Survival study of treatment adherence by patients given oral oxibutynin for hyperhidrosis

Abstract

This study was conducted to identify the variables associated with adherence to treatment by hyperhidrosis patients treated with oral oxybutynin. This information would facilitate selection of patients for this treatment and enhance our understanding of the biological behaviour of such anticholinergics when used to treat hyperhidrosis.

<p>Management Strategies Of Palmar Hyperhidrosis: Challenges And Solutions</p>

“…52 This suggests that a stepwise up-titration to the lowest dose of anticholinergics that achieves both efficacy and tolerability is needed to optimize therapeutic compliance. 11,15,65,66 It has also been suggested that if initial therapy with one oral anticholinergic agent, such as oxybutynin, is either intolerable or ineffective, the use of another, such as glycopyrrolate, will not necessarily fail in the same way and could represent a viable alternative. 63 Of note, recent research into methods of reducing anticholinergic side effects has yielded promising results.…”

Oxybutynin in primary hyperhidrosis: A long‐term real‐life study

“…A 1-point improvement in HDSS score has been associated with a 50% reduction in sweat production and a 2-point improvement with an 80% reduction. 4,5 Thirty patients with primary hyperhidrosis and HDSS score of at least two (in medical register before starting treatment) were submitted to a questionnaire to assess demographic data, HDSS and side effects of oxybutynin. There was a significant improvement in HDSS score of patients (P < .001).…”

“…All subjects showed a reduction of at least one degree on the HDSS scale (partial response), and remained in the study for at least 1 year. Moreover, 66.7% showed two degrees of improvement in HDSS (excellent response), 5 Adverse effects are summarized in Table 1.…”

Tolerance of oral oxybutynin in the treatment of hyperhidrosis

“…However, the experience gained in the administration of this drug to hundreds of patients, over many years, suggests that in some cases this good initial response to the drug becomes diminished or lost, for no apparent reason. 3 Although this phenomenon has been called "tachyphylaxis", in pharmacological terms it is more accurate to speak of "tolerance" to the gradual loss of the drug's efficacy, 4 while "tachyphylaxis" describes a rapid loss of efficacy after repeated doses. Tolerance to anticholinergic agents has been shown to parallel increased binding to muscarinic receptors leading to significant increases in the maximum apparent density of such binding sites.…”

“…However, the experience gained in the administration of this drug to hundreds of patients, over many years, suggests that in some cases this good initial response to the drug becomes diminished or lost, for no apparent reason 3 …”