2nd UPDATE: Two Studies Show Botox Helps Against Migraines
September 10 2009 - 11:17AM
Dow Jones News
Details from two studies examining Allergan Inc.'s (AGN) wrinkle
fighter Botox as a chronic migraine headache treatment could help
secure broader access to a market potentially valued at $500
million a year for the company.
Allergan announced key results from the company-sponsored
studies a year ago, including the fact that one missed its main
goal but succeeded on another point the company said the Food and
Drug Administration cares about most: reducing the frequency of
days with headaches. Data from the studies made public Thursday
showed good performance on this front, according to analysts.
The data "are solid and should lead to FDA approval" of Botox as
a treatment for people with frequent migraines, according to
William Blair's Ben Andrew.
Allergan shares, which received a big boost when the trial
results were released last September, recently traded up 1.1% to
$56.80. Jefferies analyst Peter Bye noted that investor
expectations for solid data were already "firmly in hand."
This is an important growth opportunity for the injectable drug,
which posted $1.31 billion in sales last year. Allergan has
estimated the migraine market could eventually be worth up to $500
million a year in additional sales, should the FDA grant approval,
and some analysts supported that assessment after seeing the study
details.
Though perhaps best known for treating facial creases, Botox is
also used for several different medical conditions. Along with
frown lines, the neurotoxin is approved in the U.S. to treat
uncontrollable blinking, crossed eyes, uncontrollable contractions
of neck and shoulder muscles and excessive underarm sweating. For
migraines, the drug is delivered through several injections around
the head, where it may affect migraine-related nerves.
There is already an estimated $50 million market for Botox as a
migraine treatment, since doctors can use approved drugs for other
purposes. But Allergan - which received a Department of Justice
subpoena related to Botox sales and marketing early last year -
can't market Botox for headaches without FDA approval.
Approval could also help pave the way for broader insurance
reimbursement. Additionally, Wells Fargo analyst Larry Biegelsen
said potential endorsement from the American Academy of Neurology
could drive off-label use if the FDA doesn't approve Botox for
migraines next year.
Allergan didn't issue any statement in conjunction with the
fresh study details, but spokeswoman Caroline Van Hove confirmed
the company plans to file with the FDA by the end of the third
quarter seeking clearance to market Botox for migraines. Analyst
Bye sees potential for approval in early 2011.
The new data were made available by the American Headache
Society and its international counterpart, which are hosting a
meeting in Philadelphia this week. Thus far "abstract" details are
available, which give a view into key numbers, but not broad
details.
Biegelsen said safety data need to be examined more closely. But
he also said the data look positive and match up favorably compared
with data for a well-known migraine drug - Johnson & Johnson's
(JNJ) Topamax.
As a migraine treatment, Botox is aimed at people who suffer
with the debilitating headaches at least 15 days a month and may
not get relief from other treatments. The drug doesn't stop
headaches altogether, but if it keeps them from occurring as often,
it may be a useful tool.
The two trials included a total of 1,384 patients who received
either Botox or a fake treatment and were tracked for 24 weeks. In
the first trial, Botox reduced the number of headache days by 7.8
days, compared with a 6.4-day reduction among patients on a
placebo.
In the second trial, Botox-treated patients saw a nine-day
reduction in migraines, compared with a 6.7-day reduction among
placebo-treated patients. The gap between the results with Botox
and placebo is considered statistically significant.
The first trial's main goal was to lessen the number of migraine
episodes compared with a placebo, and the trial failed on that
measure. But it succeeded on the secondary goal of cutting headache
days, which Allergan has said the FDA is most interested in seeing
anyway.
Due to this result, Allergan switched the second study's goals
before data were unmasked, and that study was successful on both
headache days and episodes.
-By Jon Kamp, Dow Jones Newswires; 617-654-6728;
jon.kamp@dowjones.com