Comparison of onabotulinumtoxinA and rimabotulinumtoxinB for the treatment of axillary hyperhidrosis

Abstract

Background: Recently, rimabotulinumtoxinB has been increasingly used as an off-label treatment of primary axillary hyperhidrosis (PAH). However, the optimal conversion ratios for onabotulinumtoxinA and rimabotulinumtoxinB remain to be determined.

Objective: To compare effectiveness, satisfaction level, and safety of rimabotulinumtoxinB with onabotulinumtoxinA at a conversion ratio of 1:30 for the treatment of PAH.

Methods: Adults with PAH were enrolled in this bilaterally paired single-subject study. Each patient was randomly treated with 1,500 U rimabotulinumtoxinB on 1 axilla and 50 U onabotulinumtoxinA contralaterally. Hyperhidrosis Disease Severity Scale was assessed before and after treatment up to 20 weeks. A 10-cm visual analog scale representing improvement of hidrotic symptom and starch-iodine test were also used to assess therapeutic efficacy.

Results: Twenty-four patients completed the study. Both groups showed comparable and efficacious anhidrotic effects through 20 weeks for any variable. There were no significant differences in terms of the onset of action or mean duration of action between the 2 groups. Overall satisfaction with the treatment was equally high in both groups.

Conclusion: Both toxins showed comparable anhidrotic effect for the treatment of axillary hyperhidrosis at a conversion ratio of 1:30.