Authors of March 2007 Report Advise That Permax Use Should Be Stopped If Possible Due To Risk of Valvulopathy, Or Heart Valve Damage
(Posted by Tom Lamb at DrugInjuryWatch.com)
A new study published in the March 2007 issue of the medical journal Archives of Neurology provides further support to the theory that the long-term use of Permax (pergolide) for Parkinson's disease increases the risk of valvulopathy, primarily cardiac valve regurgitation. In comparison, the same study found that Mirapex (pramipexole) and Requip (ropinirole), two non-ergot-derived dopamine agonists used for the treatment of Parkinson's disease, were not associated with this increased risk of heart valve damage.
The new study report is called "Cardiac Valve Regurgitation With Pergolide Compared With Nonergot Agonists in Parkinson Disease". According to the abstract for this March 2007 report, the objective of this case-control study was to determine if cardiac valve regurgitation occurs more commonly in patients with Parkinson disease (PD) treated with Permax (pergolide) than in those treated with Mirapex and Requip, the nonergot agonists, at a comparable dose.
In more detail, as reported in the March 2007 issue of Archives of Neurology, the occurrence of cardiac valve regurgitation was compared in 36 Permax users and 36 matched users of Mirapex or Requip. In the Permax group, the average regurgitation scores were 0.83 for the aortic valve, 1.42 for the mitral valve, and 1.43 for the tricuspid valve, whereas in the Mirapex / Requip group the average regurgitation scores were 0.19 for aortic valve, 0.39 for mitral valve, and 0.19 for tricuspid valve.
As reported in a March 14, 2007 Reuters Health article, the lead author of this study, Dr. Richard B. Dewey, from the University of Texas Southwestern Medical Center in Dallas, made the following observations:
Based on these and earlier findings, "we continue to advise patients who are taking pergolide to stop taking the drug if possible and, if not, to undergo yearly echocardiography looking for valve regurgitation," the authors state.
"Our practice of recommending non-ergot dopamine agonists as first-line therapy for patients needing a dopamine agonist appears to be relatively safe from the standpoint of cardiac valve function."
As background, while several studies have linked Permax with cardiac valve regurgitation, the authors of this March 2007 report state that just one study has suggested that non-ergot-derived agents also increased the risk of this type of heart valve damage.