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New Message on Pituitary Chat

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From: MinnieChat
Message 10 in Discussion

http://www.aace.com/newsroom/inthenews/AACEAlert_cabergoline.pdf    
January 9, 2007 
To: AACE Membership 
Subject: AACE Alert on Prescribing cabergoline and pergolide 
The New England Journal of Medicine published two articles and an editorial 
concerning 
the relationship between dopamine agonists and the risks of heart valve disease 
in the 
January 4th 2007 edition. These were European studies and the vast majority of 
the 
patients had Parkinson’s Disease and were taking much higher doses of these 
agents than 
would typically be required for treatment of hyperprolactinemia. The first 
article by Rene 
Schade et al demonstrates an association between the use of pergolide or 
cabergoline and 
valvular heart disease. There was no association noted with cabergoline doses 
under 3 mg 
per day and no association with other dopamine agonists, such as bromocriptine. 
In the 
second article by Renzo Zanettini et al, the study was limited to patients with 
Parkinson’s 
disease with average daily dosing of about 3.6 mg daily in the cabergoline 
group and 2.8 
mg in the pergolide group. The groups were not divided out by daily dose in 
this study. 
For patients with prolactin disorders, the use of bromocriptine and typical 
doses of 
cabergoline that fall below 3 mg per day do not appear to be associated with an 
increased 
risk of valvular disease. It would be prudent to discuss these issues with 
patients and 
evaluate those patients that may be at particular risk for valvular disease. 
AACE will 
continue to monitor the situation and update you as more information becomes 
available. 
Sincerely, 
Steven M. Petak, MD, JD, FACE, FCLM 
President, American Association of Clinical Endocrinologists

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