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Clinical question
Does gingko biloba improve symptoms of tinnitus?
Bottom line
There is no evidence from 6 randomized trials of more than 1000 patients
that gingko biloba is effective for tinnitus.
Level of Evidence: 1a
Reference
Rejali D, Sivakumar A, Balaji N. Gingko biloba does not benefit patients
with tinnitus: a randomized placebo-controlled double-blind trial and
meta-analysis of randomized trials. Clin Otolaryngol 2004; 29:226-31.
Study design: Meta-analysis (randomized controlled trials)
Setting: Outpatient (any)
Synopsis
A previous systematic review found cautious support for using gingko biloba
to treat tinnitus, but a subsequent larger trial found no benefit. This is
an updated review that also attempts to synthesize results from all of the
randomized controlled trials (RCTs) to date. These authors performed their
own RCT of 60 patients who were randomized (allocation concealed) to receive
either sustained release gingko biloba 120 mg or matching placebo. A variety
of outcomes were measured using validated measures of tinnitus, with no
significant difference seen between groups. The study was powered to detect
a 20-point change in the symptom score, which we are told is clinically
significant. The meta-analysis looked at each of the 6 RCTs on the topic,
including the authors' own, and classified patients as responders or
nonresponders on the basis of whatever outcome measure was used in that
particular study. They found no statistically significant benefit: 107 of
522 in the gingko group and 87 of 504 in the control group (21.5% vs 18.4%;
P = NS) reported symptomatic improvement.
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