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Eng-King Tan, MD, FRCP

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I read with interest the article by Kleiner-Fisman and Fisman¹ where they highlighted a 16% prevalence of peripheral edema presumably induced by pramipexole in patients with Parkinson disease (PD). This was consistent with the finding in the CALM-PD study² but much higher than the 5% in some of the earlier studies.³ Although the authors suggest that the 16% prevalence may be an overdiagnosis due to the retrospective nature of the study, there are a number of considerations that need to be examined before comparisons with published figures can be reliably made. These include problems in the recognition and diagnosis of peripheral edema and the interpretation of the causal relationship between pramipexole and this potential adverse medical complication.

In most situations, it's the patients who draw their physicians' attention to the swollen limbs. Whether it is in clinical trials or in routine neurological consultations, unless the physician . . . [Full Text of this Article]

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Peripheral Edema and Dopamine Agonists in Parkinson Disease—Reply
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