Botox

A forum to post questions, answers and discussion about general medications not specifically for multiple sclerosis, such as prednisone, painkillers, etc.

Botox

Postby lyndacarol » Mon Aug 08, 2011 5:34 pm

There seems to be growing interest in using Botox for urinary problems:

http://www.reuters.com/article/2011/08/ ... 1J20110803

"Pyott said he expects U.S. regulators this year to approve Botox for those whose overactive bladder is caused by multiple sclerosis…"

Isn't the action of Botox to paralyze muscles? The muscles of the bladder, intestines, blood vessels, and even the skeletal muscles used in all kinds of movement (walking, everyday activities, etc.) could be at the root of the problem in MS because of the elevated insulin secretion in insulin resistance. Can someone tell me why MS was ever pigeonholed as a neurological disease? If MS were strictly neurological, why would Kegel exercises (which strengthen the pelvic MUSCLE floor) improve bladder problems?

The entire article:
Overactive bladder next Botox frontier

By Ransdell Pierson

NEW YORK | Wed Aug 3, 2011 5:22pm EDT

NEW YORK (Reuters) - Overactive bladders later this year could become the next big frontier for Botox, the anti-wrinkle drug, and significantly boost sales of the $1.5 billion-a-year product, according to Allergan Inc Chief Executive David Pyott.

Allergan earlier on Wednesday reported profit growth for the second-quarter, fueled largely by sales of Botox to smooth wrinkles and for a growing range of medical uses.

Overactive bladder, caused by uncontrollable contractions of the bladder, causes frequent urination, urgent need to urinate and inability to control urination.

"Current drugs for overactive bladder just don't work that well," Pyott said in an interview, "and studies show that after a year 70 percent of patients don't respond to treatment."

Standard treatments, pills called anticholinergics, including oxybutynin and GlaxoSmithKline PLC's Vesicare, are associated with dry mouth and can cause constipation and other side effects.

A single injection of Botox into the bladder can provide significant relief for up to nine months and significantly improve quality of life, Pyott said, particularly for adults who now need to wear diapers.

Pyott said he expects U.S. regulators this year to approve Botox for those whose overactive bladder is caused by multiple sclerosis and spinal cord injury, which together number about 350,000 patients in the United States.

Several years later, Allergan hopes to win approval to market it to a broader population of patients with overactive bladder.

Pyott declined to forecast sales of Botox for overactive bladder but said Wall Street analysts are projecting annual sales of up to $500 million. "For a company with a revenue base of $5.2 billion to $5.4 billion, another $500 million franchise is kind of cool," he said.

Botox, whose active ingredient is a toxin that blocks nerve signals, gets about half its sales from reducing wrinkles and the rest from a number of medical uses, including treatment of migraine headaches and spasticity.

The product's second-quarter sales rose 16 percent to $418 million, helped by its recent approval to treat migraines and a somewhat stronger economy, which enabled more patients to pay out of pocket for cosmetic uses.

Allergan said on Wednesday that net income rose to $249 million, or 79 cents per share, from $241 million, or 78 cents per share, in the year-earlier quarter.

Excluding special items, the company earned 96 cents per share. Analysts on average expected 95 cents, according to Thomson Reuters I/B/E/S.

Sales rose almost 14 percent to $1.40 billion, topping Wall Street forecasts of $1.34 billion. They would have increased 9.6 percent if not for the weaker dollar, which drives up the value of sales in overseas markets.

"Strong top-line trends continue," JP Morgan analyst Chris Schott said in a research note, "and we expect these dynamics to continue throughout 2011."

Schott said Allergan boosted its 2011 overall sales forecast by $120 million to $170 million. But he noted the company reported higher-than-expected spending in the second quarter on sales, general and administrative expenses.

Sales of prescription eye medicines, by far the company's biggest business, rose 14 percent to $658 million.

Sales of medical devices rose 12 percent to $245 million, fueled by demand for breast implants and dermal fillers.

But sales of the company's Lap Band product, to treat obesity, continued to decline, as did sales of the company's Latisse eyelash-growth product.

Allergan nudged up its full-year profit forecast to between $3.59 and $3.63 per share, excluding special items. It had previously expected $3.56 to $3.62.

Allergan closed up 3.1 percent at $79.79 on the New York Stock Exchange.

