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'DelveInsight's "Axillary hyperhidrosis (AHH) - Market Insights, Epidemiology and Market Forecast - 2032" report delivers an in-depth understanding of historical and forecasted epidemiology as well as market trends of AHH in the United States, EU4 (Germany, France, Italy, Spain) and the United Kingdom, and Japan.
Axillary hyperhidrosis (AHH) market report provides current treatment practices, emerging drugs, market share of individual therapies, current and forecasted 7MM AHH market size from 2019 to 2032. The report also covers current AHH treatment practices/algorithms and unmet medical needs to curate the best opportunities and assess the market's potential.
Study Period: 2019-2032
Axillary hyperhidrosis (AHH) Disease Understanding and Treatment
Axillary hyperhidrosis (AHH) Overview
As per International Hyperhidrosis Society, axillary hyperhidrosis is defined by excessive underarm sweating. It is an uncontrollable, annoying, embarrassing, and isolating problem. Hyperhidrosis is categorized as either primary or secondary hyperhidrosis. Primary hyperhidrosis is idiopathic and is localized in a bilateral and symmetrical pattern affecting the axilla, palms, soles, and face. Secondary hyperhidrosis is usually focal or generalized due to underlying medical conditions.
In the US population, axillary hyperhidrosis (AHH) affects about 3.12%, of whom about 52% found sweating to interfere with daily activities and is barely tolerable (Sammons & Khachemoune, 2017).
Axillary hyperhidrosis (AHH) diagnosis
The diagnosis of Axillary hyperhidrosis (AHH) is based on Gravimetric testing (literally weighing the moisture on a filter paper, which is tedious and impractical in the clinical setting), Minor-starch-iodine test, which consists of placing starch and iodine on the area, and Ninhydrin test, which is based on the principle that ninhydrin reacts with amino acids in sweat.
Further details related to country-based variations are provided in the report…
Axillary hyperhidrosis (AHH) treatment
For the management and treatment of axillary hyperhidrosis, the goal is to reduce sweat production and sweat glands and ultimately to ameliorate symptoms and improve quality of life. A wide range of nonsurgical (e.g., topical, systemic) and surgical treatments are available for patients with focal hyperhidrosis.
Topical antiperspirant treatments are the recommended first-line treatment being the least expensive. However, they are not as effective as the other treatments in the long term and cause skin irritations. Botulinum toxin A injections are the recommended second-line treatment for patients who fail topical treatment.
Topical cryotherapy using a surface nitrous oxide cryoprobe applicator has also been tried with the rationale of freeze-damaging the sweat glands.
Microwave thermolysis is being used to treat hyperhidrosis. MiraDry is a US FDA-approved device that provides long-term efficacy with minimal transient side effects of local inflammation.
Surgery is advised when other conventional therapies fail. Local surgical approaches include excision, curettage, liposuction, and/or a combination. Conservative excision, called "Shelly procedure," scores over radical excision, which may lead to scarring and restricted arm movement.
The treatment landscape of AHH is expected to change substantially and experience growth. The upcoming launch of innovative therapies such as ECCLOCK (Botanix Pharmaceuticals) and others are expected to drive the market further.
As the market is derived using a patient-based model, the Axillary hyperhidrosis (AHH) epidemiology chapter in the report provides historical as well as forecasted epidemiology segmented by Total Diagnosed Prevalent Cases of Hyperhidrosis (HH), Total Diagnosed Prevalent Cases of Axillary Hyperhidrosis (AHH), Type-specific Cases of Axillary Hyperhidrosis (AHH), Age-specific Cases of Axillary Hyperhidrosis (AHH), and Severity-specific Cases of Axillary Hyperhidrosis (AHH) in the 7MM covering the United States, EU4 countries (Germany, France, Italy, Spain) and the United Kingdom, and Japan from 2019 to 2032.
