| アブストラクト | BACKGROUND: There is growing evidence that ergot dopamine agonists may induce cardiac valve regurgitation (CVR) in persons with Parkinson's disease. It is unclear whether the CVR risk is increased with ergot-dopamine agonist use in persons with hyperprolactinaemia, in whom the dose is much lower. OBJECTIVE: The aim of the study was to explore the association between different dopamine agonists and CVR in patients with Parkinson's disease or hyperprolactinaemia. DESIGN: Nested case-control studies conducted separately in cohorts of Parkinson's disease and hyperprolactinaemia patients. Cases were patients who developed newly diagnosed CVR. Controls were CVR-free patients from the same cohorts and were matched to cases by age, sex, database and calendar year. SETTING AND PATIENTS: Study patients were identified from over 4.5 million persons in The Health Improvement Network (THIN; UK), Health Search (Italy), and Integrated Primary Care Information (IPCI; the Netherlands) general practice databases in the years 1996-2007. The Parkinson's disease cohort included new users of dopamine agonists or levodopa, while the hyperprolactinaemia cohort included new users or non-users of dopamine agonists. MAIN OUTCOME MEASURE: Risk of newly diagnosed CVR with dopamine agonist use compared with levodopa use in the Parkinson's disease cohort, and dopamine agonist-naive patients in the hyperprolactinaemia cohort. RESULTS: In the Parkinson's disease cohort (7893 dopamine agonist users, 11 766 levodopa users), 85 incident CVR cases were identified. Increased CVR risk was observed for ergot dopamine agonists (adjusted OR [OR(adj)] 3.82; 95% CI 2.14, 6.81), but not for non-ergot dopamine agonists (OR(adj) 1.20; 95% CI 0.63, 2.29). In the hyperprolactinaemia cohort (6740 dopamine agonist users and 14 299 dopamine agonist-naive patients), 37 CVR cases were identified during a mean follow-up of 4.5 years and 3.5 years for new users and non-users of dopamine agonists, respectively. However, no association with ever use of ergot dopamine agonists was observed (OR(adj) 0.47; 95% CI 0.20, 1.19). CONCLUSION: Ergot-derived dopamine agonists are associated with an increased risk of CVR in Parkinson's disease but not in hyperprolactinaemia patients. |
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| ジャーナル名 | Drug safety |
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| 投稿日 | 2011/12/30 |
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| 投稿者 | Trifiro, Gianluca; Mokhles, M Mostafa; Dieleman, Jeanne P; van Soest, Eva M; Verhamme, Katia; Mazzaglia, Giampiero; Herings, Ron; de Luise, Cynthia; Ross, Douglas; Brusselle, Guy; Colao, Annamaria; Haverkamp, Wilhelm; Schade, Rene; van Camp, Guy; Zanettini, Renzo; Sturkenboom, Miriam C |
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| 組織名 | Department of Medical Informatics, Erasmus University Medical Center, Rotterdam,;the Netherlands. g.trifiro@erasmusmc.nl |
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| Pubmed リンク | https://www.ncbi.nlm.nih.gov/pubmed/22204718/ |
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