Long‐term results of the use of oxybutynin for the treatment of plantar hyperhidrosis

Wolosker, Nelson; Teivelis, Marcelo Passos; Krutman, Mariana; Paula, Rafael P. de; Kauffman, Paulo; Campos, José Ribas Milanez de; Puech-Leão, Pedro

doi:10.1111/ijd.12729

Cited by 19 publications

(23 citation statements)

References 20 publications

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“…Although some long‐term follow‐up studies on the use of oral oxybutynin for hyperhidrosis have been performed (all conducted by the same research group from a unit of thoracic surgery) only a select number of patients – not the whole cohort – were followed up on for more than 12 months.…”

Section: Discussionmentioning

confidence: 99%

“…In these studies oral oxybutynin has been demonstrated to be effective in the treatment of hyperhidrosis. However, only five studies include long‐term follow up (a mean of 1 year) and most involve an up‐dosing regimen with a fixed‐dose target (regardless of the patient's tolerance and response). Furthermore, no studies have been conducted to compare an up‐dosing with a fixed‐dose regimen.…”

Section: Introductionmentioning

confidence: 99%

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Oral oxybutynin for the treatment of hyperhidrosis: outcomes after one‐year follow‐up

et al. 2016

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Oral oxybutynin for the treatment of hyperhidrosis: outcomes after one‐year follow‐up

et al. 2016

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“…35-50 Following a standard protocol, they used a dose of 2.5mg per day in the first week, 5mg a day divided in two doses from day 8 up to day 42, and 10mg daily in two doses from day 43 up to day 84 (12 weeks). The method of assessing the response to treatment was always performed by questionnaires completed by patients.…”

Section: Resultsmentioning

confidence: 99%

“…49 In the plantar hyperhidrosis, out of 39 patients with follow-up longer than six months, all the women showed improvement in 84,7% of the cases (Chart 1). 50 …”

Section: Resultsmentioning

confidence: 99%

Oxybutynin as an alternative treatment for hyperhidrosis

Delort

Marchi

Corrêa

2017

An. Bras. Dermatol.

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Hyperhidrosis is the excessive production of sweating, which can be primary and focal or secondary to various pathologies. The exact cause of primary focal hyperhidrosis is still unknown, although a genetic basis is recognized, and its prevalence varies from 1% to 2.8%. The most affected sites are the armpits, palms, soles and face. It causes much discomfort, affects the quality of life, and is estimated to be undervalued by health professionals. Many treatment options are proposed, both clinical and surgical. The aim of this review is to focus on the treatment of hyperhidrosis with oxybutynin, an anticholinergic drug originally used to control overactive bladder.

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“…Seventeen studies, including the validation work, had a surgical intervention, 234,236,238-252 13 dermatology studies 55,57,60,[62][63][64][65][66][67]237,[253][254][255] and one quality-of-life review. 227 The tool was used in Austria (n = 6 [240][241][242]248,249,251 ), Brazil (n = 21 57,[60][61][62][63][64][65][66][67]234,[236][237][238][239]243,244,246,247,[252][253][254][255] ), Germany (n = 1 The survey response rate was 91% (344 patients). Patients included in the study suffered with either palmar and plantar (57.4%), palmar, axillary and plantar (25%), axillary (15.7%) or facial (6.5%) sweating.…”

Section: Hyperhidrosis Quality-of-life Questionnairementioning

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

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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.

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Long‐term results of the use of oxybutynin for the treatment of plantar hyperhidrosis

Abstract: In patients with good initial response to oxybutynin, more than 82% presented moderate or great improvement in plantar and other sites' excessive sweating; dry mouth was the most common side effect but was tolerable and did not lead any patient to interrupt treatment.

Cited by 19 publications

References 20 publications

Oral oxybutynin for the treatment of hyperhidrosis: outcomes after one‐year follow‐up

Oral oxybutynin for the treatment of hyperhidrosis: outcomes after one‐year follow‐up

Oxybutynin as an alternative treatment for hyperhidrosis

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

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