Pharmacovigilance-based drug repurposing: searching for putative drugs with hypohidrosis or anhidrosis adverse events for use against hyperhidrosis

Abstract

Background Drug repurposing refers to the application of existing drugs to new therapeutic indications. As phenotypic indicators of human drug response, drug side effects may provide direct signals and unique opportunities for drug repurposing. Objectives We aimed to identify drugs frequently associated with hypohidrosis or anhidrosis adverse reactions (that is, the opposite condition of hyperhidrosis) from the pharmacovigilance database, which could be potential candidates as anti-hyperhidrosis treatment agents. Methods In this observational, retrospective, pharmacovigilance study, adverse event reports of hypohidrosis or anhidrosis in the US Food and Drug Administration (FDA) Adverse Event Reporting System (FAERS) were assessed between January 2004 and December 2021 using reporting odds ratio (ROR) estimates and categorized by the World Health Organization Anatomical Therapeutic Chemical (ATC) classification code. The onset time of drug-associated hypohidrosis or anhidrosis was also examined. Results There were 540 reports of 192 drugs with suspected drug-associated hypohidrosis or anhidrosis in the FAERS database, of which 39 drugs were found to have statistically significant signals. Nervous system drugs were most frequently reported (187 cases, 55.82%), followed by alimentary tract and metabolism drugs (35 cases, 10.45%), genitourinary system and sex hormones (28 cases, 8.36%), and dermatologicals (22 cases, 6.57%). The top 3 drug subclasses were antiepileptics, drugs for urinary frequency and incontinence, and antidepressants. Taking disproportionality signals, pharmacological characteristics of drugs and appropriate onset time into consideration, the main putative drugs for hyperhidrosis were glycopyrronium, solifenacin, oxybutynin, and botulinum toxin type A. Other drugs, such as topiramate, zonisamide, agalsidase beta, finasteride, metformin, lamotrigine, citalopram, ciprofloxacin, bupropion, duloxetine, aripiprazole, prednisolone, and risperidone need more investigation. Conclusions Several candidate agents among hypohidrosis or anhidrosis-related drugs were identified that may be redirected for diminishing sweat production. There are affirmative data for some candidate drugs, and the remaining proposed candidate drugs without already known sweat reduction mechanisms of action should be further explored.

Repurposing of drugs against bacterial infections: A pharmacovigilance‐based data mining approach

“…The current study has identified potential drugs that can be repurposed against Pseudomonal, Staphylococcal, and Streptococcal infections through possible novel mechanisms. Very few studies have been conducted so far regarding the use of pharmacovigilance data for drug repurposing against various diseases such as hyperhidrosis (Liu et al, 2023), Raynaud's phenomenon (Zaza et al, 2020), Alzheimer's disease (Chrétien et al, 2021), and so forth. Liu et al (2023) have used the FAERS database whereas Zaza et al (2020) and B. Chrétien et al (2020) have used Vigibase (Chrétien et al, 2021; Liu et al, 2023; Zaza et al, 2020).…”

“…Very few studies have been conducted so far regarding the use of pharmacovigilance data for drug repurposing against various diseases such as hyperhidrosis (Liu et al, 2023), Raynaud's phenomenon (Zaza et al, 2020), Alzheimer's disease (Chrétien et al, 2021), and so forth. Liu et al (2023) have used the FAERS database whereas Zaza et al (2020) and B. Chrétien et al (2020) have used Vigibase (Chrétien et al, 2021; Liu et al, 2023; Zaza et al, 2020). However, to the best of our knowledge, no study has been conducted so far that uses a pharmacovigilance‐based approach for the identification of repurposed drugs against bacterial infection.…”

“…Liu et al (2023) have used the FAERS database whereas Zaza et al (2020) andB. Chrétien et al (2020) have used Vigibase (Chrétien et al, 2021;Liu et al, 2023;Zaza et al, 2020). However, to the best of our knowledge, no study has been conducted so far that uses a pharmacovigilance-based approach for the identification of repurposed drugs against bacterial infection.…”

“…Pharmacovigilance‐based drug repurposing is one of the recent concepts in which post‐marketing data is used to identify the alternative use of existing drugs (R Flower, 2013). Recently, Liu et al (2023) have identified alternative use of various drugs under the category of antidepressants, antiepileptics, and drugs for urinary frequency and incontinence for the treatment of hyperhidrosis using the pharmacovigilance approach (Liu et al, 2023). Fumaric acid approved for treating multiple sclerosis was also identified as a promising drug for treating secondary Raynaud's phenomenon using VigiBase, a World Health Organization (WHO) pharmacovigilance database (Zaza et al, 2020).…”

“…Pharmacovigilance-based drug repurposing is one of the recent concepts in which post-marketing data is used to identify the alternative use of existing drugs (R Flower, 2013). Recently, Liu et al (2023) have identified alternative use of various drugs under the category of antidepressants, antiepileptics, and drugs for urinary frequency and incontinence for the treatment of hyperhidrosis using the pharmacovigilance approach (Liu et al, 2023).…”