title: Cardiac and noncardiac fibrotic reactions caused by ergot-and nonergot-derived dopamine agonists.
abstract: There is growing evidence that the ergot-derived dopamine agonists cabergoline and pergolide can cause fibrotic cardiac valvulopathy. Data on other fibrotic reactions and nonergot-derived dopamine agonists are sparse. Aim of this study was to investigate whether there are signals that dopamine agonists are related to cardiac and other fibrotic reactions. We identified all reports of fibrotic reactions at the heart, lung, and retroperitoneal space associated with dopamine agonists within the US Adverse Event Reporting System database. Disproportionality analyses were used to calculate adjusted reporting odds ratios (RORs). For ergot-derived dopamine agonists (bromocriptine, cabergoline, pergolide), the RORs of all reactions under study were increased, whereas no such increases were observed for nonergot-derived drugs (apomorphine, pramipexole, ropinirole, rotigotine). Fibrotic reactions due to ergot-derived dopamine agonists may not be limited to heart valves. For nonergot-derived dopamine agonists, no drug safety signals were evident.
authors.affiliation: Bremen Institute for Prevention Research and Social Medicine, University of Bremen, Germany. andersohn@bips.uni-bremen.de
authors.forename: Frank
authors.initials: F
authors.lastname: Andersohn
authors.forename: Edeltraut
authors.initials: E
authors.lastname: Garbe
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001058:Apomorphine / Q000009:adverse effects; D052160:Benzothiazoles / Q000009:adverse effects; D001971:Bromocriptine / Q000009:adverse effects*; D000077465:Cabergoline; D016208:Databases, Factual; D018491:Dopamine Agonists / Q000009:adverse effects*; D004719:Endomyocardial Fibrosis / Q000139:chemically induced* / Q000453:epidemiology; D004873:Ergolines / Q000009:adverse effects*; D005260:Female; D005355:Fibrosis / Q000139:chemically induced / Q000453:epidemiology; D006349:Heart Valve Diseases / Q000139:chemically induced* / Q000453:epidemiology / Q000473:pathology; D006801:Humans; D007211:Indoles / Q000009:adverse effects; D008297:Male; D008875:Middle Aged; D010479:Pergolide / Q000009:adverse effects*; D010493:Pericarditis / Q000139:chemically induced* / Q000453:epidemiology / Q000473:pathology; D010995:Pleural Diseases / Q000139:chemically induced* / Q000453:epidemiology; D000077487:Pramipexole; D011658:Pulmonary Fibrosis / Q000139:chemically induced* / Q000453:epidemiology; D012185:Retroperitoneal Fibrosis / Q000139:chemically induced* / Q000453:epidemiology; D013764:Tetrahydronaphthalenes / Q000009:adverse effects; D013876:Thiophenes / Q000009:adverse effects; D014481:United States / Q000453:epidemiology
chemical_list: D052160:Benzothiazoles; D018491:Dopamine Agonists; D004873:Ergolines; D007211:Indoles; D013764:Tetrahydronaphthalenes; D013876:Thiophenes; C046649:ropinirole; D010479:Pergolide; D001971:Bromocriptine; D000077487:Pramipexole; C047508:rotigotine; D000077465:Cabergoline; D001058:Apomorphine