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Oral glycopyrrolate as second-line treatment for primary pediatric hyperhidrosis
Amy S Paller1, Puja R Shah, Amanda M Silverio
1Departments of Dermatology and Pediatrics, Northwestern University Feinberg School of Medicine, Chicago, Illinois 60611-2941, USA. apaller@northwestern.edu
Insights
Oral glycopyrrolate effectively treats primary focal hyperhidrosis in children. This medication offers a safe and cost-effective second-line treatment option, significantly improving quality of life for pediatric patients.
Area of Science:
- Pediatric Dermatology
- Clinical Pharmacology
Background:
- Primary focal hyperhidrosis commonly affects children and adolescents, significantly impacting their quality of life.
- Limited treatment options have been studied for pediatric hyperhidrosis.
Purpose of the Study:
- To evaluate the efficacy and safety of oral glycopyrrolate in pediatric patients with primary focal hyperhidrosis.
- To assess glycopyrrolate as a second-line therapy for children resistant or intolerant to aluminum salts.
Main Methods:
- Retrospective review of pediatric patient records over a 10-year period.
- Inclusion of patient and parent interviews where possible.
- Assessment of oral glycopyrrolate's efficacy and adverse effects.
Main Results:
- Ninety percent of 31 pediatric patients experienced improvement with oral glycopyrrolate, with 71% showing major improvement.
- Improvement was rapid, occurring within hours of administration and lasting until discontinuation.
- Common side effects included dry mouth (26%) and dry eyes (10%), which were dose-related.
Conclusions:
- Oral glycopyrrolate is a cost-effective and painless second-line treatment for pediatric primary focal hyperhidrosis.
- The medication significantly improves quality of life for children and adolescents suffering from this condition.
- Further research may be warranted given the retrospective nature and limited sample size.
Background:
Primary focal hyperhidrosis not uncommonly begins during the first two decades of life, and can have a profound effect on quality of life. Few treatment options have been studied in children.
Objective:
We sought to evaluate the response to oral glycopyrrolate in pediatric patients.
Methods:
Records of pediatric patients with hyperhidrosis seen at a pediatric hospital in a 10-year period were reviewed retrospectively and, if possible, parents and patients were also interviewed. The efficacy and adverse effects of oral glycopyrrolate were assessed.
Results:
In all, 31 children took at least one dose of oral glycopyrrolate. All had daily hyperhidrosis that affected their quality of life and were resistant or intolerant of aluminum salts. The mean age of hyperhidrosis onset was 10.3 years, and mean age of initiation of glycopyrrolate was 14.8 years. At a mean dosage of 2 mg daily, 90% of patients experienced improvement, which was major in 71% of responders. Improvement occurred within hours of administration and disappeared within a day of discontinuation. Duration of treatment averaged 2.1 years (range to 10 years). Side effects were noted by 29% of children, most commonly dry mouth (26%) and eyes (10%), and were dose-related. One patient developed blurred vision, which resolved with dosing below 5 mg/d; one patient experienced palpitations and discontinued the medication.
Limitations:
This was a retrospective analysis of a limited number of pediatric patients.
Conclusion:
Oral glycopyrrolate is a cost-effective, painless second-line therapy for children and adolescents with primary focal hyperhidrosis that impacts their quality of life.
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