Comparative effectiveness of Ginkgo injections for treating vertebrobasilar insufficiency: A systematic review and network meta-analysis

WHAT IS KNOWN AND OBJECTIVE

This study sought to assess the clinical effectiveness of Ginkgo injections (GIs) combined with conventional drugs for vertebrobasilar insufficiency (VBI).

METHODS

Randomized controlled trials (RCTs) that assessed the adjunctive effects of GIs for patients with VBI were retrieved from several English and Chinese databases from inception to December 2018. The Cochrane risk of bias method was used to evaluate the methodological quality of the eligible trials. The data were analysed by Stata 13.0 and WinBUGS 1.4.3 software.

RESULTS

A total of 20 RCTs that included 1710 patients were included. All RCTs had an unclear risk of bias or a high risk of bias. The network meta-analysis (NMA) showed that the use of four kinds of GIs, especially Ginkgo leaf extract and dipyridamole injections (GDs), as adjunctive therapies with drugs for VBI increased the total effectiveness rate. Ginkgo biloba leaf extract injections (EGbs) combined with conventional drugs were more effective than only conventional drugs for improving the results of transcranial Doppler ultrasonography (TCD). Shuxuening injections (SXNs) seemed superior for improving blood viscosity-related indicators. Adverse events were mentioned in nine trials, and there was no difference between the GI group and the control group for the incidence rate of adverse events.

WHAT IS NEW AND CONCLUSIONS

GIs showed significant benefits as an add-on therapy for VBI, as GIs increased the total effectiveness rate and improved the results of TCD examinations. Due to the limited sample size and quality of the included trials, the results of this review still need to be tested in larger, rigorous studies in the future.

Efficacy and safety of ginkgo injections in the treatment of angina pectoris caused by coronary heart disease in China: a network Meta-analysis and systematic review

OBJECTIVE

To assess the clinical efficacy and safety of ginkgo injections (GIs) combined with conventional treatment (CT) against angina pectoris (AP) due to coronary heart disease (CHD).

METHODS

Randomized controlled trials (RCTs) that used GIs to treat AP were searched in SinoMed, PubMed, China National Knowledge Infrastructure Database, Chinese Scientific Journals Database, Wanfang Database, Embase and Cochrane Library until March 2017. The Cochrane"risk of bias"method was used to evaluate the methodological quality of RCTs. Data were analyzed using Stata v13.1 and WinBUGS v1.4.3.

RESULTS

A total of 73 RCTs involving 7621 patients were included. A Bayesian network Meta-analysis of RCTs was undertaken, and the advantages of four types of GI-supplemented CT in AP treatment were determined.

CONCLUSION

GI-assisted CT was more effective against AP than CT alone. However, based on the limitations of the study, additional high-quality RCTs are required to confirm our findings.