25.01.2008 22:52:00
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Allergan, Inc. Responds to Public Citizen's Allegation Regarding a Fatality Following BOTOX(R) Cosmetic Treatment
In response to public reports suggesting a causal link between a BOTOX®
Cosmetic treatment in 2003 and a fatality, Allergan, Inc. (NYSE:AGN)
today provided further assurance to patients and the public about BOTOX®
Cosmetic and BOTOX®
(Botulinum Toxin Type A).
On January 23, Public Citizen, an advocacy group founded by Ralph Nader,
filed a petition with the U.S. Food and Drug Administration (FDA)
requesting labeling changes for botulinum toxins marketed in the United
States. In media interviews today, a representative of Public Citizen
appeared to suggest that BOTOX®
Cosmetic caused the death of a single patient in 2004. This is untrue.
"Since its approval, over a million people
have been treated with BOTOX®
Cosmetic. In its entire history, there has never been a single reported
death where a causal link to BOTOX®
Cosmetic was established,” said Dr. Sef
Kurstjens, Allergan’s Chief Medical Officer. "In
a recent interview, a representative of Public Citizen appeared to
suggest that there was a reported fatality associated with BOTOX®
Cosmetic. A medical review of this actual case demonstrates that the
patient passed away in the winter of 2004 from complications associated
with staphylococcus pneumonia, not from a BOTOX®
Cosmetic treatment the patient received 7 weeks earlier. This conclusion
is consistent with the assessment of the treating physician.”
BOTOX® Cosmetic
is approved in the United States for the aesthetic treatment of
glabellar lines (the vertical lines between the brows). Additionally,
under a separate label, BOTOX®
has been approved for more than 18 years to treat serious medical
conditions such as cervical dystonia, strabismus (crossed eyes), and
blepharospasm (uncontrollable blinking). BOTOX® is often administered to patients who suffer from other
chronic, debilitating neurological conditions who are at increased risk
for mortality from underlying diseases, concomitant medications and
other risk factors which themselves can cause serious adverse events.
Nevertheless, reported serious adverse events after therapeutic
treatment of BOTOX®
are rare.
In the United States, adverse event reports are reported into the FDA’s
Adverse Event Reporting System (AERS) database. The AERS database is
intended to encourage physicians to report any drug reaction; however,
the report of the event does not by itself mean that the treatment
caused the event, just that the event occurred after treatment with the
drug. As the FDA cautions, "for any given
report, there is no certainty that a suspected drug caused the reaction.”1
So, for instance, if Allergan is notified of an adverse event from any
source, it is required to make an "adverse
event report” to the FDA even if Allergan or
the physician has not established that BOTOX® caused the event and, indeed, even if the treating physician
has affirmatively concluded that BOTOX®
was not the cause of the event.
In its petition, Public Citizen cites adverse event reports culled from
the AERS database over a 10-year period from 1997 through 2006. A
representative for Public Citizen stated in press interviews that there
is a definite causal relationship between BOTOX®
and these adverse events. This conclusion, however, is contrary to
Public Citizen’s own admission in its
petition which explicitly states that "causality
cannot be proved” with respect to these
adverse event reports.2 "Our first priority is the safety and well
being of the patients who use our products,”
added Dr. Kurstjens. "In the last 18 years
since BOTOX® was
first approved by the FDA to treat rare eye disorders, Allergan has
vigilantly monitored the use of the product and worked closely with the
FDA to ensure that all appropriate warnings and guidance are in the
product labels. We also work closely with the medical community to
educate them on the safe administration of the product. And we proudly
stand behind the more than 20 years of research that has supported the
approval of 20 different indications for BOTOX®
around the world.”
For any medical inquiries related to the proper use of BOTOX®
Cosmetic or BOTOX®,
please contact Allergan’s Medical
Information Department at 1-800-433-8871.
Important BOTOX®
and BOTOX®
Cosmetic (Botulinum Toxin Type A) Information
BOTOX® is
indicated for the treatment of cervical dystonia in adults to decrease
the severity of abnormal head position and neck pain associated with
cervical dystonia.
BOTOX® is also
indicated for the treatment of strabismus and blepharospasm associated
with dystonia, including benign essential blepharospasm or VII nerve
disorders in patients 12 years of age and above.
The efficacy of BOTOX®
treatment in deviations over 50 prism diopters, in restrictive
strabismus, in Duane’s syndrome with lateral
rectus weakness, and in secondary strabismus caused by prior surgical
over-recession of the antagonist has not been established. BOTOX®
is ineffective in chronic paralytic strabismus except when used in
conjunction with surgical repair to reduce antagonist contracture.
And BOTOX® is
indicated for the treatment of severe primary axillary hyperhidrosis
that is inadequately managed with topical agents.
BOTOX® Cosmetic is
approved for the temporary treatment of moderate to severe frown lines
between the brows in people ages 18-65.
