The National Institute for Health and Care Excellence (NICE) has recommended axunio UK’s glycopyrronium bromide (GPB) cream for routine NHS use in England as a treatment option for adults with severe primary axillary hyperhidrosis (PAHH).
GPB cream is designed to block the signalling pathway that activates the sweat glands, helping to reduce excessive sweating, and is a self-administered topical treatment available to patients in both primary and secondary care.
In the phase 3b study, median total sweat production was significantly reduced by 65.6% following 12 weeks of treatment with GPB 1% cream compared with baseline. At week 12, 54.1% of patients had a ≥50% reduction in sweat production; 36% had a ≥75% reduction and 22% had a ≥90% reduction.
Patients’ quality of life was improved at all study time points up to 72 weeks compared to baseline.
The treatment is recommended for adults whose symptoms have not been adequately controlled with lifestyle measures, topical aluminium-based antiperspirants and oral antimuscarinic medicines, or for whom these options are contraindicated or not tolerated.
This recommendation marks an important step forward in the treatment of severe PAHH as it represents the first time NICE has evaluated and recommended a treatment option specifically for hyperhidrosis.
Severe PAHH is characterised by excessive sweating beyond what is required for normal temperature regulation and it can have a greater impact on a patient’s quality of life than other skin conditions such as atopic eczema, acne, psoriasis or rosacea.
Hyperhidrosis is estimated to affect between 1% and 5% of the population and can have a substantial impact on daily activities, social interactions, emotional well-being and quality of life. Despite this burden, the condition remains under-recognised and under-diagnosed.
Primary hyperhidrosis commonly begins during childhood or adolescence and may persist throughout life. Studies suggest that between 25% and 50% of affected individuals have a family history of the condition, indicating a potential genetic component.
NICE estimates that approximately 75,000 people in England may be eligible for treatment with GPB cream. The NICE recommendation is supported by evidence from a multicentre phase 3a study, consisting of a 4-week double-blind and placebo-controlled treatment period, followed by an open-label phase 3b extension study of 72 weeks.