The drug chapter segment of the axillary hyperhidrosis (AHH) report encloses a detailed analysis of AHH-marketed drugs and late-stage (Phase III and Phase II) pipeline drugs. It also helps understand the AHH clinical trial details, expressive pharmacological action, agreements and collaborations, approval and patent details, advantages and disadvantages of each included drug and the latest news and press releases.
Marketed Drugs
QBREXZA (glycopyrronium): Journey Medical Corporation
QBREXZA (glycopyrronium) is an anticholinergic indicated for topical treatment of primary axillary hyperhidrosis in adult and pediatric patients 9 and older. It is applied directly to the skin and blocks sweat production by inhibiting sweat gland activation.
The safety of QBREXA in children below 9 years of age is unknown. Moreover, the most common serious adverse effect of using QBREXA wipes are blurred vision and dehydration. Co-administration of QBREXZA with other anticholinergic wipes should also be avoided. It is also not recommended for people with kidney, prostate, or bladder problems, especially if they have trouble passing urine. Thus, there is a need for better anticholinergic treatment options for axillary hyperhidrosis.
AXHIDROX (glycopyrronium bromide): Dr. Wolff Group
AXHIDROX contains the active glycopyrronium and belongs to a group of sweat-reducing medicines called antihidrotics. Axhidrox is used for topical treatment of severe primary axillary hyperhidrosis in adults. In June 2022, Dr. Wolff Group recently announced that its topical cream AXHIDROX, containing 1% glycopyrronium bromide, was granted marketing authorization in Germany to treat severe primary axillary hyperhidrosis in adults.
The administration of AXHIDROX is associated with blurred vision, drowsiness, tiredness, and dizziness. Blurred vision, in particular, may occur if AXHIDROX gets into the eyes.
Note: Detailed current therapies assessment will be provided in the full report of AHH…
Emerging Drugs
ECCLOCK (sofpironium bromide): Botanix Pharmaceuticals
Sofpironium Bromide is an anticholinergic/antimuscarinic drug that blocks sweating at the gland by binding to the receptor, thereby blocking the sweat signal. It is formulated as a gel for topical application. Ecclock is indicated to treat primary axillary hyperhidrosis.
A patented applicator delivers it to the underarms as a gel formulation that allows the patient to avoid direct contact with the drug on their hands. The drug blocks sweating at the gland by binding to the receptor, thereby blocking the sweat signal.
As per DelveInsight analysis, ECCLOCK (sofpironium bromide) is expected to generate approximately USD 300 million in the 7MM by 2032.
Note: Detailed emerging therapies assessment will be provided in the final report…
Drug Class Insights
A wide range of nonsurgical (e.g., topical, systemic) and surgical treatments are available for patients with focal hyperhidrosis. These treatment modalities vary in their therapeutic efficacy, duration of effect, side effects, cost, and scientific evidence of their efficacy.
Topical antiperspirant treatments are the recommended first-line treatment being the least expensive. However, they are not as effective as the other treatments in the long term and cause skin irritations. Botulinum toxin A injections are the recommended second-line treatment for patients who fail topical treatments. Results last average, between 4 and 9 months, but are painful and costly.
First-line treatment recommendations for primary focal axillary hyperhidrosis include a topical antiperspirant that may be either a clinical-strength formulation available over the counter or a prescription-strength formulation containing aluminum and zirconium salts, or glycopyrronium cloth, which was approved in June 2018 and made commercially available in October 2018 for treatment of primary axillary hyperhidrosis in the US.
Second-line therapies include focal injections of botulinum toxin A or microwave thermolysis, although botulinum toxin A may be used as a first-line therapy in severe cases. Other options for persistent symptoms of hyperhidrosis include oral systemic therapies, such as glycopyrrolate or oxybutynin, removal of sweat glands (suction curettage), and endoscopic thoracic sympathectomy surgery.
QBREXZA (glycopyrronium) was approved in 2018 by the US FDA for the topical treatment of primary axillary hyperhidrosis in adults and pediatric patients 9 years and older. However, this drug also has various side effects and is not recommended for people with kidney, prostate, or bladder problems, especially if they have trouble passing urine. Thus, there is a need for better anticholinergic treatment options for axillary hyperhidrosis.
