Chili Peppers Seen Helping 36 Million Migraine Sufferers; “We’re all looking for the next magic pill.”

Chili Peppers Seen Helping 36 Million Migraine Sufferers

Chili peppers and migraines have traits in common, a fact scientists are exploiting to develop drugs capable of preventing the debilitating headache’s painful symptoms before they attack.

The link between how skin reacts when rubbed with chili oil and what happens in the brain during a migraine has attracted the world’s largest biotechnology company, Amgen Inc. (AMGN), and other companies seeking to create medicines for the more than 36 million Americans who suffer from migraines.

Symptoms include nausea, vomiting, dizziness and sensitivity to touch, yet treatment options are limited. Some pharmaceutical companies that have tried recently to develop migraine therapies, such as Bristol-Myers Squibb Co. (BMY) and Merck & Co. (MRK), have abandoned their efforts while the few drugs on the market are ineffective for many people and carry the danger of serious side-effects for those at risk of heat attack or stroke.

“Migraines are an extremely common disorder, and it effects people really in the prime of their lives,” Rob Lenz, who is leading Amgen’s migraine drug development, said in an interview. Still, no drugs have been “developed specifically for the treatment of migraines,” he said. “They were developed as anti-epileptics, or blood pressure lowering agents.”

That may soon change. Amgen, based in Thousand Oaks, California, and other biotechnology companies such as Alder Biopharmaceuticals Inc., Arteaus Therapeutics LLC, and Labrys Biologics Inc. are targeting a chemical released during a migraine that carries a “pain” signal from nerve to nerve. By blocking a receptor from receiving the message, these companies aim to create drugs that cut off developing migraines before symptoms start.Targeted Injections

Similar pain-signal transmission occurs when chili oil touches the skin. In that situation, the capsaicin in the pepper causes the body to release calcitonin gene-related peptides, or CGRP, leading to an increase in blood flow to the affected area. To show the Amgen drug works, researchers injected it under the skin of patients who had chili oil on their skin. The therapy blocked the CGRP that causes increased blood flow.

“It sounds simple, but it’s important — it tells us that our drug is getting into the body in relative concentrations that are generally well tolerated and that block CGRP,” Lenz said.

The new class of drugs under development are biologics, often delivered by injection, and are more complex, targeted and longer lasting in the body than the earlier failed attempts, Lenz said.

Sales Potential

Amgen’s AMG 334 and Alder’s ALD 403 are being tested in the second of three clinical trials typically required for U.S. regulatory approval.

“We’ll have data on this before the year is out,” Randall Schatzman, chief executive officer of closely held Alder, based in Bothell, Washington, said in an interview.

If those trials yield results, the sales potential for these drugs will be significant. Michael Yee, an analyst with RBC Capital Markets in San Francisco, said Amgen’s new migraine treatment may reach $1 billion in sales should it gain approval.

Allergan Inc. (AGN)’s Botox, used primarily for cosmetic treatments, is also approved as a preventative therapy for migraines, though only for severe sufferers who have attacks lasting four hours or more at least 15 days a month. That means only about 10 percent of migraine patients qualify for that option. Sales for Botox as a migraine treatment alone could reach $1 billion during the next decade, Anne-Elise Tobin, an analyst with Burlington, Massachusetts-based Decision Resources, said in an interview. The new class of drugs would be for a bigger patient population with less frequent migraines.

Botox Success

“Botox demonstrates the market potential for a new emerging prophylaxis therapy,” said Tobin, who estimates the global market for all migraine treatments should increase 87 percent to $5.8 billion in 2021 from $3.1 billion in 2011.

Amgen increased 3.7 percent to $111.38 at the close of trading April 19 in New York. The stock gained 34 percent in 2012, it’s best annual increase since 1999, as investors rewarded the company for its buyback program, dividend and sales increase.

Currently, the most popular migraine treatments are oral drugs called triptans, first introduced in the 1990s, such as GlaxoSmithKline Plc’s Imitrex, which constrict blood vessels in the brain to relieve swelling and pain.

Pain Blockers

Those medicines attempt to halt migraines once they begin. The new therapies aim to eliminate the need to wait for attacks to occur, said John Latham, chief scientific officer at Alder.

“Once the migraine symptoms flair, it’s very hard to resolve them, and most of the people at that stage of the game let it run its course,” Latham said in a phone interview. “You can go into a dark room, turn the lights off, put ear plugs on, use an ice pack, but there’s not much you can do pharmaceutically to kick the migraine back in its place.”

That’s why the new pain blocker approach holds so much promise. By blocking a receptor in the brain from receiving the message, migraines could be avoided completely, said Peter Goadsby, director of the University of California, San Francisco’s Headache Center. Goadsby helped discover CGRP’s connection to migraines and has consulted with drug companies working on developing his findings into medicines.

“What these antibody approaches hope to do is to either block the receptor or mop up the CGRP itself,” he said.

This isn’t the first time drugmakers have targeted CGRP to stop migraines. Bristol-Myers and Merck were working a few years ago on so-called small molecule therapies, taken orally, to prevent headaches. While Merck’s drug, telcagepant, worked better than a placebo in a study, the company shelved development on concerns about liver damage. Bristol-Myers also said it wouldn’t continue development of its drug.

“The whole migraine world was thrown into a tizzy because this was supposed to be the next big thing,” Cathy Glaser, president and co-founder of the Migraine Research Foundation, said in an interview. “We’re all looking for the next magic pill.”

To contact the reporter on this story: Ryan Flinn in San Francisco at

About bambooinnovator
Kee Koon Boon (“KB”) is the co-founder and director of HERO Investment Management which provides specialized fund management and investment advisory services to the ARCHEA Asia HERO Innovators Fund (, the only Asian SMID-cap tech-focused fund in the industry. KB is an internationally featured investor rooted in the principles of value investing for over a decade as a fund manager and analyst in the Asian capital markets who started his career at a boutique hedge fund in Singapore where he was with the firm since 2002 and was also part of the core investment committee in significantly outperforming the index in the 10-year-plus-old flagship Asian fund. He was also the portfolio manager for Asia-Pacific equities at Korea’s largest mutual fund company. Prior to setting up the H.E.R.O. Innovators Fund, KB was the Chief Investment Officer & CEO of a Singapore Registered Fund Management Company (RFMC) where he is responsible for listed Asian equity investments. KB had taught accounting at the Singapore Management University (SMU) as a faculty member and also pioneered the 15-week course on Accounting Fraud in Asia as an official module at SMU. KB remains grateful and honored to be invited by Singapore’s financial regulator Monetary Authority of Singapore (MAS) to present to their top management team about implementing a world’s first fact-based forward-looking fraud detection framework to bring about benefits for the capital markets in Singapore and for the public and investment community. KB also served the community in sharing his insights in writing articles about value investing and corporate governance in the media that include Business Times, Straits Times, Jakarta Post, Manual of Ideas, Investopedia, TedXWallStreet. He had also presented in top investment, banking and finance conferences in America, Italy, Sydney, Cape Town, HK, China. He has trained CEOs, entrepreneurs, CFOs, management executives in business strategy & business model innovation in Singapore, HK and China.

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