Efficacy and safety of topical sofpironium bromide gel for the treatment of axillary hyperhidrosis: A phase II, randomized, controlled, double-blinded trial

J Am Acad Dermatol. 2020 Jun;82(6):1321-1327. doi: 10.1016/j.jaad.2020.02.016. Epub 2020 Feb 15.

Abstract

Background: Primary axillary hyperhidrosis has limited noninvasive, effective, and well-tolerated treatment options.

Objective: To evaluate the topical treatment of axillary hyperhidrosis with the novel anticholinergic sofpironium bromide.

Methods: A phase II, multicenter, randomized, controlled, double-blinded study. Participants were randomized to 1 of 3 dosages or vehicle, with daily treatment for 42 days. Coprimary end points were the percentage of participants exhibiting ≥1-point improvement in the Hyperhidrosis Disease Severity Measure-Axillary (HDSM-Ax) score by logistic regression, and change in HDSM-Ax as a continuous measure by analysis of covariance. Pair-wise comparisons were 1-sided with α = 0.10.

Results: At the end of therapy, 70%, 79%, 76%, and 54% of participants in the 5%, 10%, 15%, and vehicle groups exhibited ≥1-point improvement in HDSM-Ax (P < .05). Least-square mean (SE) changes in HDSM-Ax were -2.02 (0.14), -2.09 (0.14), 2.10 (0.14), and -1.30 (0.14) (all P ≤ .0001). Most treatment-related adverse events were mild or moderate.

Limitations: Not powered to detect changes in gravimetric sweat production.

Conclusion: Sofpironium bromide gel produced meaningful reductions in hyperhidrosis severity and had an acceptable safety profile.

Keywords: HDSM-Ax; anticholinergic; axillary hyperhidrosis; retrometabolic drug; sofpironium bromide; topical.

Publication types

  • Clinical Trial, Phase II
  • Multicenter Study
  • Randomized Controlled Trial

MeSH terms

  • Adult
  • Axilla
  • Cholinergic Antagonists / adverse effects
  • Cholinergic Antagonists / therapeutic use*
  • Double-Blind Method
  • Female
  • Gels
  • Glycopyrrolate / analogs & derivatives
  • Humans
  • Hyperhidrosis / drug therapy*
  • Male
  • Middle Aged
  • Severity of Illness Index
  • Sweat / metabolism
  • Vision Disorders / chemically induced
  • Xerostomia / chemically induced
  • Young Adult

Substances

  • Cholinergic Antagonists
  • Gels
  • Glycopyrrolate