Evaluation of clinical efficacy of Ginkgo biloba extract in the treatment of knee osteoarthritis: a randomized clinical trial

Background: Osteoarthritis (OA) is a degenerative joint disease characterized by deteriorating articular cartilage. Most patients may not get enough control of symptoms in spite of the availability of various treatment options. Because of the synergistic impact of flavonoids and ginkgolides, Ginkgo biloba (GB) has been shown to possess antioxidant and anti-inflammatory properties besides its generally safe profile. This study aims to assess the efficacy of the Ginkgo biloba extract (GBE) in patient with Knee OA. Methods: This is a randomized double blinded clinical trial conducted in a private orthopaedic clinic in Al-Najaf Government-Iraq. Patients were randomized into two groups; Group A administered the standard treatment (diclofenac capsule 100 milligram sustained released with paracetamol 1 gram twice daily) with GBE 120 milligram twice daily, while Group B administered the standard treatment with placebo (starch) capsule only. The Knee injury and Osteoarthritis Outcome Score (KOOS) was performed to assess the efficacy of the GBE in patient with Knee OA for eight weeks. Results: 60 patients successfully completed the eight weeks follow up. Pain, symptoms, sport, activity of daily living (ADL) scores showed significant improvement in Group A from the first two weeks after treatment with GB in comparison with group B. however, scores of quality of life (QOL) were not significantly improved in two group comparison at each assessment week. Only 10 patients reported gastrointestinal adverse effects during the study which were all mild. Conclusions: GB may provide additional beneficial health effects to patients with knee OA based on KOOS scores when add to the standard treatment regime. Registration: ClincialTrials.gov (NCT05398874, https://clinicaltrials.gov/ct2/show/NCT05398874).