General Dermatology

AbobotulinumtoxinA Treatment Leads to Positive Outcomes for Hyperhidrosis

Colby Stong
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Women are at higher risk of hyperthyroidism than men, although both sexes can be affected, with risk greatest in patients with a family history of Graves disease or other thyroid disorders.7 In patients with hyperthyroidism, epidermal thinning is the most commonly reported skin manifestation.8 Other skin anomalies include softness, excessive perspiration (ie, hyperhidrosis; pictured), and warmth, causing skin to feel like that of an infant.3 Itching, generalized pruritus, chronic urticaria, vitiligo, and diffuse skin pigmentation have also been reported.8 Dermal changes most commonly result from autoimmunity, rather than from hormones directly affecting the skin.3
Women are at higher risk of hyperthyroidism than men, although both sexes can be affected, with risk greatest in patients with a family history of Graves disease or other thyroid disorders.7 In patients with hyperthyroidism, epidermal thinning is the most commonly reported skin manifestation.8 Other skin anomalies include softness, excessive perspiration (ie, hyperhidrosis; pictured), and warmth, causing skin to feel like that of an infant.3 Itching, generalized pruritus, chronic urticaria, vitiligo, and diffuse skin pigmentation have also been reported.8 Dermal changes most commonly result from autoimmunity, rather than from hormones directly affecting the skin.3
Evidence regarding the treatment approaches and outcomes associated with abobotulinumtoxinA (aboBoNT-A) treatment of hyperhidrosis were identified in a review study.

AbobotulinumtoxinA (aboBoNT-A) treatment demonstrated positive outcomes for patients with hyperhidrosis and sweating-related disorders, researchers reported in a study published in the Journal of the American Academy of Dermatology.

The investigators conducted a systematic literature review to identify evidence regarding treatment approaches and outcomes associated with aboBoNT-A in patients with hyperhidrosis. They searched Embase, MEDLINE, and the Cochrane Library for relevant observational studies, randomized controlled trials (RCTs), and non-RCTs, as well as bibliographies of review articles and US Congress proceedings from January 1, 2017 through July 19, 2019.

A total of 191 articles were identified, 23 of which were considered relevant (3 observational studies, 10 non-RCTs, and 10 RCTs). The studies were conducted in Austria, Brazil, Egypt, France, Germany, Italy, Iran, Sweden, the United Arab Emirates, and the United Kingdom. The articles included data on axillary (13), palmar (7), and forehead (1) hyperhidrosis, compensatory hyperhidrosis of the back (1), Frey syndrome (1), and diabetic gustatory sweating (1).

Overall, all studies found that aboBoNT-A reduced sweating with no serious adverse events, according to the researchers.

A total of 13 studies that reported on treatment approaches for axillary hyperhidrosis found that aboBoNT-A reduced sweating, with a duration of action of treatment ranging from 3 to 10 months. For palmar hyperhidrosis, 7 studies reported on aboBoNT-A treatment approaches, with 6 finding a mean or median duration of treatment effect of 3 to 10 months, and all 7 studies reported mild or moderate adverse events.

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The investigators noted that variability in the injection technique used in the included studies affects the outcomes of aboBoNT-A treatment and is a study limitation when data were compared across studies.

“Evidence regarding treatment approaches and outcomes for forehead hyperhidrosis, compensatory hyperhidrosis, Frey syndrome, and diabetic gustatory sweating was limited,” the study authors commented. “Patient satisfaction was high and improvements to quality of life were observed following aboBoNT-A treatment for axillary and palmar hyperhidrosis. Further research using comparable outcome measures will allow for comparison across studies and aid in understanding how treatment approaches and patient outcomes can be optimized.”

Disclosures: The study was funded by Ipsen. Several of the authors declared affiliations with the pharmaceutical industry. Please see the original reference for a full list of disclosures.

Reference

Galadari H, Galadari I, Smit R, et al. Treatment approaches and outcomes associated with the use of abobotulinumtoxinA for the treatment of hyperhidrosis: A systematic review [published online August 8, 2020]. J Am Acad Dermatol. doi: https://doi.org/10.1016/j.jaad.2020.07.123

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