Behandlung erfasst. Die Studiendaten zu Cholinesterasehemmern waren konsistenter als jene zu Ginkgo, insbesondere bezüglich der Patientenpopulationen und Zielgrößen. Signifikante Vorteile hinsichtlich der Kognition gegenüber Placebo zeigten sich unter Donepezil (5 und 10 mg), Rivastigmin (6–12 mg) und Galantamin (16 und 24 mg). Ein signifikanter Vorteil gegenüber Placebo zeigte sich bei Ginkgo nur, wenn alle Dosierungen gepoolt wurden. Ähnliche Anteile von Patienten brachen die Behandlung unter Ginkgo und unter Placebo ab. Cholinesterasehemmer wurden ebenfalls gut vertragen, wenngleich bei einigen Dosierungen ein signifikant größerer Anteil der Patienten unter aktiver Behandlung die Studie im Vergleich zu Placebo abbrach. Ein Ansatz der evidenzbasierten Medizin, der die Qualität klinischer Studien berücksichtigt, ist für die Beurteilung der Sicherheit und Wirksamkeit von Arzneimitteln essenziell.
| Reference Key |
a2004ltigtginkgobilobalti
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|---|---|
| Authors | A. Kurz; B. van Baelen |
| Journal | dementia and geriatric cognitive disorders |
| Year | 2004 |
| DOI |
10.1159/000079388
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| URL | |
| Keywords | Keywords not found |
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