Comparison of intradermal injection with iontophoresis of abobotulinum toxin A for the treatment of primary axillary hyperhidrosis: A randomized, controlled trial

Montaser‐Kouhsari, Laleh; Zartab, Hamed; Fanian, Férial; Noorian, Negin; Sadr, Bardia; Nassiri-Kashani, Mansour; Firooz, Alireza

doi:10.3109/09546634.2012.739679

Cited by 15 publications

(19 citation statements)

References 12 publications

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“…Duration of effect is only a few days with tap water and anticholinergic iontophoresis [19], however iontophoresis with BoNT may provide relief for three months [24]. Out of 27 patients who underwent iontophoresis with BoNT, 100% were found to have statistically significant improvement in sweating via gravimetry ( p < 0.05) [24,25,26]. The short- lived effect of current methods of electrophoresis makes it undesirable [27].…”

Section: Treatmentsmentioning

confidence: 99%

“…In a prospective, assessor blind study, Montaser-Kouhsari et al [25] compared the effect of A/Abo injection with A/Abo iontophoresis in 11 patients with AH. A/Abo (250 U) was injected intradermally into one axilla and the same dose was iontophoresed in the other.…”

Section: Axillary Hyperhidrosis (Ah)mentioning

confidence: 99%

“…In teenagers (who constitute a sizeable number of patients with primary hyperhydrosis) however, pain is often not acceptable and the return rate for treatment is low. The new data with iontophoresis [24,25,26] are encouraging and may particularly prove useful for young individuals with this condition. Unfortunately, the magnitude of the response with iontophoresis is still suboptimal and less than that seen with the injection technique (only 30%–35% sweat reduction beyond two weeks).…”

Section: Conclusion and Clinical Commentsmentioning

confidence: 99%

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Hyperhidrosis: Anatomy, Pathophysiology and Treatment with Emphasis on the Role of Botulinum Toxins

Lakraj

Moghimi

Jabbari

2013

Toxins

102

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Clinical features, anatomy and physiology of hyperhidrosis are presented with a review of the world literature on treatment. Level of drug efficacy is defined according to the guidelines of the American Academy of Neurology. Topical agents (glycopyrrolate and methylsulfate) are evidence level B (probably effective). Oral agents (oxybutynin and methantheline bromide) are also level B. In a total of 831 patients, 1 class I and 2 class II blinded studies showed level B efficacy of OnabotulinumtoxinA (A/Ona), while 1 class I and 1 class II study also demonstrated level B efficacy of AbobotulinumtoxinA (A/Abo) in axillary hyperhidrosis (AH), collectively depicting Level A evidence (established) for botulinumtoxinA (BoNT-A). In a comparator study, A/Ona and A/Inco toxins demonstrated comparable efficacy in AH. For IncobotulinumtoxinA (A/Inco) no placebo controlled studies exist; thus, efficacy is Level C (possibly effective) based solely on the aforementioned class II comparator study. For RimabotulinumtoxinB (B/Rima), one class III study has suggested Level U efficacy (insufficient data). In palmar hyperhidrosis (PH), there are 3 class II studies for A/Ona and 2 for A/Abo (individually and collectively level B for BoNT-A) and no blinded study for A/Inco (level U). For B/Rima the level of evidence is C (possibly effective) based on 1 class II study. Botulinum toxins (BoNT) provide a long lasting effect of 3–9 months after one injection session. Studies on BoNT-A iontophoresis are emerging (2 class II studies; level B); however, data on duration and frequency of application is inconsistent.

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Section: Treatmentsmentioning

confidence: 99%

Section: Axillary Hyperhidrosis (Ah)mentioning

confidence: 99%

Section: Conclusion and Clinical Commentsmentioning

confidence: 99%

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Hyperhidrosis: Anatomy, Pathophysiology and Treatment with Emphasis on the Role of Botulinum Toxins

Lakraj

Moghimi

Jabbari

2013

Toxins

102

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“…A preliminary randomized study comparing iontophoretically administered vs . intradermal injections of botulinum toxin treatment in patients with palmar hyperhidrosis recently showed that injections are more effective but more painful for the administration of BTX‐A . A larger trial is currently ongoing (clinicaltrials.gov identifier: NCT01262339) and will provide further data.…”

Section: Current Applications and Perspectivesmentioning

confidence: 99%

Trials and tribulations of skin iontophoresis in therapeutics

Roustit

Blaise

Cracowski

2013

Brit J Clinical Pharma

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Iontophoresis is a method of non-invasive transdermal drug delivery based on the transfer of charged molecules using a low-intensity electric current. Both local and systemic administration are possible; however, the skin pharmacokinetics of iontophoretically delivered drugs is complex and difficult to anticipate. The unquestionable theoretical advantages of the technique make it attractive in several potential applications. After a brief review of the factors influencing iontophoresis, we detail the current applications of iontophoresis in therapeutics and the main potential applications under investigation, including systemic and topical drugs and focusing on the treatment of scleroderma-related ulcerations. Finally, we address the issue of safety, which could be a limitation to the routine clinical use of iontophoresis.

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“…They have revealed the superiority of botulinum treatment in all measured points (respectively 84%, 76% and 50% vs 73%, 22%, and 32%). Short observation period may be considered to be disadvantage of their research (44).…”

Section: Botulinum Toxin Therapymentioning

confidence: 99%

Diagnosis and Treatment of Primary Hyperhidrosis

Stefaniak¹,

Dobosz²,

Kaczor³

et al. 2013

Polish Journal of Surgery

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Comparison of intradermal injection with iontophoresis of abobotulinum toxin A for the treatment of primary axillary hyperhidrosis: A randomized, controlled trial

Abstract: This study has shown that injection is a more effective method for the administration of BTX-A, though iontophoresis can also be considered a non-invasive and painless method in some patients.

Cited by 15 publications

References 12 publications

Hyperhidrosis: Anatomy, Pathophysiology and Treatment with Emphasis on the Role of Botulinum Toxins

Hyperhidrosis: Anatomy, Pathophysiology and Treatment with Emphasis on the Role of Botulinum Toxins

Trials and tribulations of skin iontophoresis in therapeutics

Diagnosis and Treatment of Primary Hyperhidrosis

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