A retrospective literature review indicates that patients with different types of hyperhidrosis respond well to treatment with abobotulinumtoxinA (Dysport, Galderma) to prevent hyperstimulation of eccrine sweat glands. OnabotulinumtoxinA (Botox, Allergan) has been approved by the U.S. FDA for the treatment of primary axillary hyperhidrosis, but abobotulinumtoxinA and incobotulinumtoxinA (Xeomin, Merz) are not, although abobotulinumtoxinA is approved in Europe for the treatment of severe primary hyperhidrosis.
“The aim of this systematic literature review was to assess the evidence regarding treatment approaches, efficacy, safety and patient-reported outcomes relating to [abobotulinumtoxinA] treatment of hyperhidrosis,” Dr. Hassan Galadari and colleagues wrote in the paper published in the Journal of the American Academy of Dermatology. He is with the College of Medicine and Health Sciences at United Arab Emirates University.
The authors used EMBASE, MEDLINE, and the Cochrane Library to identify relevant observational studies, randomized controlled trials, and non-randomized controlled trials. A total of 191 unique articles met their criteria, with 23 considered relevant (three observational studies, 10 non-randomized controlled trials, and 10 randomized controlled trials).
These articles provided data on various forms of hyperhidrosis: axillary (13), palmar (7), and forehead (1) hyperhidrosis, compensatory hyperhidrosis of the back (1), Frey syndrome (1), and diabetic gustatory sweating (1).
For axillary hyperhidrosis, the authors reported the number of injection points per axilla ranged from five to 20 points with a dose of 3 to 33 U per point. The total dose for a single axilla ranged from 100 to 300 U, they said. The mean number of injection sessions was one to six, with intervals between sessions of six to 12 months.
The authors report that analysis of the relevant studies showed abobotulinumtoxinA reduced sweating, and no serious adverse events were noted. Following the treatment, patients reported high satisfaction with the outcomes and improvements to their quality of life.
The authors did note there was variability in the injection technique when data were compared across the various studies.