(Editing by Dave Zimmerman, Lisa Von Ahn and Steve Orlofsky)

(This story corrects paragraph 6 to say that Botox may work up to nine months (not a year) for overactive bladder, and corrects in paragraph 8 that the company hopes to sell the drug later to a broader group of OAB patients (but not for nocturia))
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Postby Wonderfulworld » Tue Aug 09, 2011 12:05 pm

I agree Lynda except for this:
Quote:
If MS were strictly neurological, why would Kegel exercises (which strengthen the pelvic MUSCLE floor) improve bladder problems?

The Kegel exercises work for lack of muscle tone of the bladder. Many MS-related bladder problems are caused by incorrect signalling in the brain - it thinks it needs to empty yet it doesn't. Or by spasming in the detrusor/ sphincter muscle that shuts before complete emptying is achieved, leaving a residue.

Kegel exercises do nothing if the problem is caused by a truly MS-related issue, but they are great if you have loss of muscle tone in the bladder.
~~~~~~~~~~~~~~~
Concussus Resurgo
~~~~~~~~~~~~~~~
RR-MS dx 1998 and Coeliac dx 2003
~~~~~~~~~~~~~~~
Copaxone, Cymbalta. EPO, Fish Oils, Vitamin D3 2000 IU daily, Cal/Mag/Zinc, Multivitamin/mineral, Co-Enzyme Q10, Probiotics, Milk Thistle.
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Postby lyndacarol » Tue Aug 09, 2011 4:59 pm

WonderfulWorld – I thank you for sharing your ideas with me; I enjoy the exchange of thoughts. From a TV spot recently I heard: "if no one ever challenged the status quo, the earth would still be flat." We are trying to challenge the status quo!

You wrote:
The Kegel exercises work for lack of muscle tone of the bladder. Many MS-related bladder problems are caused by incorrect signalling in the brain - it thinks it needs to empty yet it doesn't. Or by spasming in the detrusor/ sphincter muscle that shuts before complete emptying is achieved, leaving a residue.

Kegel exercises do nothing if the problem is caused by a truly MS-related issue, but they are great if you have loss of muscle tone in the bladder.


I wonder if inappropriate action by muscles (either smooth, as the detrusor/sphincter around the bladder, or skeletal muscles) prompted by either incorrect signaling by nerves or excess insulin flooding those cells and causing hypotonia (lack of muscle tone) or spasming in the muscles is the mechanism for most of our MS symptoms. Or perhaps, detrusor/sphincter muscles fail to coordinate their actions. To me, the muscles seem to be the key player. Which scientists would study this area?
Last edited by lyndacarol on Fri Oct 07, 2011 5:50 pm, edited 1 time in total.
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Postby lyndacarol » Tue Aug 09, 2011 5:05 pm

WonderfulWorld – In the Momentum magazine, Fall 2011 issue, which arrived yesterday, there is an article, "The role of drugs or surgery," which focuses on mobility. On page 18 Botox is listed as a medication used in mobility problems:

"Botox, or botulinum toxin, is another option for spasticity management. This drug paralyzes the muscles and is given as an injection into specific muscle groups.

'Botox often relieves painful spasms but it may not necessarily improve mobility, so it's important to have good communication about this decision and clear expectations among all parties,' Dr. Boissy cautioned."

Just thought you might find this interesting.
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Postby Wonderfulworld » Wed Aug 10, 2011 11:39 am

Quote:
Or perhaps, detrusor/sphincter muscles fail to coordinate their actions. To me, the muscles seem to be the key player. Which scientists would study this area?

I think this is likely too. I think Urologists/Neurologist combinations perhaps?

Quote:
WonderfulWorld – First, I apologize for using this thread on Aimspro/bladder problems for Botox/bladder problems; I do not wish to be a hijacker. Since Botox is in the news more and more with a connection to MS, perhaps a request to NHE for the creation of a Botox forum would be appropriate. I will do so and see if our postings here, WW, can be moved to that new forum; if you think likewise, please add your voice to the suggestion to NHE.

Not at all Lynda, half the fun of thisisms is seeing where threads go with info and musings.
I will ask NHE also, it would be interesting to have a dedicated forum especially as the treatment is becoming more popular.
The article sounds interesting, especially for those with leg spasms.
~~~~~~~~~~~~~~~
Concussus Resurgo
~~~~~~~~~~~~~~~
RR-MS dx 1998 and Coeliac dx 2003
~~~~~~~~~~~~~~~
Copaxone, Cymbalta. EPO, Fish Oils, Vitamin D3 2000 IU daily, Cal/Mag/Zinc, Multivitamin/mineral, Co-Enzyme Q10, Probiotics, Milk Thistle.
Wonderfulworld
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