Important BOTOX®
and BOTOX®
Cosmetic (Botulinum Toxin Type A) Safety Information
BOTOX® and BOTOX®
Cosmetic treatment should not be injected in the presence of infection
at the proposed injection site(s) and in individuals with known
hypersensitivity to any ingredient in the formulation.
Serious heart problems and serious allergic reactions have been reported
rarely. If you think you’re having an
allergic reaction or other unusual symptoms, such as difficulty
swallowing, speaking or breathing, call your doctor immediately.
Individuals with peripheral motor neuropathic diseases (e.g.,
amyotrophic lateral sclerosis, or motor neuropathy) or neuromuscular
junctional disorders (e.g., myasthenia gravis or Lambert-Eaton syndrome)
should only receive BOTOX® or BOTOX® Cosmetic
with caution. Patients with neuromuscular disorders may be at increased
risk of clinically significant systemic side effects with BOTOX® or BOTOX® Cosmetic.
For full prescribing information, please visit www.botox.com
and www.botoxcosmetic.com.
BOTOX® for
Blepharospasm in Patients = 12 Years of Age:
Reduced blinking from BOTOX® injection of the orbicularis muscle can lead to corneal exposure,
persistent epithelial defect and corneal perforation. The most
frequently reported treatment-related adverse reactions in these
patients are ptosis (20.8%), superficial punctate keratitis (6.3%) and
eye dryness (6.3%).
BOTOX® for
Strabismus in Patients = 12 Years of Age:
Inducing paralysis in one or more extraocular muscles may produce
spatial disorientation, double vision or past pointing. The most
commonly reported adverse effects are ptosis (16%) and vertical
deviation (17%).
BOTOX® for
Cervical Dystonia in Adults: There have been rare cases of dysphagia
severe enough to warrant the insertion of a gastric feeding tube. The
most frequently reported adverse reactions in patients with cervical
dystonia are dysphagia (19%), upper respiratory infection (12%), neck
pain (11%), and headache (11%).
BOTOX® for
Severe Primary Axillary Hyperhidrosis Inadequately Managed with Topical
Agents: The most frequently reported adverse events (3 - 10%) are
injection site pain and hemorrhage, non-axillary sweating, infection,
pharyngitis, flu syndrome, headache, fever, neck or back pain, pruritus,
and anxiety.
BOTOX® Cosmetic
for Temporary Improvement in the Appearance of Moderate to Severe Frown
Lines Between the Brows in Adults 18-65: The most common side
effects following injection include temporary eyelid droop and nausea.
Localized pain, infection, inflammation, tenderness, swelling, redness
and/or bleeding/bruising may be associated with the injection.
Forward-Looking Statements
This press release contains "forward-looking
statements,” including statements regarding
the safety, effectiveness and adverse events associated with BOTOX®.
These statements are based on current expectations of future events. If
underlying assumptions prove inaccurate or unknown risks or
uncertainties materialize, actual results could vary materially from
Allergan's expectations and projections. Risks and uncertainties
include, among other things, general industry, biologic and
pharmaceutical market conditions; technological advances and patents
attained by competitors; challenges inherent in the research and
development and regulatory processes; inconsistency of treatment results
among patients; potential difficulties in manufacturing; and
governmental laws and regulations affecting domestic and foreign
operations. Additional information concerning these and other risk
factors can be found in press releases issued by Allergan, as well as
Allergan's public periodic filings with the Securities and Exchange
Commission, including the discussion under the heading "Risk Factors" in
Allergan's 2006 Form 10-K and Allergan's Form 10-Q for the quarter ended
September 28, 2007. Copies of Allergan's press releases and additional
information about Allergan is available on the World Wide Web at www.allergan.com
or you can contact the Allergan Investor Relations Department by calling
1-714-246-4636.
About Allergan, Inc.
Founded in 1950, Allergan, Inc., with headquarters in Irvine,
California, is a multi-specialty health care company that discovers,
develops and commercializes innovative pharmaceuticals, biologics and
medical devices that enable people to live life to its greatest
potential – to see more clearly, move more
freely, express themselves more fully. The Company employs more than
7,500 people worldwide and operates state-of-the-art R&D facilities and
world-class manufacturing plants. In addition to its
discovery-to-development research organization, Allergan has global
marketing and sales capabilities with a presence in more than 100
countries.
1. U.S. Food and Drug Administration, Center for Drug Evaluation
Research, Office of Post-Marketing Drug Risk Assessment. File for
Quarterly Data Extract from the Adverse Event Reporting System.
Available at: http://www.fda.gov/cder/aers/extract.htm.
Accessed: January 25, 2008.
2. Citizen.org. Petition to the FDA requesting regulatory action
concerning the possible spread of botulinum toxin (Botox, Myobloc) from
the site of injection to other parts of the body (HRG Publication #1834).
Available at: http://www.citizen.org/publications/release.cfm?ID=7559.
Accessed: January 25, 2008.
© 2008 Allergan,
Inc. Irvine, CA 92612. ®
and ™ marks owned by Allergan, Inc.
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