Gingko biloba compound injections linked to better stroke outcomes

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People with ischemic (clot-caused) stroke who were treated with intravenous injections of a combination of biologically active ingredients from ginkgo biloba in the first two weeks after a stroke had better recovery of cognitive function, according to a preliminary study presented at the American Stroke Association’s International Stroke Conference 2024. The meeting will be held in Phoenix, Feb. 7-9, and is a world premier meeting for researchers and clinicians dedicated to the science of stroke and brain health.

Ginkgo biloba is an herb extracted from the dried leaves and seeds of the Ginkgo tree, one of the oldest living tree species and native to East Asia. It is widely used in traditional Chinese medicine and is available as a supplement to the active ingredients of ginkgo biloba delivered by IV in the United States, widely used in China to treat stroke because of its potential antioxidant properties to protect nerve cells. Disadvantages According to the National Center for Complementary and Integrative Health, ginkgo biloba is not approved by the US Food and Drug Administration for any medicinal use, and there is insufficient evidence to support approved uses outside of the FDA. Health.

In early 2023, the researchers of this study published the results of a multicenter trial in China indicating that people with ischemic stroke may recover better from their overall stroke symptoms if they are treated with daily injections of the ginkgo diterpene lactone meglumine (GDLM) combination. . Biologically active constituents of Ginkgo biloba. The present investigation analyzed the cognitive recovery of participants in that study.

“If our positive results are confirmed in other trials, GDLM injections could one day be used to improve cognitive function in patients after ischemic stroke.”

Anxin Wang, PhD, Associate Professor of Clinical Epidemiology, Beijing Tiantan Hospital, Capital Medical University, Beijing

Researchers analyzed cognitive recovery in 3,163 stroke survivors (mean age 63 years; 36% female) treated for mild to moderate ischemic stroke at 100 centers in China. Beginning within 48 hours of the stroke, approximately half of the stroke survivors were randomized to receive daily intravenous injections of 25 mg of GDLM for 14 days, while the other half received daily, intravenous placebo injections. Cognitive performance was assessed at 14 days and 90 days using the Montreal Cognitive Assessment Scale (MOCA), a 30-point face-to-face screening test of cognitive performance frequently used with stroke survivors. At baseline -; Within 48 hours of stroke and before starting treatment, most patients’ cognitive status was moderately impaired, with a mean score of 17 out of 30.

Compared to their initial cognitive screening results:

  • By day 14, stroke survivors who received the ginkgo biloba compound injection had improved cognitive scores compared to those who received the placebo (on average 3.93 points vs. 3.62 points higher, respectively); And
  • At day 90, those who received the ginkgo biloba compound injection had significantly improved cognitive scores compared to the placebo (an average of 5.51 points vs. 5.04 points).

“The proportion of patients who reached clinically significant levels was 20% higher in the GDLM group, indicating that GDLM injections can improve cognitive function in patients with acute ischemic stroke,” Wang said. “Since the follow-up time in this study was only 90 days, long-term studies are needed to determine the long-term effects of GDLM injections.”

“GDLM has shown a neuroprotective effect through multiple mechanisms, such as dilating brain blood vessels and improving brain cell tolerance to hypoxia (oxygen) and increasing cerebral blood flow. GDLM also has neuroprotective antioxidation, anti-inflammation and anti-apoptosis effects. (prevents cell death) ) ) properties,” Wang said. “Additionally, laboratory studies have previously indicated that GDLM can promote the release of chemicals associated with the prevention of neurodegenerative diseases such as Parkinson’s disease and Alzheimer’s disease.”

A 2022 American Heart Association Scientific Statement: Complementary and Alternative Medicine in the Management of Heart Failure, noted that complementary and alternative medicine may have some benefits and potentially serious risks, so it is important to involve the healthcare team.

“Although this American Heart Association statement focuses on the use of supplements in patients with heart failure, the same approach and caution should be used in the treatment of all cardiovascular diseases, including stroke,” said chair of the scientific statement writing committee Sherrill L. Chow, Pharm.D., FAHA, of Calif. is an associate professor of pharmacy practice and administration at Western University of Health Sciences in Pomona and an associate clinical professor of medicine at the University of California, Irvine. “Stroke patients should not take ginkgo biloba or other herbs or supplements without consulting their doctors and pharmacists. If this new research proves effective in future clinical trials, it could be a valuable tool for post-stroke care; however, efficacy and all Safety needs to be demonstrated to meet the same standards as prescription drugs and to secure FDA approval.” Dr. Chow was not involved in this study.

The study was an exploratory analysis conducted within a larger trial, so the results need to be confirmed in an independent trial. These findings for adults in China may not be generalizable to people in other countries.

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