As few potential therapies are being investigated to manage axillary hyperhidrosis, predicting that the treatment space will experience significant reconstitution during 2023-2032 is safe. However, the challenges of the rigid and burdensome structure of regulatory authorities will decide the fate of all these pipeline therapies and their impact on overall revenue generation.
Key players such as ECCLOCK (Botanix Pharmaceuticals) and others are evaluating their lead candidates in different stages of clinical development, respectively. They aim to investigate their products for the treatment of AHH.
This section focuses on the uptake rate of potential drugs expected to be launched in the market during 2019-2032. For example, for ECCLOCK, which is expected to be launched in the US by 2024, the drug uptake is expected to be slow-medium, with a probability-adjusted peak patient share of ~2% in the US, expected to peak at 8 years from the year of launch.
Further detailed analysis of emerging therapies drug uptake in the report…
Axillary Hyperhidrosis (AHH) Pipeline Development Activities
The report provides insights into different therapeutic candidates in Phase III, Phase II, and Phase I stage. It also analyzes key players involved in developing targeted therapeutics.
Pipeline development activities
The report covers information on collaborations, acquisitions and mergers, licensing, and patent details for Axillary hyperhidrosis (AHH) emerging therapies.
KOL Views
To keep up with current market trends, we take KOLs and 'SME's opinions working in the domain through primary research to fill the data gaps and validate our secondary research. Industry experts contacted for insights on AHH evolving treatment landscape, patient reliance on conventional therapies, patient's therapy switching acceptability, and drug uptake, along with challenges related to accessibility, include Medical/scientific writers and Professors from renowned universities in the US, Europe, the UK, and Japan.
Delveinsight's analysts connected with 50+ KOLs to gather insights; however, interviews were conducted with 15+ KOLs in the 7MM. New York University School of Medicine, East Virginia Medical School, King's College London, etc., were contacted. Their opinion helped understand and validate current and emerging therapy treatment patterns of AHH market trends. This will support the clients in potential upcoming novel treatments by identifying the overall scenario of the market and the unmet needs.
Qualitative Analysis
We perform Qualitative and Market Intelligence analysis using SWOT analysis. In the SWOT analysis, strengths, weaknesses, opportunities, and threats in terms of disease diagnosis, patient awareness, patient burden, competitive landscape, cost-effectiveness, and geographical accessibility of therapies are provided. These pointers are based on the Analyst's discretion and assessment of the patient burden, cost analysis, and existing and evolving treatment landscape.
There has been an increase in the prevalence due to the introduction of newer tools such as Axillary Sweating Daily Diary (ASDD) for proper clinical evaluation of patient-reported outcome (PRO) measures to assess the severity of axillary hyperhidrosis in clinical trials. This has reduced underreporting of physicians, contributing to the strengths of the AHH market.
The market of AHH presents wide opportunities as, apart from QBREXZA, there are no better therapies for the anticholinergic class of drugs due to its adverse effects. Pharmaceutical companies have a huge opportunity due to the dearth of approved treatment options in the anticholinergic class of drugs in axillary hyperhidrosis.
Market Access and Reimbursement
The cost of newly approved medications is usually high, so patients escape from proper treatment or opt for off-label and cheap medications. It affects market access to newly launched medications, and reimbursement is crucial. The decision to reimburse often comes down to the 'drug's price relative to the benefit it produces in treated patients. Market access and reimbursement options can differ depending on regulatory status, target population size, the setting of care, unmet needs, the magnitude of incremental benefit claims, and costs.
The report further provides detailed insights on the country-wise accessibility and reimbursement scenarios, cost-effectiveness scenario of approved therapies, programs making accessibility easier and out-of-pocket costs more affordable, insights on patients insured under federal or state government prescription drug programs, etc.
Key Questions
Market Insights
Epidemiology Insights
Current Treatment Scenario, Marketed Drugs, and Emerging Therapies