Topical anticholinergic medications for primary hyperhidrosis: A protocol for a systematic review and meta-analysis

Abstract Background Primary hyperhidrosis (PHH) is a chronic condition characterized by excessive sweating. Several topical anticholinergic agents have been developed, but the evidence for the efficacy and tolerability of changing medication pathways of anticholinergics for PHH is limited. We will review the available literature to derive information regarding the efficacy and safety of different medicines used for the topical treatment of patients with hyperhidrosis. Methods PubMed, Cochrane Library, Embase, Web of Science, and Cochrane Central Register of Controlled Trials will be searched from inception to May 2023 for studies that may be eligible for inclusion. Randomized controlled trials (RCTs) of PHH treated with topical anticholinergic drugs will be included in the analysis. The primary outcomes will include the severity of hyperhidrosis measured quantitatively, the Hyperhidrosis Disease Severity Scale (HDSS) score, or the proportion of subjects with a minimum 2-grade improvement from baseline in HDSS, the Hyperhidrosis Disease Severity Measure-Axillary (HDSM-Ax) score, and Dermatology Life Quality Index (DLQI). The secondary outcomes will focus on safety and tolerability. Study selection, data extraction, and assessment of the risk of bias will be independently performed by two investigators. Data synthesis will be performed using Review Manager 5.4 software. Results The results will be published as a peer-reviewed article. Conclusions This review will systematically evaluate the existing evidence on the efficacy and safety of topical anticholinergic agents in the treatment of PHH. These conclusions will provide supporting evidence for the current guidelines and more reliable evidence-based medicine references for clinical practitioners and researchers. PROSPERO registration number CRD42022312316