Abstract
Focal hyperhidrosis often has a substantial psychological and social impact on quality of life, since it interferes with daily activities. To date, for the treatment of focal hyperhidrosis, the botulinum toxin type A is an effective second line tool. The purpose of this study was to compare Onabotulinumtoxin A (Botox®) and Incobotulinumtoxin A (Xeomin®) administration in the treatment of palmar hyperhidrosis. In a double-blind clinical trial, 25 patients with moderate or severe palmar hyperhidrosis received in the same session intradermal injections of Onabotulinumtoxin A on one hand and Incobotulinumtoxin A on the other. Several measures of efficacy and safety were evaluated: disease severity improvement, sweat reduction, hand-grip strength decrease, pain/discomfort during the treatment, and patient’s global satisfaction. All patients were responsive to the treatments (HDSS at T4 vs HDDs at T0; p < 0.0001), and no significant difference between Onabotulinumtoxin A and Incobotulinumtoxin A in terms of anhidrotic effect (Minor’s test at T4; p = 0.51), long-term efficacy (Minor’s test at T12; p = 0.76), (Minor’s test at T24; p = 0.58), subjective pain related to the injections (p = 0.88), muscle strength reduction after treatment (p = 0.56), and global satisfaction with the treatment (p = 0.26). Onabotulinum toxin A and Incobotulinumtoxin A seem to be comparable in terms of anhidrotic effect (short-term results), duration of benefits (long-term efficacy), muscle strength reduction (safety), pain related to injections (tolerability), and treatment satisfaction expressed by patients.
Similar content being viewed by others
References
Brin MF (1997) Dosing, administration, and a treatment algorithm for use of botulinum toxin A for adult-onset spasticity. Spasticity Study Group. Muscle Nerve Suppl. 6:S208–S220
Campanati A, Lagalla G, Penna L, Gesuita R, Offidani A (2004) Local neural block at the wrist for treatment of palmar hyperhidrosis with botulinum toxin: technical improvements. J Am Acad Dermatol 51(3):345–348
Campanati A, Bernardini ML, Gesuita R, Offidani A (2007) Plantar focal idiopathic hyperhidrosis and botulinum toxin: a pilot study. Eur J Dermatol 17:52–54
Campanati A, Sandroni L, Gesuita R, Giuliano A, Giuliodori K, Marconi B, Ganzetti G, Offidani A (2011) Treatment of focal idiopathic hyperhidrosis with Botulinum Toxin Type A: clinical predictive factors of relapse-free survival. J Eur Acad Dermatol Venereol 25(8):917–921
Carli L, Montecucco C, Rossetto O (2009) Assay of diffusion of different botulinum neurotoxin type a formulations injected in the mouse leg. Muscle Nerve 40(3):374–380
Carruthers A, Carruthers J (2000) Toxins 99, new information about the botulinum neurotoxins. Dermatol Surg 26:174–176
Dressler D (2010) Comparing Botox and Xeomin for axillar hyperhidrosis. J Neural Transm. 117(3):317–319
Dressler D (2012) Five-year experience with incobotulinumtoxin A (Xeomin®): the first botulinum toxin drug free of complexing proteins. Eur J Neurol 19(3):385–389
Durif F (1995) Clinical bioequivalence of the current commercial preparations of botulinum toxin. Eur J Neurol 2:17–18
Evidente VG, Fernandez HH, Ledoux MS, Brashear A, Grafe S, Hanschmann A, Comella CL (2013) A randomized, double-blind study of repeated incobotulinumtoxin A (Xeomin®) in cervical dystonia. J Neural Transm [Epub ahead of print]
Frevert J (2009a) Xeomin: an innovative new botulinum toxin type A. Eur J Neurol 16(Suppl 2):11–13
Frevert J (2009b) Xeomin® is free from complexing proteins. Toxicon 54(5):697–701
