AbstractBackgroundHyperhidrosis (HH), characterized by excessive sweating, poses a significant challenge to patients’ quality of life. This meta-analysis evaluates the safety and efficacy of topical glycopyrronium bromide (GBP) in treating primary hyperhidrosis, a chronic condition affecting various body regions.

摘要背景多汗症（HH）以出汗过多为特征，对患者的生活质量提出了重大挑战。这项荟萃分析评估了局部使用溴化格隆溴铵（GBP）治疗原发性多汗症（一种影响身体各个部位的慢性病）的安全性和有效性。

Despite its prevalence, primary axillary hyperhidrosis is often undertreated due to a lack of awareness and social stigma.MethodsFollowing PRISMA guidelines, we conducted a systematic review and meta-analysis of randomized controlled trials comparing GBP to a placebo in primary hyperhidrosis patients.

尽管其患病率很高，但由于缺乏意识和社会耻辱感，原发性腋窝多汗症通常未得到充分治疗。方法根据PRISMA指南，我们对原发性多汗症患者的GBP与安慰剂进行了随机对照试验的系统评价和荟萃分析。

Eligibility criteria included outcomes related to perspiration suppression and symptom improvement.ResultsFour RCTs involving 1401 patients were included. GBP significantly increased Hyperhidrosis Disease Severity Scale (HDSS) responders (RR = 2.33, 95% CI [1.99 to 2.74], p < 0.00001) and Axillary Sweating Daily Diary (ASDD/ASDD-C) responders (MD = 3.07, 95% CI [2.32 to 4.06], p < 0.002) without significantly causing adverse events.

资格标准包括与排汗抑制和症状改善有关的结果。结果共纳入4项随机对照试验，涉及1401例患者。GBP显着增加多汗症疾病严重程度量表（HDSS）应答者（RR=2.33，95%CI[1.99-2.74]，p<0.00001）和腋下出汗每日日记（ASDD/ASDD-C）应答者（MD=3.07，95%CI[2.32-4.06]，p<0.002），而没有显着引起不良事件。

Dermatology life quality index was also significantly improved in the GBP group (MD = -2.32, 95% CI [-3.09, -1.55], P < 0.00001).ConclusionGBP demonstrated effectiveness in reducing sweat production while improving HDSS and DLQI scores. Adverse events included dry mouth and anticholinergic effects. Dry eye and local skin reactions were not significant, which makes GBP promising in managing primary hyperhidrosis, offering improvements in symptoms and quality of life.

GBP组的皮肤病生活质量指数也显着改善（MD=-2.32，95%CI[-3.09，-1.55]，P<0.00001）。结论GBP可有效减少汗液产生，同时改善HDSS和DLQI评分。不良事件包括口干和抗胆碱能作用。干眼症和局部皮肤反应不明显，这使得GBP有望治疗原发性多汗症，改善症状和生活质量。

While adverse events should be considered, further research with larger sample sizes and long-term follow-up is warranted for comprehensive clinical integration.Key points.

虽然应考虑不良事件，但有必要进行更大样本量和长期随访的进一步研究，以进行全面的临床整合。关键点。

• We found that topical glycopyrronium can be an effective treatment for hyperhidrosis, reducing sweat production and improving patients’ symptoms.

•我们发现外用格隆溴铵可以有效治疗多汗症，减少汗液产生并改善患者症状。

• We also found that the increase in certain adverse events necessitates careful consideration in clinical decision-making.

•我们还发现，某些不良事件的增加需要在临床决策中仔细考虑。

IntroductionHyperhidrosis (HH) is characterized by excessive and disproportionate sweating beyond what is expected to control body temperature. It’s a chronic condition and can be classified into primary and secondary forms1,2. Statistically, the prevalence of primary HH in the US is 4.8%, 12.8% in Japan, and 16.3% in Germany1,3.Primary hyperhidrosis is described as idiopathic and affects specific body regions, usually the axillae, palms, soles, or craniofacial region, resulting from overactive sympathetic nerves.

