Sofpironium bromide: an investigational agent for the treatment of axillary hyperhidrosis.

Stamatios Gregoriou, Aikaterini Tsiogka, George Kontochristopoulos, Annamaria Offidani, Anna Campanati

Expert opinion on investigational drugs 2022 Jan

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In recent years, increased knowledge about pathophysiology of primary hyperhidrosis has led to novel therapeutic advances. Topical and systemic anticholinergic agents have been proven beneficial in reducing sweat production in primary axillary hyperhidrosis (PAH), although their use is limited by the increased likelihood of systemic anticholinergic drug reactions, particularly regarding systemic agents. This paper provides an overview of pharmaceutical characteristics, efficacy and safety data from phase II and III clinical trials on sofpironium bromide (SB), a topical anticholinergic agent that has been employed for the treatment of PAH and has already received its first approval in Japan for the treatment of PAH in the form of 5% gel formulation. The retrometabolic drug design of topical SB presents distinct advantages, by limiting systemic absorption and therefore development of anticholinergic adverse events. This along with the popularity of the non-greasy gel formulation is expected to increase compliance. However, this therapy still offers a temporary control of PAH, compared to sympathectomy or device-based treatments, such as microwave thermolysis. Hence, physicians should balance the effectiveness against adverse events of each therapeutic modality and use a personalized approach based on patient's needs.

Citation

Stamatios Gregoriou, Aikaterini Tsiogka, George Kontochristopoulos, Annamaria Offidani, Anna Campanati. Sofpironium bromide: an investigational agent for the treatment of axillary hyperhidrosis. Expert opinion on investigational drugs. 2022 Jan;31(1):15-21