{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T01:45:04Z","timestamp":1791337504923,"version":"4.3.1"},"reference-count":22,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2024,10,19]],"date-time":"2024-10-19T00:00:00Z","timestamp":1729296000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2024,10,19]],"date-time":"2024-10-19T00:00:00Z","timestamp":1729296000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/501100002386","name":"Cairo University","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100002386","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Sci Rep"],"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Background<\/jats:title>\n                <jats:p>Hyperhidrosis (HH), characterized by excessive sweating, poses a significant challenge to patients\u2019 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. Despite its prevalence, primary axillary hyperhidrosis is often undertreated due to a lack of awareness and social stigma.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Methods<\/jats:title>\n                <jats:p>Following PRISMA guidelines, we conducted a systematic review and meta-analysis of randomized controlled trials comparing GBP to a placebo in primary hyperhidrosis patients. Eligibility criteria included outcomes related to perspiration suppression and symptom improvement.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>Four RCTs involving 1401 patients were included. GBP significantly increased Hyperhidrosis Disease Severity Scale (HDSS) responders (RR\u2009=\u20092.33, 95% CI [1.99 to 2.74], <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.00001) and Axillary Sweating Daily Diary (ASDD\/ASDD-C) responders (MD\u2009=\u20093.07, 95% CI [2.32 to 4.06], <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.002) without significantly causing adverse events. Dermatology life quality index was also significantly improved in the GBP group (MD = -2.32, 95% CI [-3.09, -1.55], <jats:italic>P<\/jats:italic>\u2009&lt;\u20090.00001).<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusion<\/jats:title>\n                <jats:p>GBP 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. While adverse events should be considered, further research with larger sample sizes and long-term follow-up is warranted for comprehensive clinical integration.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1038\/s41598-024-74430-4","type":"journal-article","created":{"date-parts":[[2024,10,19]],"date-time":"2024-10-19T02:01:46Z","timestamp":1729303306000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Efficacy and safety of topical glycopyrronium bromide in treating axillary hyperhidrosis: systematic review and meta-analysis"],"prefix":"10.1038","volume":"14","author":[{"given":"Amr","family":"Elrosasy","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohamed Abo","family":"Zeid","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Raghad","family":"Samha","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hazim","family":"Alkousheh","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shirin","family":"cadri","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nina","family":"cadri","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Doaa","family":"Mashaly","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8258-2977","authenticated-orcid":false,"given":"Aya","family":"Ehab","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lava","family":"Abdullah","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Esraa M.","family":"AlEdani","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2024,10,19]]},"reference":[{"key":"74430_CR1","doi-asserted-by":"publisher","first-page":"315","DOI":"10.1111\/bjd.19810","volume":"185","author":"C Abels","year":"2021","unstructured":"Abels, C. et al. A glycopyrronium bromide 1% cream for topical treatment of primary axillary hyperhidrosis: efficacy and safety results from a phase IIIa randomized controlled trial*. Br. J. Dermatol.185, 315\u2013322 (2021).","journal-title":"Br. J. Dermatol."},{"key":"74430_CR2","doi-asserted-by":"publisher","first-page":"278","DOI":"10.1111\/jdv.12518","volume":"29","author":"MY Hyun","year":"2015","unstructured":"Hyun, M. Y. et al. Efficacy and safety of topical glycopyrrolate in patients with facial hyperhidrosis: a randomized, multicentre, double-blinded, placebo\u2010controlled, split\u2010face study. J. Eur. Acad. Dermatol. Venereol.29, 278\u2013282 (2015).","journal-title":"J. Eur. Acad. Dermatol. Venereol."