简介多汗症（HH）的特征是出汗过多且不成比例，超出了预期的控制体温的范围。这是一种慢性病，可分为原发性和继发性疾病1,2。据统计，美国原发性HH的患病率为4.8%，日本为12.8%，德国为16.3%1,3。原发性多汗症被描述为特发性，并影响特定的身体区域，通常是腋窝，手掌，脚底或颅面区域，由交感神经过度活跃引起。

Primary axillary hyperhidrosis is characterized by excessive underarms sweating and bilateral presentation4,5. Secondary HH could be due to certain medical conditions (endocrine, neurological, cardiovascular, infection and neoplasm) or pharmacological causes2,6.The adverse effects of HH on life quality could be anxiety and depression, which lead to decreased work productivity and could be more than 3.5 times more prevalent in patients with HH.

原发性腋窝多汗症的特征是腋下出汗过多和双侧表现4,5。继发性HH可能是由于某些医疗条件（内分泌，神经，心血管，感染和肿瘤）或药理学原因2,6。HH对生活质量的不利影响可能是焦虑和抑郁，这导致工作效率下降，HH患者的患病率可能超过3.5倍。

In addition, low self-compassion and imposter phenomenon may affect the mental, social, professional, and educational domains of lives in patients with HH3,4,7,8,9,10. Most patients with primary axillary hyperhidrosis either wait a few years to seek medical attention or do not seek treatment at all, despite the condition’s high prevalence rates, severe symptoms, and impact on quality of life.

此外，低自我同情和冒名顶替现象可能会影响HH3,4,7,8,9,10患者的心理，社会，专业和教育领域。大多数原发性腋窝多汗症患者要么等待几年才能就医，要么根本不寻求治疗，尽管该病的患病率很高，症状严重，并影响生活质量。

This is probably due to a lack of awareness that primary axillary hyperhidrosis is treatable, treatment compliance, or due to social stigma of excessive sweating and low level of satisfaction3,4,11,12,13.Treatments for hyperhidrosis have generally involved blocking sweat from reaching the skin’s surface (e.g., antiperspirants) containing aluminium salts in range from 10 to 35%, blocking neuronal transduction to the sweat glands (e.g.

。

Data availability

数据可用性

The datasets used and/or analyzed during the current study are available from the corresponding author on reasonable request.

本研究中使用和/或分析的数据集可根据合理要求从通讯作者处获得。

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Popa, Iași, RomaniaShirin cadri & Nina cadriFaculty of medicine, October 6 university, 6th of October City, EgyptDoaa MashalyFaculty of Medicine, Aswan University, Aswan, EgyptAya EhabZaira Research Academy, Damascus, Syrian Arab RepublicLava AbdullahBasra Medical College, Basra, IraqEsraa M. AlEdaniAuthorsAmr ElrosasyView author publicationsYou can also search for this author in.

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Reprints and permissionsAbout this articleCite this articleElrosasy, A., Zeid, M.A., Samha, R. et al. Efficacy and safety of topical glycopyrronium bromide in treating axillary hyperhidrosis: systematic review and meta-analysis.

转载和许可本文引用本文ElRosasy，A.，Zeid，M.A.，Samha，R。等人。局部用格隆溴铵治疗腋臭的疗效和安全性：系统评价和荟萃分析。

Sci Rep 14, 24537 (2024). https://doi.org/10.1038/s41598-024-74430-4Download citationReceived: 01 February 2024Accepted: 26 September 2024Published: 19 October 2024DOI: https://doi.org/10.1038/s41598-024-74430-4Share this articleAnyone you share the following link with will be able to read this content:Get shareable linkSorry, a shareable link is not currently available for this article.Copy to clipboard.

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KeywordsHyperhidrosisGlycopyrronium BromideMeta-analysisQuality of lifeAdverse events

关键词高血糖症溴代吡咯烷酮Meta分析生活质量不良事件