The lack of available treatments for axillary hyperhidrosis (AH), a disease characterized by increased sweat production in the armpits, offers an opportunity for pharmaceutical and biotechnology companies, according to GlobalData, a leading data and analytics company.

Mandana Emamzadeh, PhD, Pharma Analyst at GlobalData, comments: “GlobalData has identified several key unmet needs in the AH space, including the need for improved anticholinergic drug delivery systems, therapies causing longer-lasting neuromuscular blockade, increased awareness and education, and better insurance coverage for treatments.

“Brickell Biotech’s Ecclock (sofpironium bromide), an anticholinergic drug, is currently the only pipeline agent in Phase III development. Therefore, opportunity remains for drug developers in the AH market.”

Emamzadeh outlines some of these unmet needs in further detail:

Improved anticholinergic delivery systems

Journey Medical Corporation’s Qbrexza (glycopyrronium tosylate), a topical anticholinergic drug, was approved by the FDA in 2018 and has become a game-changer in the AH treatment paradigm.

Emamzadeh explains: “Being easy to use and showing few side effects, Qbrexza’s wipes saw rapid acceptance by patients and improved adherence. However, the product does require hand contact with the drug, which isn’t ideal.”

Emamzadeh adds: “Despite having superior efficacy to Qbrexza, Ecclock does not offer a better delivery method. Key opinion leaders (KOLs) interviewed by GlobalData believed that a topical anticholinergic product utilizing a novel delivery system would be welcomed. They advised dispensing anticholinergic drugs using a roll-on device, rather than a wipe or gel, as it prevents the patient from touching the medications, avoiding potential cross-contamination to the face and eyes.”

Longer-lasting neuromuscular blockade

After failing to respond or losing response to antiperspirants and topical anticholinergics, patients with AH are eligible to receive neuromuscular blockade via local botulinum toxin injection. The only marketed drug in this class that is approved for use in AH is AbbVie’s Botox (onabotulinumtoxin A).

Emamzadeh notes: “Botulinum toxin therapies only present a temporary solution to symptoms due to their four to six month duration of action. The absence of pipeline agents in the neuromuscular blockade drug class offers opportunity for the development of alternative neurotoxin drugs that require less-frequent injection than Botox.”

Increased awareness and education

The negative impacts of AH on social functioning are often underestimated. KOLs noted that the majority of patients remain undiagnosed and do not seek treatment – despite the availability of treatments that can effectively control sweating and improve patients’ quality of life.

Emamzadeh continues: “There remains a significant need for greater investment into educational strategies to increase awareness about AH and the types of treatments that are currently available. This will help to increase the diagnosis rate and bring significant quality-of-life improvements to the AH patient population.”

Improved insurance coverage

Generally, health insurance coverage for AH treatment in the US is limited.

Emamzadeh adds: “Regardless of severity, patients must receive prescription antiperspirants as first-line therapy to be able to receive topical anticholinergics as a second-line therapy. In addition, insurance coverage only applies to medications and not to procedures – such as the microwave energy treatment, miraDry or surgery. Therefore, better strategies are needed to improve insurance coverage.”