},{"key":"74430_CR3","doi-asserted-by":"publisher","first-page":"128","DOI":"10.1016\/j.jaad.2018.07.002","volume":"80","author":"DA Glaser","year":"2019","unstructured":"Glaser, D. A. et al. Topical glycopyrronium tosylate for the treatment of primary axillary hyperhidrosis: results from the ATMOS-1 and ATMOS-2 phase 3 randomized controlled trials. J. Am. Acad. Dermatol.80, 128\u2013138e2 (2019).","journal-title":"J. Am. Acad. Dermatol."},{"key":"74430_CR4","doi-asserted-by":"publisher","first-page":"86","DOI":"10.1111\/1346-8138.16188","volume":"49","author":"H Yokozeki","year":"2022","unstructured":"Yokozeki, H., Fujimoto, T., Wanatabe, S., Ogawa, S. & Fujii, C. Topical glycopyrronium tosylate in Japanese patients with primary axillary hyperhidrosis: a randomized, double-blind, vehicle\u2010controlled study. J. Dermatol.49, 86\u201394 (2022).","journal-title":"J. Dermatol."},{"key":"74430_CR5","doi-asserted-by":"publisher","first-page":"823","DOI":"10.1111\/jdv.18843","volume":"37","author":"R Szeimies","year":"2023","unstructured":"Szeimies, R. et al. Long\u2010term efficacy and safety of 1% glycopyrronium bromide cream in patients with severe primary axillary hyperhidrosis: results from a phase 3b trial. J. Eur. Acad. Dermatol. Venereol.37, 823\u2013830 (2023).","journal-title":"J. Eur. Acad. Dermatol. Venereol."},{"key":"74430_CR6","first-page":"E61","volume":"14","author":"S Gregoriou","year":"2021","unstructured":"Gregoriou, S. et al. Treatment of Axillary bromhidrosis with topical 2% glycopyrronium bromide cream: a Prospective, non-randomized, open-label study. J. Clin. Aesthet. Dermatol.14, E61\u2013E63 (2021).","journal-title":"J. Clin. Aesthet. Dermatol."},{"key":"74430_CR7","doi-asserted-by":"publisher","unstructured":"Shayesteh, A., Boman, J. & Nylander, E. Impostor phenomenon is a common feature among individuals with primary hyperhidrosis. SAGE Open. Med. 12. https:\/\/doi.org\/10.1177\/20503121231220828 (2024).","DOI":"10.1177\/20503121231220828"},{"key":"74430_CR8","doi-asserted-by":"publisher","first-page":"490","DOI":"10.1111\/pde.14135","volume":"37","author":"AA Hebert","year":"2020","unstructured":"Hebert, A. A. et al. Long-term efficacy and safety of topical glycopyrronium tosylate for the treatment of primary axillary hyperhidrosis: Post hoc pediatric subgroup analysis from a 44\u2010week open\u2010label extension study. Pediatr. Dermatol.37, 490\u2013497 (2020).","journal-title":"Pediatr. Dermatol."},{"key":"74430_CR9","doi-asserted-by":"publisher","first-page":"e275","DOI":"10.1016\/j.jaad.2019.12.021","volume":"83","author":"SM Siscos","year":"2020","unstructured":"Siscos, S. M., Figenshau, K. & Rajpara, A. Use of gloves when applying topical glycopyrronium for treatment of primary axillary hyperhidrosis. J. Am. Acad. Dermatol.83, e275 (2020).","journal-title":"J. Am. Acad. Dermatol."},{"key":"74430_CR10","doi-asserted-by":"publisher","first-page":"1141","DOI":"10.1007\/s40261-019-00853-x","volume":"39","author":"YN Lamb","year":"2019","unstructured":"Lamb, Y. N. Topical glycopyrronium Tosylate in Primary Axillary Hyperhidrosis: A Profile of its use. Clin. Drug Investig. 39, 1141\u20131147 (2019).","journal-title":"Clin. Drug Investig"},{"key":"74430_CR11","doi-asserted-by":"crossref","unstructured":"Masur, C., Soeberdt, M., Kilic, A., Knie, U. & Abels, C. Safety and efficacy of topical formulations containing 0.5, 1, and 2% glycopyrronium bromide in patients with primary axillary hyperhidrosis: a randomized, double-blind, placebo-controlled study. Br. J. Dermatol. 182, bjd.18234 (2019).","DOI":"10.1111\/bjd.18234"},{"key":"74430_CR12","doi-asserted-by":"publisher","first-page":"135","DOI":"10.1007\/s40257-018-0395-0","volume":"20","author":"DM Pariser","year":"2019","unstructured":"Pariser, D. M. et al. Topical glycopyrronium tosylate for the treatment of primary axillary hyperhidrosis: patient-reported outcomes from the ATMOS-1 and ATMOS-2 phase III randomized controlled trials. Am. J. Clin. Dermatol.20, 135\u2013145 (2019).","journal-title":"Am. J. Clin. Dermatol."},{"key":"74430_CR13","doi-asserted-by":"publisher","first-page":"2131","DOI":"10.1111\/jdv.13745","volume":"30","author":"DM Baker","year":"2016","unstructured":"Baker, D. M. Topical glycopyrrolate reduces axillary hyperhidrosis. J. Eur. Acad. Dermatol. Venereol.30, 2131\u20132136 (2016).","journal-title":"J. Eur. Acad. Dermatol. Venereol."},{"key":"74430_CR14","doi-asserted-by":"publisher","first-page":"1373","DOI":"10.1111\/bjd.12857","volume":"170","author":"DR Hale","year":"2014","unstructured":"Hale, D. R., MacKenzie, A. I. & Kavanagh, G. M. Our experience of glycopyrrolate 2% cream for axillary hyperhidrosis. Br. J. Dermatol.170, 1373 (2014).","journal-title":"Br. J. Dermatol."