Ginkgo biloba Extract for Intermittent Claudication in Patients with Peripheral Arterial Disease: A Systematic Review and Meta-Analysis of Randomized Controlled Trials
- 1Division of Vascular and Transplant Surgery, Department of Surgery, Seoul St. Mary’s Hospital, The Catholic University of Korea, Seoul 06591, Republic of Korea
- 2Academic Research Service Department, LSK Global Pharma Services Co., Ltd., Seoul 04535, Republic of Korea
- 3Clinical Strategy Department, LSK Global Pharma Services Co., Ltd., Seoul 04535, Republic of Korea
Abstract
Background/Objectives: Intermittent claudication (IC) secondary to peripheral artery disease (PAD) causes exertional leg pain and discomfort, which limits functional walking capacity. The clinical efficacy of Ginkgo biloba extract (GBE) as a therapeutic agent for IC is debatable. This systematic review and meta-analysis evaluated the efficacy and safety of GBE compared with a placebo in patients with IC due to PAD. Methods: Databases including PubMed, Embase, the Cochrane Library, and CINAHL were searched until 24 April 2026. Eligible studies included randomized, double-blind, controlled trials (RCTs) comparing placebo. Primary outcome was absolute claudication distance (ACD) at the end of the study. Secondary outcomes were initial claudication distance (ICD), ankle-brachial index (ABI), ankle pressure, and adverse events. Walking outcomes across various treadmill protocols were standardized to estimate caloric expenditure (kcal). A random-effects model was used to pool the effect estimates across trials. Risk of bias was assessed using the Cochrane risk-of-bias tool (RoB 2). Results: A total of 14 RCTs comprising 893 participants represent the total number randomized were included. GBE was associated with a statistically significant but modest improvement in ACD compared with placebo (mean difference [MD], 3.50 kcal; 95% CI, 0.02 to 6.98; p = 0.049). This benefit was significant in trials with a 24-week duration (MD, 4.67 kcal; 95% CI, 2.26 to 7.08; p < 0.001) but not in 12–16 weeks trials (MD, 1.35 kcal; 95% CI, −2.39 to 5.09; p = 0.48). No significant changes were observed for ICD or resting ABI/ankle pressure. GBE was well tolerated, with an overall adverse event incidence comparable to placebo. Conclusions: In patients with IC due to PAD, GBE therapy improves absolute walking performance, with a significant effect observed in trials evaluating 24 weeks of treatment. Given its favorable safety and tolerability profile, GBE can represent a clinically relevant and well-tolerated therapeutic option to support functional walking capacity, particularly for patients unable to tolerate or use conventional pharmacological agents.
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BibTeX
@article{ohe2026ginkgo,
title = {{Ginkgo biloba Extract for Intermittent Claudication in Patients with Peripheral Arterial Disease: A Systematic Review and Meta-Analysis of Randomized Controlled Trials}},
author = {Haengjin Ohe and Jinhee Hwang and Suk Ran Kim and Seonwoo Kim and Sun Cheol Park},
journal = {Journal of Clinical Medicine},
year = {2026},
month = nov,
doi = {10.3390/jcm15218606},
url = {https://www.mdpi.com/2077-0383/15/21/8606},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Ginkgo biloba Extract for Intermittent Claudication in Patients with Peripheral Arterial Disease: A Systematic Review and Meta-Analysis of Randomized Controlled Trials
AU - Haengjin Ohe
AU - Jinhee Hwang
AU - Suk Ran Kim
AU - Seonwoo Kim
AU - Sun Cheol Park
PY - 2026
DA - 2026/11/04
JO - Journal of Clinical Medicine
DO - 10.3390/jcm15218606
UR - https://www.mdpi.com/2077-0383/15/21/8606
AB - Background/Objectives: Intermittent claudication (IC) secondary to peripheral artery disease (PAD) causes exertional leg pain and discomfort, which limits functional walking capacity. The clinical efficacy of Ginkgo biloba extract (GBE) as a therapeutic agent for IC is debatable. This systematic review and meta-analysis evaluated the efficacy and safety of GBE compared with a placebo in patients with IC due to PAD. Methods: Databases including PubMed, Embase, the Cochrane Library, and CINAHL were searched until 24 April 2026. Eligible studies included randomized, double-blind, controlled trials (RCTs) comparing placebo. Primary outcome was absolute claudication distance (ACD) at the end of the study. Secondary outcomes were initial claudication distance (ICD), ankle-brachial index (ABI), ankle pressure, and adverse events. Walking outcomes across various treadmill protocols were standardized to estimate caloric expenditure (kcal). A random-effects model was used to pool the effect estimates across trials. Risk of bias was assessed using the Cochrane risk-of-bias tool (RoB 2). Results: A total of 14 RCTs comprising 893 participants represent the total number randomized were included. GBE was associated with a statistically significant but modest improvement in ACD compared with placebo (mean difference [MD], 3.50 kcal; 95% CI, 0.02 to 6.98; p = 0.049). This benefit was significant in trials with a 24-week duration (MD, 4.67 kcal; 95% CI, 2.26 to 7.08; p < 0.001) but not in 12–16 weeks trials (MD, 1.35 kcal; 95% CI, −2.39 to 5.09; p = 0.48). No significant changes were observed for ICD or resting ABI/ankle pressure. GBE was well tolerated, with an overall adverse event incidence comparable to placebo. Conclusions: In patients with IC due to PAD, GBE therapy improves absolute walking performance, with a significant effect observed in trials evaluating 24 weeks of treatment. Given its favorable safety and tolerability profile, GBE can represent a clinically relevant and well-tolerated therapeutic option to support functional walking capacity, particularly for patients unable to tolerate or use conventional pharmacological agents.
SN - 2077-0383
ER -