Duration of Qbrexza Treatment for Primary Hyperhidrosis
Qbrexza (glycopyrronium tosylate) can be used long-term for primary axillary hyperhidrosis, with safety and efficacy demonstrated for up to 48 weeks of continuous daily use.
Evidence for Long-Term Use
The most robust evidence comes from a 44-week open-label extension study that followed patients who completed initial 4-week double-blind trials 1. This study specifically evaluated the safety and efficacy of extended glycopyrronium tosylate treatment:
- Treatment duration studied: Up to 48 weeks total (4 weeks double-blind + 44 weeks open-label extension) 1
- Efficacy maintained throughout: At week 44, the Hyperhidrosis Disease Severity Scale responder rate was 63.2%, with sweat production reductions of 71.3% from baseline 1
- Quality of life improvements sustained: Dermatology Life Quality Index scores remained improved at 8.7 ± 6.2 at week 44 1
Safety Profile with Extended Use
Long-term daily application was generally well tolerated 1:
- Most treatment-emergent adverse events were mild or moderate (>90% of cases) 1
- Cumulative discontinuation rate due to adverse events was only 8.0% over 44 weeks 1
- Common adverse events included dry mouth (16.9%), blurred vision (6.7%), and application-site pain (6.4%) 1
- Most patients (67.5%) had no local skin reactions 1
- No new safety signals emerged with extended use 1
Clinical Application
There is no predetermined endpoint for discontinuing Qbrexza - treatment should continue as long as:
- The patient continues to experience benefit (maintained reduction in sweating and improved quality of life) 1
- The medication remains well-tolerated 1
- The patient desires ongoing treatment 2
The medication provides a self-administered, non-invasive option that can be used chronically, similar to how patients with chronic conditions use maintenance therapies 2. Efficacy appears within hours of administration and disappears within a day of discontinuation, allowing for flexible use patterns if needed 3.
Important Considerations
- Qbrexza is approved for patients aged ≥9 years 1, 2
- Proper application technique is critical: wipe each underarm once with the same cloth, wash hands immediately after, and avoid ocular contact to minimize systemic absorption and anticholinergic adverse events 4
- Limited systemic absorption occurs with proper topical application compared to oral glycopyrrolate formulations 4