Dopamine agonists and valvular heart disease in patients with Parkinson's disease: evidence and mystery

Abstract

Dopamine agonists and valvular heart disease in patients with Parkinson's disease: evidence and mysterySince the first case report [28], further case reports [4,7,8,19,21,27,30], one observational report [2], case-control studies [12,17,18,[31][32][33][34], and one cohort study [26] conducted in PD patients have demonstrated similar findings of fibrotic VHD caused by ergot dopamine ag-JON 5012 ■ Abstract High doses of the ergot dopamine agonists, pergolide and cabergoline, frequently cause valvular regurgitation and, somewhat less frequently, valvular heart disease (VHD) in Parkinson's disease. Most patients with valvular regurgitation have no cardiac signs

Assessing the Impact on Health of Pharmacovigilance Activities: Example of Four Safety Signals

“…However, some studies did not find this dose relationship of the ADR. Therefore, more research is necessary to determine the effect of dose on the development of ADRs [27,36,[39][40][41][42][43][44]. There is also some debate on the correlation between duration of treatment and the increased risk of valvulopathy [27,28,37,38,[45][46][47].…”

Medication Management of Parkinson's Disease: Early versus Advanced Stages

“…Thus, valvular regurgitation caused by pergolide is infrequently reported in Japan. 32 There are several methods to perform a switch, such as overnight (switching within 1 day with estimated conversion factor and weekly adjustments thereafter), overlap, or gradually (stopping the former medication and then switching to the new one over several days to weeks). In advanced PD, patients reach superior Unified Parkinson's Disease Rating Scale (UPDRS) score to baseline more quickly in rapid than slow titration groups (mean 2.1 weeks vs. 5.3 weeks).…”

Development, Validation, and Use of Quantitative Structure−Activity Relationship Models of 5-Hydroxytryptamine (2B) Receptor Ligands to Identify Novel Receptor Binders and Putative Valvulopathic Compounds among Common Drugs

“…2 After the initial 2002 report, other cases of VHD associated with pergolide or other dopamine agonists such as cabergoline used as anti-parkinsonian drugs were identified. [3][4][5] In January of 2007, The New England Journal of Medicine published two large European studies that independently verified the association of VHD with pergolide and cabergoline. 6,7 Finally, on March 29, 2007, the Food and Drug Administration issued a Public Health Advisory for the voluntary market withdrawal of pergolide.…”

“…More recently, a group at the Mayo Clinic reported VHD in patients taking the anti-Parkinson drug pergolide . After the initial 2002 report, other cases of VHD associated with pergolide or other dopamine agonists such as cabergoline used as anti-parkinsonian drugs were identified. − In January of 2007, The New England Journal of Medicine published two large European studies that independently verified the association of VHD with pergolide and cabergoline. , Finally, on March 29, 2007, the Food and Drug Administration issued a Public Health Advisory for the voluntary market withdrawal of pergolide. These stunning withdrawals of drugs from the market stressed the importance of elucidating the mechanism by which these drugs induce valvulopathy and of determining the valvulopathic risk that may be associated with new drug candidates or even existing drugs.…”