},{"key":"74430_CR15","doi-asserted-by":"publisher","first-page":"387","DOI":"10.1016\/j.jaad.2011.01.023","volume":"66","author":"HW Walling","year":"2012","unstructured":"Walling, H. W. Systemic therapy for primary hyperhidrosis: a retrospective study of 59 patients treated with glycopyrrolate or clonidine. J. Am. Acad. Dermatol.66, 387\u2013392 (2012).","journal-title":"J. Am. Acad. Dermatol."},{"key":"74430_CR16","doi-asserted-by":"publisher","first-page":"825","DOI":"10.1111\/j.1365-2230.2006.02224.x","volume":"31","author":"GM Sega-Hall","year":"2006","unstructured":"Sega-Hall, G. M., Smith, P. & Haworth, A. E. A case of isolated axillary hyperhidrosis successfully treated topically with 1% glycopyrronium cream. Clin. Exp. Dermatol.31, 825 (2006).","journal-title":"Clin. Exp. Dermatol."},{"key":"74430_CR17","doi-asserted-by":"publisher","first-page":"103","DOI":"10.1016\/j.jclinepi.2021.02.003","volume":"134","author":"MJ Page","year":"2021","unstructured":"Page, M. J. et al. Updating guidance for reporting systematic reviews: development of the PRISMA 2020 statement. J. Clin. Epidemiol.134, 103\u2013112 (2021).","journal-title":"J. Clin. Epidemiol."},{"key":"74430_CR18","doi-asserted-by":"publisher","first-page":"210","DOI":"10.1186\/s13643-016-0384-4","volume":"5","author":"M Ouzzani","year":"2016","unstructured":"Ouzzani, M., Hammady, H., Fedorowicz, Z. & Elmagarmid, A. Rayyan\u2014a web and mobile app for systematic reviews. Syst. Rev.5, 210 (2016).","journal-title":"Syst. Rev."},{"key":"74430_CR19","doi-asserted-by":"publisher","DOI":"10.1002\/9781119536604","volume-title":"Cochrane handbook for systematic reviews of interventions, sixth","author":"JPT Higgins","year":"2019","unstructured":"Higgins, J. P. T. et al. Cochrane handbook for systematic reviews of interventions, sixth (2019)."},{"key":"74430_CR20","doi-asserted-by":"crossref","unstructured":"Sterne, J. A. C. et al. RoB 2: a revised tool for assessing risk of bias in randomised trials. BMJ. 366, l4898\u2013l4898 (2019).","DOI":"10.1136\/bmj.l4898"},{"key":"74430_CR21","doi-asserted-by":"publisher","first-page":"665","DOI":"10.1007\/s40262-020-00975-y","volume":"60","author":"DM Pariser","year":"2021","unstructured":"Pariser, D. M., Lain, E. L., Mamelok, R. D., Drew, J. & Mould, D. R. Limited systemic exposure with topical glycopyrronium tosylate in primary axillary hyperhidrosis. Clin. Pharmacokinet.60, 665\u2013676 (2021).","journal-title":"Clin. Pharmacokinet."},{"key":"74430_CR22","doi-asserted-by":"publisher","unstructured":"Woodford, H. J. & Stevenson, J. M. Anticholinergic drugs and dementia: time for transparency in the face of uncertainty. Cochrane Database Syst. Rev. 9. https:\/\/doi.org\/10.1002\/14651858.ED000154 (2021).","DOI":"10.1002\/14651858.ED000154"}],"container-title":["Scientific Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.nature.com\/articles\/s41598-024-74430-4.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.nature.com\/articles\/s41598-024-74430-4","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.nature.com\/articles\/s41598-024-74430-4.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,10,22]],"date-time":"2024-10-22T17:06:12Z","timestamp":1729616772000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.nature.com\/articles\/s41598-024-74430-4"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,10,19]]},"references-count":22,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2024,12]]}},"alternative-id":["74430"],"URL":"https:\/\/doi.org\/10.1038\/s41598-024-74430-4","relation":{},"ISSN":["2045-2322"],"issn-type":[{"value":"2045-2322","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,10,19]]},"assertion":[{"value":"1 February 2024","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"26 September 2024","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"19 October 2024","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"This article does not contain any studies with human participants or animals performed by any of the authors.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"<!--Emphasis Type='Bold' removed-->Ethics approval and consent to participate"}},{"value":"Not applicable.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"<!--Emphasis Type='Bold' removed-->Consent for publication"}},{"value":"The authors declare no competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"24537"}}