Cargando…

A systematic evidence-based review of treatments for primary hyperhidrosis

OBJECTIVE: Hyperhidrosis (excessive sweating) is associated with significant quality-of-life burden yet is often undertreated. With limited FDA-approved treatments, health care providers must determine optimal treatment among approved and off-label options. Key objectives of this review were to reas...

Descripción completa

Detalles Bibliográficos
Autores principales: Stuart, Michael E., Strite, Sheri A., Gillard, Kristin Khalaf
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Taylor & Francis 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7781989/
https://www.ncbi.nlm.nih.gov/pubmed/33489435
http://dx.doi.org/10.1080/21556660.2020.1857149
_version_ 1783631795629064192
author Stuart, Michael E.
Strite, Sheri A.
Gillard, Kristin Khalaf
author_facet Stuart, Michael E.
Strite, Sheri A.
Gillard, Kristin Khalaf
author_sort Stuart, Michael E.
collection PubMed
description OBJECTIVE: Hyperhidrosis (excessive sweating) is associated with significant quality-of-life burden yet is often undertreated. With limited FDA-approved treatments, health care providers must determine optimal treatment among approved and off-label options. Key objectives of this review were to reassess, update, and expand a previous systematic review of commonly used treatment options for primary hyperhidrosis, including consideration of aluminum and zirconium compounds. METHODS: We performed a qualitative systematic review of efficacy, health-related quality of life, satisfaction, and safety of interventions, replicating and expanding the strategy outlined in a previous systematic review, with the addition of studies utilizing a within-patient design. We performed a critical appraisal of identified studies to determine risk of bias (RoB) and strength of evidence (SOE). RESULTS: A total of 32 studies were eligible for critical appraisal. Only three studies – two clinical trials of glycopyrronium cloth (2.4%) and one trial of botulinum toxin A injections in axillary hyperhidrosis were rated as “low” RoB; both had SOE ratings of “moderate” for use in axillary hyperhidrosis – the highest rating included in this review. CONCLUSIONS: Optimal treatment choice depends on several factors, including understanding the quality of evidence regarding each treatment’s efficacy and safety (considerations of convenience and cost are beyond the scope of this review). In hyperhidrosis, as in other clinical conditions, treatment decisions should be patient centered. At this time, because of the quality of evidence, only imprecise estimates of effect are possible for hyperhidrosis treatments included in this review, and statements about comparative effectiveness are not possible.
format Online
Article
Text
id pubmed-7781989
institution National Center for Biotechnology Information
language English
publishDate 2020
publisher Taylor & Francis
record_format MEDLINE/PubMed
spelling pubmed-77819892021-01-21 A systematic evidence-based review of treatments for primary hyperhidrosis Stuart, Michael E. Strite, Sheri A. Gillard, Kristin Khalaf J Drug Assess Hyperhidrosis OBJECTIVE: Hyperhidrosis (excessive sweating) is associated with significant quality-of-life burden yet is often undertreated. With limited FDA-approved treatments, health care providers must determine optimal treatment among approved and off-label options. Key objectives of this review were to reassess, update, and expand a previous systematic review of commonly used treatment options for primary hyperhidrosis, including consideration of aluminum and zirconium compounds. METHODS: We performed a qualitative systematic review of efficacy, health-related quality of life, satisfaction, and safety of interventions, replicating and expanding the strategy outlined in a previous systematic review, with the addition of studies utilizing a within-patient design. We performed a critical appraisal of identified studies to determine risk of bias (RoB) and strength of evidence (SOE). RESULTS: A total of 32 studies were eligible for critical appraisal. Only three studies – two clinical trials of glycopyrronium cloth (2.4%) and one trial of botulinum toxin A injections in axillary hyperhidrosis were rated as “low” RoB; both had SOE ratings of “moderate” for use in axillary hyperhidrosis – the highest rating included in this review. CONCLUSIONS: Optimal treatment choice depends on several factors, including understanding the quality of evidence regarding each treatment’s efficacy and safety (considerations of convenience and cost are beyond the scope of this review). In hyperhidrosis, as in other clinical conditions, treatment decisions should be patient centered. At this time, because of the quality of evidence, only imprecise estimates of effect are possible for hyperhidrosis treatments included in this review, and statements about comparative effectiveness are not possible. Taylor & Francis 2020-12-24 /pmc/articles/PMC7781989/ /pubmed/33489435 http://dx.doi.org/10.1080/21556660.2020.1857149 Text en © 2020 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group. https://creativecommons.org/licenses/by-nc/4.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial License (http://creativecommons.org/licenses/by-nc/4.0/ (https://creativecommons.org/licenses/by-nc/4.0/) ), which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Hyperhidrosis
Stuart, Michael E.
Strite, Sheri A.
Gillard, Kristin Khalaf
A systematic evidence-based review of treatments for primary hyperhidrosis
title A systematic evidence-based review of treatments for primary hyperhidrosis
title_full A systematic evidence-based review of treatments for primary hyperhidrosis
title_fullStr A systematic evidence-based review of treatments for primary hyperhidrosis
title_full_unstemmed A systematic evidence-based review of treatments for primary hyperhidrosis
title_short A systematic evidence-based review of treatments for primary hyperhidrosis
title_sort systematic evidence-based review of treatments for primary hyperhidrosis
topic Hyperhidrosis
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7781989/
https://www.ncbi.nlm.nih.gov/pubmed/33489435
http://dx.doi.org/10.1080/21556660.2020.1857149
work_keys_str_mv AT stuartmichaele asystematicevidencebasedreviewoftreatmentsforprimaryhyperhidrosis
AT stritesheria asystematicevidencebasedreviewoftreatmentsforprimaryhyperhidrosis
AT gillardkristinkhalaf asystematicevidencebasedreviewoftreatmentsforprimaryhyperhidrosis
AT stuartmichaele systematicevidencebasedreviewoftreatmentsforprimaryhyperhidrosis
AT stritesheria systematicevidencebasedreviewoftreatmentsforprimaryhyperhidrosis
AT gillardkristinkhalaf systematicevidencebasedreviewoftreatmentsforprimaryhyperhidrosis