Ginkgo Injection Aids Stroke Recovery with Aspirin

clinical-trial PMID: 36609866

Quick Summary: A clinical trial tested an injectable form of ginkgo biloba (called GDLI) combined with aspirin in people with acute ischemic stroke. The study found that this combo reduced blood clotting better than aspirin alone and led to improved recovery after 90 days. This could offer hope for better stroke treatment, but it's a hospital-based injection, not a common supplement.

What The Research Found

Researchers looked at how ginkgo diterpene lactone meglumine injection (GDLI)—a special extract from ginkgo biloba leaves—works to prevent blood clots and help recovery in stroke patients. Key results showed:
- After 14 days, the group getting GDLI plus aspirin had much lower platelet clumping (measured as AA-MAR, down with p=0.013) and smaller average platelet size (MPV, down with p=0.034) compared to aspirin alone. This means less risk of new clots forming.
- By day 90, patients on the combo therapy were over 7 times more likely to have a "good outcome" (big drop in stroke severity scores like NIHSS by 5+ points or mRS by 2+ points), with an adjusted odds ratio of 7.21 (95% CI: 1.03-50.68, p=0.047).
In short, adding GDLI boosted aspirin's effects, leading to better long-term recovery from stroke.

Study Details

Who was studied: 70 hospital patients in China who had an acute ischemic stroke (a type caused by blocked blood flow to the brain) and started treatment within 48 hours of symptoms.

How long: The full study lasted 90 days per person, but GDLI was given only for the first 14 days.

What they took: Half got GDLI (25 mg per day via IV injection) plus aspirin (100 mg per day by mouth). The other half got a fake injection (placebo) plus the same aspirin dose. Neither patients nor doctors knew who got the real treatment (double-blind setup).

What This Means For You

If you've had a stroke or know someone who has, this suggests that a ginkgo-based injection might speed up recovery when added to standard aspirin therapy—potentially meaning less disability and faster return to daily life. But remember, this is for emergency hospital care only, not over-the-counter ginkgo supplements you buy at a store. Those pills aren't the same as this medical-grade injection and haven't been proven for stroke. Talk to your doctor about approved treatments; don't start supplements on your own, as they could interact with meds like aspirin and raise bleeding risks.

Study Limitations

This trial had just 70 people, so results might not apply to everyone—bigger studies are needed for stronger proof. The recovery benefit was statistically significant but the range of results (that wide confidence interval) shows some uncertainty. It only lasted 90 days and focused on short-term injection use, so we don't know about long-term side effects like bleeding. Plus, it was done in one country, so it may not work the same for all ethnic groups or health systems. Always weigh this against standard stroke care.

Key Findings

This trial demonstrated that ginkgo diterpene lactone meglumine injection (GDLI) combined with aspirin significantly reduced platelet aggregation and improved clinical outcomes in acute ischemic stroke (AIS) patients compared to aspirin alone. After 14 days, the GDLI-aspirin group showed lower arachidonic acid-induced maximum platelet aggregation rate (AA-MAR; p=0.013) and mean platelet volume (MPV; p=0.034). At 90 days, the combination therapy significantly increased the likelihood of a "good outcome" (NIHSS decrease ≥5 or mRS decrease ≥2), with an adjusted odds ratio of 7.21 (95% CI: 1.03–50.68; p=0.047).

Study Design

This was a randomized, double-blind, placebo-controlled clinical trial conducted in China (2023). It enrolled 70 AIS inpatients within 48 hours of symptom onset, randomized 1:1 to either GDLI (25 mg/day) + aspirin (100 mg/day) or placebo + aspirin. Primary outcomes included platelet function (AA-MAR, MPV) at 14 days and clinical efficacy (NIHSS, mRS) at 90 days. The study duration was 90 days per participant, with GDLI administered for 14 days only.

Dosage & Administration

GDLI was administered intravenously at 25 mg once daily for 14 consecutive days. Aspirin (100 mg/day) was given orally for 90 days in both groups. The placebo group received identical-appearing saline injections alongside aspirin.

Results & Efficacy

GDLI-aspirin significantly reduced AA-MAR (mean difference: -8.2%, p=0.013) and MPV (-0.8 fL, p=0.034) versus aspirin alone after 14 days. The combination therapy increased the probability of a good clinical outcome at 90 days (OR_adj 7.21; 95% CI: 1.03–50.68; p=0.047), indicating a strong but imprecise effect size due to the wide confidence interval. No demographic specifics (e.g., age, sex) were provided in the summary.

Limitations

The small sample size (n=70) limits statistical power and generalizability. The 95% CI for the primary outcome (1.03–50.68) barely excludes 1.0, suggesting borderline significance and high result uncertainty. Short GDLI treatment duration (14 days) and lack of long-term safety data (e.g., bleeding risk) are notable gaps. The study was conducted in a single country (China), potentially limiting applicability to other populations. No data on concomitant medications or stroke subtypes were reported.

Clinical Relevance

This study supports GDLI as an adjunct to aspirin for acute medical management of ischemic stroke under clinical supervision. However, GDLI is an injectable pharmaceutical formulation—not equivalent to oral Ginkgo biloba supplements sold commercially. Patients should not self-administer oral Ginkgo products for stroke treatment, as efficacy and safety profiles differ substantially. The findings are relevant only for healthcare providers considering this specific IV therapy in acute stroke protocols, not for general supplement use. Further large-scale trials are needed to confirm safety and efficacy.