Anti-Parkinson’s drugs can cause heart valve damage-Studies

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Parkinson's disease patients taking two anti-Parkinson drugs, named Permax and Dostinex are at greater risk of developing the same kind of heart damage that led to the removal of the diet drug combination "fen-phen," according to two studies published in the Jan. 4 issue of New England Journal of Medicine.

The drugs, Pergolide, developed by Eli Lilly & Co. and sold under the brand name Permax and Cabergoline, developed by Pfizer Inc. and sold under the brand Dostinex carry serious risks of damaging heart valves, the studies warned.

Fen-phen was an anti-obesity medication, which consisted of two drugs, fenfluramine and phentermine. After reports of valvular heart disease and pulmonary hypertension, specifically in women who took the "fen-phen" combination therapy, the Food and Drug Administration (FDA) requested its withdrawal from the market in September 1997.

The studies, one of which analyzed the records of 11,417 patients in Britain and one of which tested 245 patients in Italy, indicate that a quarter of those who take the above mentioned anti-Parkinson’s drugs had moderate to severe heart valve problems.

The British study, conducted by Dr. Edeltraut Garbe and colleagues from the Institute of Clinical Pharmacology, Charité, University Medicine, Germany, showed patients taking pergolide were 7.1 times more likely to develop heart valve damage than those who took other Parkinson’s treatments. They also found that patients taking mega doses of the drug had a 37 times greater risk.

And in case of cabergoline, patients were 4.9 times more likely to develop heart valve damage, while the large doses put the patients at 50.3 times more risks of damaging heart valve, a serious condition that can lead to heart failure and sudden death.

Almost 30 percent of the patients undergoing pergolide or cabergoline treatments were at greater risk for heart valve problems, the British study authors concluded.

In the second study Dr. Renzo Zanettini and his fellow researchers from the Instituti Clinici di Perfezionamento in Milan, Italy collected echocardiogram images of the hearts of 155 patients taking various Parkinson's treatments and a comparison group of 90 healthy people. Of Parkinson's disease patients 64 were taking pergolide, 49 were taking cabergoline, and 42 were taking non-ergot-derived dopamine agonists.

Zanettini lead group found that 23.4 percent of the patients taking pergolide had heart valve problems, while the figure rose to 28.6 percent in the case of cabergoline. None of the patients taking non-ergot-derived dopamine agonists had a heart problem, while just 5.6 percent in the control group suffered heart damage.

Like the British research, this study also showed the risks of advanced heart valve disease for those patients who were taking higher doses of pergolide or cabergoline.

"If you have Parkinson's, you need to find out from your doctor if you're taking a medication that could cause this risk of serious heart damage," suggests Dr. Bryan L. Roth, of the Department of Pharmacology at the University of North Carolina and author of a journal editorial, published along with the two studies.

"I would recommend not prescribing these medications at all. Our hope is that these two studies will encourage the FDA to remove these drugs from use" he added.