Topical glycopyrrolate for axillary hyperhidrosis

MacKenzie, AI; Burns, Carrick; Kavanagh, G.M.

doi:10.1111/bjd.12320

Cited by 30 publications

(10 citation statements)

References 6 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In our experience, topical glycopyrrolate (0.5–4% cream, solution or pads) is very effective in treating craniofacial hyperhidrosis . In line with local National Health Service recommendations, we reserve BoNTA largely for axillary hyperhidrosis.…”

mentioning

confidence: 81%

Site of botulinum toxin type A administration in craniofacial hyperhidrosis

Hussain

Kavanagh

2014

Clin Exp Dermatol

View full text Add to dashboard Cite

mentioning

confidence: 81%

Site of botulinum toxin type A administration in craniofacial hyperhidrosis

Hussain

Kavanagh

2014

Clin Exp Dermatol

View full text Add to dashboard Cite

“…However, the results in axillary hyperhidrosis have been less clinically meaningful. An uncontrolled study of 35 patients with axillary hyperhidrosis who had failed aluminum chloride hexahydrate therapy was unable to show a consistent and meaningful benefit from glycopyrrolate compounded in Cetomacrogol Cream BP [30]. Glycopyrrolate may be used topically twice daily although some authors recommend applying it nightly [31].…”

Section: Current Therapies For Hyperhidrosismentioning

confidence: 99%

Current and Emerging Medical Therapies for Primary Hyperhidrosis

Grabell

Hebert

2016

Dermatol Ther (Heidelb)

View full text Add to dashboard Cite

Hyperhidrosis is defined as the production of sweat beyond what is physiologically necessary to maintain thermal homeostasis. This disease state may (and typically does) have a significant impact on the patient’s quality of life. Medications including antiperspirants, anticholinergics, and botulinum toxin have been shown to be effective in the management of hyperhidrosis. Several medical device technologies have also proven to be effective. This review article will explore the current and emerging pharmacological and medical device treatments for hyperhidrosis and provide a framework for treating patients who suffer with primary forms of hyperhidrosis.

show abstract

“…The DLQI was used in studies to measure quality of life on various areas of the body; studies of axillary sweating combined with other parts of the body, such as palms or feet, were most common (n = 26 54,56,69,77,101,103,106,107,114,[119][120][121]139,147,158,170,173,176,214,221,223,263,266,273,274 ). Studies were identified of the palm or palm and foot combined (n = 11 61,128,208,222,230,264,265,[269][270][271][272] ) and of other combinations including the face, palm and/or foot or generalised hyperhidrosis (n = 11 116,117,210,217,227,232,261,262,267,268,275 ).…”

Section: Review Of Quality-of-life Measures/toolsmentioning

confidence: 99%

Interventions for hyperhidrosis in secondary care: a systematic review and value-of-information analysis

Wade

Rice

Llewellyn

et al. 2017

Health Technol Assess

View full text Add to dashboard Cite

BackgroundHyperhidrosis is uncontrollable excessive sweating that occurs at rest, regardless of temperature. The symptoms of hyperhidrosis can significantly affect quality of life. The management of hyperhidrosis is uncertain and variable.ObjectiveTo establish the expected value of undertaking additional research to determine the most effective interventions for the management of refractory primary hyperhidrosis in secondary care.MethodsA systematic review and economic model, including a value-of-information (VOI) analysis. Treatments to be prescribed by dermatologists and minor surgical treatments for hyperhidrosis of the hands, feet and axillae were reviewed; as endoscopic thoracic sympathectomy (ETS) is incontestably an end-of-line treatment, it was not reviewed further. Fifteen databases (e.g. CENTRAL, PubMed and PsycINFO), conference proceedings and trial registers were searched from inception to July 2016. Systematic review methods were followed. Pairwise meta-analyses were conducted for comparisons between botulinum toxin (BTX) injections and placebo for axillary hyperhidrosis, but otherwise, owing to evidence limitations, data were synthesised narratively. A decision-analytic model assessed the cost-effectiveness and VOI of five treatments (iontophoresis, medication, BTX, curettage, ETS) in 64 different sequences for axillary hyperhidrosis only.Results and conclusionsFifty studies were included in the effectiveness review: 32 randomised controlled trials (RCTs), 17 non-RCTs and one large prospective case series. Most studies were small, rated as having a high risk of bias and poorly reported. The interventions assessed in the review were iontophoresis, BTX, anticholinergic medications, curettage and newer energy-based technologies that damage the sweat gland (e.g. laser, microwave). There is moderate-quality evidence of a large statistically significant effect of BTX on axillary hyperhidrosis symptoms, compared with placebo. There was weak but consistent evidence for iontophoresis for palmar hyperhidrosis. Evidence for other interventions was of low or very low quality. For axillary hyperhidrosis cost-effectiveness results indicated that iontophoresis, BTX, medication, curettage and ETS was the most cost-effective sequence (probability 0.8), with an incremental cost-effectiveness ratio of £9304 per quality-adjusted life-year. Uncertainty associated with study bias was not reflected in the economic results. Patients and clinicians attending an end-of-project workshop were satisfied with the sequence of treatments for axillary hyperhidrosis identified as being cost-effective. All patient advisors considered that the Hyperhidrosis Quality of Life Index was superior to other tools commonly used in hyperhidrosis research for assessing quality of life.LimitationsThe evidence for the clinical effectiveness and safety of second-line treatments for primary hyperhidrosis is limited. This meant that there was insufficient evidence to draw conclusions for most interventions assessed and the cost-effectiveness analysis was restricted to hyperhidrosis of the axilla.Future workBased on anecdotal evidence and inference from evidence for the axillae, participants agreed that a trial of BTX (with anaesthesia) compared with iontophoresis for palmar hyperhidrosis would be most useful. The VOI analysis indicates that further research into the effectiveness of existing medications might be worthwhile, but it is unclear that such trials are of clinical importance. Research that established a robust estimate of the annual incidence of axillary hyperhidrosis in the UK population would reduce the uncertainty in future VOI analyses.Study registrationThis study is registered as PROSPERO CRD42015027803.FundingThe National Institute for Health Research Health Technology Assessment programme.

show abstract

Topical glycopyrrolate for axillary hyperhidrosis

Cited by 30 publications

References 6 publications

Site of botulinum toxin type A administration in craniofacial hyperhidrosis

Site of botulinum toxin type A administration in craniofacial hyperhidrosis

Current and Emerging Medical Therapies for Primary Hyperhidrosis

Interventions for hyperhidrosis in secondary care: a systematic review and value-of-information analysis

Contact Info

Product

Resources

About