Glaser DA, Hebert AA, Pariser DM, Solish N (2007) Primary focal hyperhidrosis: scope of the problem. Cutis 79(Suppl 5):5–17 (Review)
Haider A, Solish N (2005) Focal hyperhidrosis: diagnosis and management. CMAJ 172:69–75
Hamilton GF, McDonald C, Chenier TC (1992) Measurement of grip strength: validity and reliability of the sphygmomanometer and jamar grip dynamometer. J Orthop Sports Phys Ther 16(5):215–219
Hamm H, Naumann MK, Kowalski JW, Kütt S, Kozma C, Teale C (2006) Primary focal hyperhidrosis: disease characteristics and functional impairment. Dermatology 212:343–353
Hexsel D, Rodrigues TC, Soirefmann M, Zechmeister-Prado D (2010) Recommendations for performing and evaluating the results of the minor test according to a sweating intensity visual scale. Dermatol Surg 36(1):120–122
Hornberger J, Grimes K, Naumann M et al (2004) Recognition, diagnosis, and treatment of primary focal hyperhidrosis. J Am Acad Dermatol 51:274–286
Illigens BM, Gibbons CH (2009) Sweat testing to evaluate autonomic function. Clin Auton Res 19:79–87
Park J, Lee MS, Harrison AR (2011) Profile of Xeomin® (incobotulinumtoxin A) for the treatment of blepharospasm. Clin Ophthalmol 5:725–732
Lear W, Kessler E, Solish N, Glaser DA (2007) An epidemiological study of hyperhidrosis. Dermatol Surg 33(1 Spec No.) S69–S75
Lowe NJ, Yamauchi PS, Lask GP, Patnaik R, Iyer S (2002) Efficacy and safety of botulinum toxin type A in the treatment of palmar hyperhidrosis: a double-blind, randomized, placebo-controlled study. Dermatol Surg 28:822–827
Pickett A, O’Keeffe R, Panjwani N (2007) The protein load of therapeutic botulinum toxins. Eur J Neurol 14:e11
Sampaio C, Ferreira JJ, Simoes F, Rosas MJ, Magalhaes M, Correia AP et al (1997) DYSBOT: a single-blind, randomized parallel study to determine whether any differences can be detected in the efficacy and tolerability of two formulations of botulinum toxin type A—Dysport and Botox—assuming a ratio of 4:1. Mov Disord 12:1013–1018
Sato K, Kang WH, Saga K, Sato KT (1989) Biology of sweat glands and their disorders. II. Disorders of sweat gland function. J Am Acad Dermatol 1:713–726
Skroza N, Bernardini N, La Torre G, La Viola G, Potenza C (2011) Correlation between dermatology life quality index and minor test and differences in their levels over time in patients with axillary hyperhidrosis treated with botulinum toxin type A. Acta Dermatoverereol Croat 19:16–19
Solish N, Bertucci V, Dansereau A et al (2007) A comprehensive approach to the recognition, diagnosis, and severity-based treatment of focal hyperhidrosis: recommendations of the Canadian Hyperhidrosis Advisory Committee. Dermatol Surg 33:908–923
Strutton DR, Kowalski JW, Glaser DA, Stang PE (2004) US prevalence of hyperhidrosis and impact on individuals with axillary hyperhidrosis: results from a national survey. J Am Acad Dermatol 51:241–248
Vadoud-Seyedi J, Heenen M, Simonart T (2001) Treatment of idiopathic palmar hyperhidrosis with botulinum toxin. Report of 23 cases and review of the literature. Dermatology 203(4):318–321
Author information
Authors and Affiliations
Corresponding author
Additional information
A. Campanati and K. Giuliodori equally contributed to the manuscript.
Rights and permissions
About this article
Cite this article
Campanati, A., Giuliodori, K., Martina, E. et al. Onabotulinumtoxin type A (Botox®) versus Incobotulinumtoxin type A (Xeomin®) in the treatment of focal idiopathic palmar hyperhidrosis: results of a comparative double-blind clinical trial. J Neural Transm 121, 21–26 (2014). https://doi.org/10.1007/s00702-013-1074-1
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00702-013-1074-1