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Mayo: Parkinson's drug may damage heart valvesMaura Lerner
Star Tribune Published Dec. 11, 2002    VALV11Mayo Clinic doctors say a drug 
for Parkinson's disease could damage people's heart valves in much the same 
way as the diet drug combination known as fen-phen.
Mayo physicians discovered heart valve disease in three women taking 
pergolide, or Permax, a drug used to treat restless-leg syndrome as well as 
Parkinson's, according to a study released Tuesday.
They said the valve damage was "strikingly similar" to that found in patients 
taking fen-phen (fenfluramine and phentermine), the diet pill combo that was 
pulled off the market in 1997 after Mayo brought to light the valve problems. 
"Given this possible association, we recommend that all patients taking 
pergolide undergo a thorough cardiovascular examination," the authors 
reported in December's Mayo Clinic Proceedings.
The drug's manufacturer, Eli Lilly and Co., said it has received about a 
dozen reports of valve disease in the half-million patients who have taken 
Permax in the past 13 years. "We're talking about very rare occurrences," 
said Kindra Strupp, a corporate spokeswoman in Indianapolis. 
But she said the company is changing its warning label to add that risk, at 
the request made by the U.S. Food and Drug Administration several weeks ago, 
about the same time that the company learned of the Mayo Clinic's study. 
"There's not really a clear causal relationship," she said of the findings. 
But "we just know that, given the nature of the reports, that it seems 
prudent to make sure we include this in our label."
The report, by cardiologist Dr. Raul Espinosa and colleagues, urged patients 
to stop taking pergolide if valve disease is detected.
In an accompanying editorial, another cardiologist says the danger deserves 
notice. "Is the association with use of the drug real? Yes, until proved 
otherwise," wrote Dr. Shahbudin Rahimtoola, a professor at the University of 
Southern California at Los Angeles.
"One could argue that this is a report of only three patients and that we 
should wait for more cases; however, try telling that to patients and 
families of those who subsequently develop [disease] that requires valve 
replacement."
He said more research is needed to confirm the risk. 
The drug has been known to pose risks to people with irregular heartbeats.
-- Maura Lerner is at [log in to unmask]

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