Adjusting oral oxybutynin medication for hyperhidrosis to reflect seasonal temperature variations

Abstract

Most studies of oral oxybutynin (OOx) for the treatment of hyperhidrosis (HH) have assumed a stable treatment protocol, without taking into account adverse effects (AE) or seasonal variations in temperature. The objective is to evaluate adjusting the dose of OOx according to the time of year. Prospective study of patients who began OOx for HH between 2007 and 2017, and maintained treatment for at least 1 year, with a progressively increasing dose was performed. All patients were recommended to vary the dose of medication according to the time of year. Baseline epidemiological data, the response to treatment and AE were analyzed. About 122 patients were included (average age of 33.8 years). Up to 60.7% varied the dose. Significantly better results were obtained in the group that varied the dose. Twenty patients suspended the treatment in winter. Among them the adjusted OR was 3.04 (95% CI 1.24-7.45) for an excellent response. The frequency of AE was 74.6% with no differences among groups. Most patients are able to control their HH without requiring the same dose of OOx throughout the year. Given that the possible AE of OOx are dose-dependent, it seems reasonable to vary it according to the time of year.

Adjusting oral glycopyrrolate medication for hyperhidrosis to reflect seasonal temperature variations

“…A previous study with a similar design to ours evaluated the potential usefulness of adjusting the dose of OOx for HH according to the ambient temperature 18 and found, as in the present study, that the patients who varied the treatment dose in this respect obtained a significant reduction in HDSS and a better response at 12 months, compared with the group that did not vary the dose, and with a similar profile of adverse effects.…”

“…As in the OOx study, 18 both treatment strategies appear to have a similar safety profile. We observed no significant differences in total adverse effects at 12 months or in the specific case of oral xerosis.…”

“…In the OOx study, 18 the patients who were more likely to adjust the dose according to the ambient temperature were slightly older and predominantly female. However, in our study, there were no significant differences with respect to age or sex (probably due to the small sample size), although there was a slightly higher percentage of women in the group with seasonal dose changes.…”

“…Hence, adjusting the dose according to seasonal considerations could be of considerable benefit to the patient. In this respect, a previous study has evaluated the potential utility of adjusting the dose of OOx according to ambient temperature 18 ; however, such an analysis has not previously been performed with OGly.…”