A slide in an electronic presentation Dr. Mitchell Brin gives when he talks about Botox reads “topical toxin.”
It refers to an early-stage idea that’s part of an effort toward possible future treatment of an undisclosed malady by a to-be-decided formulation of the signature drug sold by Allergan Plc in Irvine.
It represents the kind of thing Brin does every day.
“I manage the research portfolio” of current and possible future uses for Botox, he said.
The senior vice president of global drug development at Allergan and chief scientific officer for Botox is one of the recipients of this year’s Business Journal Innovator of the Year awards (see related stories on pages 1, 6, 8 and 9).
Allergan is the longtime local drugmaker acquired in March 2015 by Actavis Plc. Actavis is based in Ireland, has U.S. operations in New Jersey, and kept Allergan’s name when it bought the firm.
Botox—a contraction of the words “botulinum toxin”—is a drug Allergan owns, makes and markets that’s based on a naturally occurring protein from bacteria that can kill nerve tissue; in rotten food, it can cause botulism. It’s widely known for treating wrinkles.
The uncertainty he faces some days—whether or not Botox will work on a particular issue—is more than balanced by a simple plan.
“Allergan uses Botox to help people,” he said.
Changed Lives
“This is a product that changes lives,” said Brin, who’s been working with the drug as a physician for 32 years and at Allergan for about half of that time.
Botox actually has 11 indications in the U.S.—regulatory approvals for specific uses—that delve far deeper than lines on one’s forehead, and beyond that into therapeutic applications. It’s approved to combat excessive armpit sweating, overactive bladder and chronic migraines.
Another use is for people who—literally—can’t keep their eyes open, a condition called blepharospasm.
“We’re always looking for more” applications for the drug, Brin said.
Areas of healthcare Botox currently touches include neurology, urology, dermatology and aesthetics.
It works in muscles, glands and pain nerves.
“We take a product of nature and make it good for people,” Brin said. “It helps them feel and function better.”
Dimensions
The research behind Botox began at the Department of Defense in 1934 and continued with studies in the late 1960s and early 1970s at the University of Wisconsin.
It has involved studying how sausage spoils, as well as canny doctors who noticed quirks in patients.
One physician who treated a person with Botox for a cosmetic use found that it also helped ease migraines.
Brin said that innovation with Botox is guided by serendipity and science, by what the drug can do now and what it might be able to do in the future.
“It’s about knowing the dimensions of the drug and keeping an open mind, because there are new dimensions to be learned.”
Those dimensions include the how, why and where in the body to use Botox and the exact amount of it to use.
Potent
Add nine zeroes and a number to the right of a decimal, and that’s roughly the number of milligrams of Botox in one dose. It depends on which of the indications is being treated.
Botox is injected—a vial looks not just unassuming but empty. Look closely, and note a smear of white on the bottom of the bottle. That’s Botox.
A vial contains mostly human albumin—a blood protein—and salt.
There are seven federal agencies that regulate or monitor the drug’s development, transport and use, due to its potency—the Food and Drug Administration, the FBI, the Transportation Security Administration, the Federal Aviation Administration, the Centers for Disease Control and Prevention, and the departments of homeland security and commerce.
Sometimes Botox doesn’t work. Allergan studied it at one time for prostate illness before discontinuing the efforts.
The drug might be useful for osteoarthritis, for major depressive disorder or in open-heart surgery for atrial fibrillation.
