银杏叶提取物处方与德国轻度认知障碍门诊患者痴呆发病率的关联：一项回顾性队列研究。

Association Between Ginkgo Biloba Extract Prescriptions and Dementia Incidence in Outpatients with Mild Cognitive Impairment in Germany: A Retrospective Cohort Study.

机构信息

Institute for Social Medicine, Occupational Medicine, and Public Health (ISAP) of the Medical Faculty at the University of Leipzig, Leipzig, Germany.

Department of Psychiatry, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany.

出版信息

J Alzheimers Dis. 2022;86(2):703-709. doi: 10.3233/JAD-215348.

DOI:10.3233/JAD-215348

PMID:35124648

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9028600/

Abstract

BACKGROUND

Clinical trials have demonstrated a significant effectiveness of Ginkgo biloba therapy versus placebo in patients with dementia.

OBJECTIVE

The present study aims to analyze the impact of Ginkgo biloba drug prescriptions on dementia incidence in patients with mild cognitive impairment (MCI) in a real-world setting.

METHODS

This retrospective study was based on the IQVIA Disease Analyzer database and included patients aged 65 or older with a first diagnosis of MCI from January 2000 to December 2019. Each patient was followed for up to 20 years after MCI diagnosis until February 2021. Date of the first diagnosis of dementia or loss to follow-up, whichever occurred first, was noted. To estimate the association between Ginkgo biloba prescriptions during the follow-up and dementia incidence, a multivariable Cox regression analysis was performed, adjusted for age, sex, health insurance, documented co-diagnoses, and prescription of cholinesterase inhibitors.

RESULTS

Overall, 24,483 MCI patients (mean age: 77.0 years, 56.3% women) were included. It was found that > 2 prescriptions of Ginkgo biloba were significantly associated with a reduced dementia incidence (HR: 0.71 (95% CI: 0.55-0.91), p = 0.007), as compared with no Ginkgo biloba prescription. The effect of receiving > 3 Ginkgo biloba prescriptions was even stronger, with an HR of 0.64 (95% CI: 0.48-0.86), p = 0.003), while for > 4 prescriptions the HR was 0.58 (95% CI: 0.41-0.82) (p = 0.002).

CONCLUSION

All-cause dementia incidence decreased with higher numbers of Ginkgo biloba prescriptions in MCI patients.

摘要

背景

临床试验已经证明，银杏叶疗法在痴呆症患者中比安慰剂更有效。

目的

本研究旨在分析在真实环境中，轻度认知障碍（MCI）患者的银杏叶药物处方对痴呆症发病率的影响。

方法

这是一项基于 IQVIA Disease Analyzer 数据库的回顾性研究，纳入了 2000 年 1 月至 2019 年 12 月首次诊断为 MCI 的年龄在 65 岁及以上的患者。每位患者从 MCI 诊断后最多随访 20 年，直至 2021 年 2 月。记录首次诊断痴呆症或失访的日期，以先发生者为准。为了评估随访期间银杏叶处方与痴呆症发病率之间的关联，进行了多变量 Cox 回归分析，调整了年龄、性别、医疗保险、并存诊断和胆碱酯酶抑制剂的处方。

结果

共有 24483 例 MCI 患者（平均年龄：77.0 岁，56.3%为女性）纳入研究。结果发现，与未开具银杏叶处方相比，开具>2 次银杏叶处方与痴呆症发病率降低显著相关（HR：0.71（95%CI：0.55-0.91），p=0.007）。接受>3 次银杏叶处方的效果甚至更强，HR 为 0.64（95%CI：0.48-0.86），p=0.003），而接受>4 次银杏叶处方的 HR 为 0.58（95%CI：0.41-0.82）（p=0.002）。