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Parkinson's Permax Heart Valve Disease
Since Permax was approved in 1988, 12,000 to 25,000 patients have been 
prescribed the drug to treat the symptoms associated with Parkinson's. 
Permax is primarily used to treat Parkinson's patients during the early 
stages of the disease. Recent studies have revealed Permax heart valve 
disease problems in Parkinson's patients following long-term use of the 
drug.

Men and women are affected by Parkinson's disease in almost equal numbers. 
Parkinson's disease is the most commonly diagnosed neurodegenerative 
disorder after Alzheimer's. According to the National Institute of 
Neurological Disorders and Stroke, around 50,000 new Parkinson's Disease 
cases are reported annually. Since its approval doctors have prescribed 
Permax to over 500,000 Parkinson's and Restless Legs Syndrome patients.

Parkinson's symptoms are characterized in four primary ways:

. rest tremor of a limb (shaking with the limb at rest)
. rigidity (stiffness of the limbs and trunk)
. slowness of movement (bradykinesia)
. postural instability (poor balance)

Permax (peroglide) is a member of a class of drugs referred to as dopamine 
agonists and is used to help treat symptoms of Parkinson's disease. Most 
Parkinson's symptoms are caused by a lack of dopamine. Medications such at 
Permax are used to treat Parkinson's by attempting to mimic dopamine which 
helps improve the symptoms associated with Parkinson's disease.

Recent studies have shown an increased risk of Permax heart valve disease in 
Parkinson's patients who have taken the drug over a long period of time. A 
new Permax study, "Cardiac Valve Regurgitation With Peroglide Compared With 
Nonergot Agonists in Parkinson Disease", was published in the March 2007 
issue of the medical journal Archives of Neurology. This study involved 
Parkinson's patients and showed an increased risk of Permax heart valve 
disease following long-term use of the drug. Two other Permax studies 
conducted in Britain and Italy also revealed a significant increase in 
Parkinson's patients developing heart valve disease. Permax valve injuries 
were found in around one-fourth of Parkinson's patients taking the drug.

In 2006 a black box warning was added to the Permax label following serious 
concerns of heart valve disease risks in Parkinson's patients taking the 
drug. On March 29, 2007 the FDA announced a Permax recall after more studies 
revealed increasing evidence of Permax heart valve disease in Parkinson's 
patients. The FDA stated that the withdrawal of Permax from the marketplace 
would not be immediate in order to allow time for doctors and patients to 
discuss appropriate alternative treatment options.

Rayilyn Brown
Director AZNPF
Arizona Chapter National Parkinson Foundation
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