Thirty-five units of botulinum toxin type A for treatment of axillary hyperhidrosis in female patients

Marcella, Stefanie; Goodman, Greg; Cumming, Simon; Foley, Peter; Morgan, Vanessa

doi:10.1111/j.1440-0960.2010.00723.x

Cited by 4 publications

(3 citation statements)

References 8 publications

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“…A number of trials found evidence that the injection of 50 units (U) of BoNT-A per axilla is effective in IH [18][19][20][21][22]. Marcella et al observed that 35U per axilla can be effective and appreciated in female patients with moderate hyperhidrosis, suggesting the possibility of a tailored treatment [24]. Based on these results, an established level of evidence (Level A) exists only for BoNT-A treatment of idiopatic axillary hyperhidrosis [10].…”

Section: Resultsmentioning

confidence: 99%

Therapeutic Use of Botulinum Neurotoxins in Dermatology: Systematic Review

Martina

Diotallevi

Radi

et al. 2021

Toxins

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Botulinum toxin is a superfamily of neurotoxins produced by the bacterium Clostridium Botulinum with well-established efficacy and safety profile in focal idiopathic hyperhidrosis. Recently, botulinum toxins have also been used in many other skin diseases, in off label regimen. The objective of this manuscript is to review and analyze the main therapeutic applications of botulinum toxins in skin diseases. A systematic review of the published data was conducted, following Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines. Botulinum toxins present several label and off-label indications of interest for dermatologists. The best-reported evidence concerns focal idiopathic hyperhidrosis, Raynaud phenomenon, suppurative hidradenitis, Hailey–Hailey disease, epidermolysis bullosa simplex Weber–Cockayne type, Darier’s disease, pachyonychia congenita, aquagenic keratoderma, alopecia, psoriasis, notalgia paresthetica, facial erythema and flushing, and oily skin. Further clinical trials are still needed to better understand the real efficacy and safety of these applications and to standardize injection and doses protocols for off label applications.

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Section: Resultsmentioning

confidence: 99%

Therapeutic Use of Botulinum Neurotoxins in Dermatology: Systematic Review

Martina

Diotallevi

Radi

et al. 2021

Toxins

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“…Studies that were found to use the HDSS tool were conducted globally, including the USA and Canada (n = 21 21,27,29,52,77,107,108,139,159,160,164,175,176,179,180,208,209,218,225,226,229 ), Spain (n = 6 167,207,210,224,230,231 ), the UK (n = 5 91,97,125,222,232 ), Germany (n = 5 2,131,145,161,227 ), Italy (n = 5 102,106, 136,214,223 ), France (n = 3 59,61,211 ), South Korea (n = 3 51,171,174 ), Australia (n = 2 53,221 ), Egypt (n = 2 213,219 ), Iran (n = 2 28,220 ), the Netherlands (n = 2 ...…”

Section: Hyperhidrosis Disease Severity Scalementioning

confidence: 99%

“…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

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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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Impact of Hyperhidrosis on Quality of Life and its Assessment

Hamm¹

2014

Dermatologic Clinics

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Thirty-five units of botulinum toxin type A for treatment of axillary hyperhidrosis in female patients

Cited by 4 publications

References 8 publications

Therapeutic Use of Botulinum Neurotoxins in Dermatology: Systematic Review

Therapeutic Use of Botulinum Neurotoxins in Dermatology: Systematic Review

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

Impact of Hyperhidrosis on Quality of Life and its Assessment

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