Dopamine agonists and ischemic complications in Parkinson's disease: a nested case-control study

Eur J Clin Pharmacol. 2012 Jan;68(1):83-8. doi: 10.1007/s00228-011-1084-6. Epub 2011 Jul 22.

Abstract

Background: It has been suggested that ergoline dopamine agonists can cause ischemic complications. The effect of dopamine agonists in general on the prevalence of ischemic events in patients with Parkinson's disease (PD) has not been studied.

Objective: Our aim was to investigate the association between the use of dopamine agonists and hospitalization due to ischemic events in patients with PD.

Methods: We performed a nested case-control study using the PHARMO Institute for Drug Outcome Research database. All patients issued at least one prescription for levodopa after the age of 55 years between 1994 and 2006 were initially identified. Cases were patients who were hospitalized for the first time after November 1997 for an ischemic event and were matched to as many as four controls. Exposure to dopamine agonists during the year preceding the index date was identified.

Results: The study population consisted of 542 cases and 2,155 controls. The mean effect of dopamine agonist use 1 year prior to the index date on ischemic events requiring hospitalization is shown with 95% probability in the 0.95-1.49 range. Stratified results according to the type of dopamine agonist showed no risk differences between ergoline and nonergoline agonists.

Conclusions: This study does not support an association between dopamine agonist use and an increased risk of ischemic events requiring hospitalization.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Antiparkinson Agents / adverse effects*
  • Antiparkinson Agents / therapeutic use
  • Brain Ischemia / chemically induced
  • Brain Ischemia / etiology
  • Brain Ischemia / therapy
  • Case-Control Studies
  • Databases, Factual
  • Dopamine Agonists / adverse effects*
  • Dopamine Agonists / therapeutic use
  • Drug Prescriptions
  • Ergolines / adverse effects
  • Ergolines / therapeutic use
  • Female
  • Hospitalization
  • Humans
  • Ischemia / chemically induced*
  • Ischemia / etiology
  • Ischemia / therapy
  • Levodopa / therapeutic use
  • Male
  • Myocardial Ischemia / chemically induced
  • Myocardial Ischemia / etiology
  • Myocardial Ischemia / therapy
  • Netherlands / epidemiology
  • Parkinson Disease / drug therapy*
  • Parkinson Disease / physiopathology
  • Practice Patterns, Physicians'
  • Prevalence
  • Raynaud Disease / chemically induced
  • Raynaud Disease / etiology
  • Raynaud Disease / therapy
  • Severity of Illness Index

Substances

  • Antiparkinson Agents
  • Dopamine Agonists
  • Ergolines
  • Levodopa