Parkinson's Drug Linked to Heart Valve Damage

NEW YORK (Reuters Health) - Taking the drug Permax, or pergolide, to treat Parkinson's disease or restless legs syndrome appears to be associated with an increased risk of developing a problem with the aortic valve, the main outlet of the heart, investigators have found.

"Physicians should not hesitate to use the drug when indicated, but be aware of the relatively low risk of valvular disease when the drug is used in standard doses," co-author Dr. Joseph Kaplan told Reuters Health.

Kaplan and colleagues from the Mayo Clinic College of Medicine in Jacksonville, Florida, investigated how often heart valve disease occurred in patients taking pergolide, prompted by previous reports of problems in at least 15 patients.

The team found that among 55 patients taking pergolide for at least 6 months, 45 percent had some degree of aortic regurgitation -- a weakness in the aortic valve that allows the backflow of blood. The condition was also seen in 21 percent of a comparison group of subjects not taking pergolide.

Only one patient taking pergolide had severe valvular regurgitation, the researchers report in the Mayo Clinic Proceedings.

Patients with moderate to severe aortic regurgitation were on an average dose of 3.0 milligrams daily of pergolide, the researchers note, whereas the average dose among patients with mild or no aortic regurgitation was only 0.5 milligrams per day.

"If a cause-effect relationship exists between the use of pergolide and valvular heart disease, it likely occurs at a low but clinically important incidence and may be associated with dosage," the researcher conclude.

"Since there are many effective agents for both Parkinson's and restless legs syndrome, clinicians may wish to make pergolide a second- or third-line drug when prescribing for these disorders," Kaplan suggested.

SOURCE: Mayo Clinic Proceedings, August 2005.