BioWorld Perspectives Contributing Writer

One can only hope that what goes around comes around. Lately, it has become common that a drug designed for one purpose gets a second life because of desirable side effects that have little or nothing to do with the original intent. Sometimes, the drug even gets a third life.

When the other incarnations of the drugs have little or no apparent medical value, and are instead used for what amounts to pure vanity, should we be using biotech research to put them on the market? The answers are as varied as the products.

For instance, human growth hormone originally was intended for children with growth disorders. Then "older people seeking the fountain of youth and athletes wanting a boost started finding illegal suppliers of HGH for muscle growth and overall toning," reported USA Today. HGH, a substance secreted by the pituitary gland, promotes growth during childhood and adolescence. The hormone acts on the liver and other tissues to stimulate production of insulin-like growth factor I, which is responsible for the growth-promoting effects of growth hormone and also reflects the amount produced.

Now researchers are looking at HGH to reduce body fat while increasing muscle mass, to delay AIDS wasting syndrome, and to treat Jacob-Creuzfeldt disease. It also may spur the regrowth of heart tissue and improve heart function, according to researchers at Children's Hospital Boston and Harvard Medical School.

Allergan's Botox and Latisse Success Stories
Similarly, Botox originally was approved by the FDA to reduce eye spasms. Then patients and the company saw that it eliminated wrinkles, helping people look younger. Allergan Inc., of Irvine, Calif., was primarily known for its eye care products before Botox, a drug made from a toxin produced by the bacterium Clostridium botulinum, which also causes a life-threatening type of food poisoning. The Botox injections work by weakening or paralyzing certain muscles or by blocking certain nerves, thus being effective on both spasms and wrinkles.

Allergan's Botox may yet have another life as researchers use the original concept of reducing spasms, but apply it to another part of the body. According to Anjali Shah, assistant professor, Divisions of Physical Medicine and Rehabilitation and Neurology, at the University of Texas Southwestern Medical Center and his colleagues, botulinum toxin type A injections can decrease spasticity and improve the quality of life in multiple sclerosis patients with spastic foot drop. The injections focally target spasticity and do not cause fatigue, he said on the Multiple Sclerosis Resource Centre website. Other reports claim that Botox might have application in treating headaches, and Allergan is seeking FDA approval for that application.

Along the same lines, Allergan found a second use for another drug. Originally, the biopharmaceutical company got FDA approval for Lumigan, a drug to treat glaucoma, one of the leading causes of blindness. Lumigan decreases pressure within the eye either by slowing the production of a fluid in the eye or by increasing the fluid drainage.

It also noticed that one of the side effects of Lumigan is longer, thicker, and darker eyelashes, and a new vanity product was born. Allergan developed a spin-off called Latisse, which the FDA approved for eyelash enhancement in December. While Lumigan drops are used in the eyes; Latisse is applied to the upper eyelid. Could bimatoprost, the active ingredient common to both drugs, have yet another use?

Turning Drugs that Beautify into Research Dollars
If bimatoprost had been discovered for its eyelash enhancing value before it garnered attention for its ability to treat glaucoma, it could have been considered a frivolous use of research dollars – if Allergan had even been willing to research it. Now that the company has found both medical and cosmetic uses for the same compound, it will rake in billions of dollars and be likely to fund research for even more uses of bimatoprost and other products.

In fact, one of the advantages of developing products that appeal to the Hollywood set — and of Allergan's proximity to that area 50 miles to the north — is that Hollywood stars often get involved in benefits that can generate high visibility and even more dollars for research. With Latisse as the catalyst, Allergan has teamed up with actress Brooke Shields and eyebrow specialist Anastasia Soare to help raise as much as $1 million for the Make a Wish Foundation.

The scientific community can hope that Latisse keeps delivering on its claims and that such luminaries as Brooke Shields will want to help Allergan to keep promoting the product, thereby generating sales and, ultimately, the research dollars that will create the next generation of medical treatment. Then the exercise in vanity will be an exercise in humanitarian good as well.

Published: August 20, 2009