Glycopyrronium cloth may reduce palmar hyperhidrosis

The use of glycopyrronium cloth without occlusion for 30 minutes had the best results in treating palmar hyperhidrosis, according to results of a virtually conducted study.

“Hyperhidrosis (HH) is a disorder of eccrine sweat production in an amount in excess of what is needed for thermoregulation,” David M. Pariser, MD, of the department of dermatology at Eastern Virginia Medical School in Norfolk, Virginia, and colleagues wrote. “Glycopyrronium tosylate cloth (GC) (Qbrexza, Journey Medical Corp.) is a topical anticholinergic approved in the U.S. in 2018 for treatment of primary axillary hyperhidrosis in patients 9 years or older.”

The cloth is used off-label to treat palmar hyperhidrosis, or excessive sweating of the palms, however anticholinergic adverse events can occur.

This study included 120 patients with palmar hyperhidrosis who were treated with 2.4% GC in one of four application method groups: 30 minutes in cotton gloves, 30 minutes under occlusion, overnight in cotton gloves and 15 minutes in cotton gloves.

The overall mean change in Hand Sweat Severity was 4.2 in cohort A, 2.6 in cohort B, 4 in cohort C and 2.6 in cohort 3.

Patient Impression Severity improved by 1.6 in cohort A, 1.1 in cohort B, 1.8 in cohort C and 1.4 in cohort D.

Adverse events were reported in 51 subjects, with a total of 112 events recorded. Of these, 67 were determined to be study drug related.

Blurred vision was the most reported drug related adverse event, most likely from inadvertent touching of the eyes despite warnings regarding eye contact, according to the authors.

“In this uncontrolled open label study of four methods of application of GC, 30 minutes under cotton gloves produced the best efficacy by the several parameters studied,” the authors wrote. “Although overnight under cotton gloves produced nearly the same efficacy, there were over twice as many adverse events related to treatment compared to 30 minutes.”

Further randomized, vehicle controlled studies are needed to determine the efficacy and safety of GC for palmar hyperhidrosis.