Qbrexza Cloths for Hyperhidrosis of Amputation Sites

NCT ID: NCT04924036

Last Updated: 2026-01-22

Study Results

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Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

PHASE2

Total Enrollment

13 participants

Study Classification

INTERVENTIONAL

Study Start Date

2021-09-27

Study Completion Date

2023-12-03

Brief Summary

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This is a Prospective, Double Blinded, Placebo Controlled, Randomized, Cross-over trial using Qbrexza Cloths to treat hyperhidrosis of amputation sites. There is a 2 week screening period where patients will use an activity monitor to establish baseline activity level, then patients will be randomized to receive either Qbrexza cloths or placebo for 4 weeks, then a 2 week washout, and then a 4-week cross-over treatment period.

Detailed Description

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BACKGROUND:

Approximately 1 in 190 people in the United States have experienced a limb amputation. Of these patients with amputations, over sixty percent suffer from hyperhidrosis at the amputation site. Amputation site hyperhidrosis interferes with these patients' daily activities as well as their ability to engage in vigorous activity beneficial to their overall health. In fact, amputees identified heat and sweating as what reduces their quality of life more than any other problem, even pain. Despite the significant impact hyperhidrosis has on amputees' quality of life and ability to stay physically active, there are no self-administered, non-invasive, well-tolerated treatments for amputation site hyperhidrosis. Botulinum toxin injections are an available treatment option for focal hyperhidrosis. However, the large surface area covered by the prosthetic and prosthetic sleeve often necessitates very large volumes of botulinum toxin for effective treatment at amputation sites. This is costly, making it difficult to be able to treat the entire affected area. Botulinum toxin also requires office visits and repeat treatments every 4-6 months.

Glycopyrronium cloths are a unique treatment possibility, because they can easily be used over a large body surface area and can easily be self-administered at home. At this time, glycopyrronium cloths are only FDA approved for use in the axillae. There are two primary differences between the use of these cloths at amputation sites and axillae: 1) the amputation site is occluded during daytime hours by the prosthetic and 2) the area treated for amputation-site hyperhidrosis (the entire area covered by the prosthetic sleeve) is typically a much larger surface area than the axillae. These factors could significantly increase systemic absorption of glycopyrronium and cause systemic side effects. In order to minimize these effects, the medication will be applied at night, when the site is not occluded. Frequent visits with the investigator will also encourage early reporting of symptoms which could be the result of systemic side effects associated with use on a larger surface area. Patient reported outcomes will be used to determine effectiveness.

This is a Prospective, Double Blinded, Placebo Controlled, Randomized, Cross-over trial.

Participants will be randomized, using a 1:1 ratio, to one of 2 arms:

* Arm #1: At Baseline participants will receive active treatment for 4 weeks, completing a 1 week wash out period and then concluding with 4 weeks of placebo treatment
* Arm #2: At baseline participants will receive placebo for 4 weeks, completing a 1 week washout period and then concluding with active treatment for 4 weeks.

Primary Objective 1. Determine if daily use of glycopyrronium cloths applied to the amputation site decreases hyperhidrosis severity and improved fit and function of the prosthetic as measured by patient reported outcome measures.

Primary Endpoints

1\. Determine the change in ASDD-m Impact scores between the end of the treatment and placebo periods.

Conditions

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Amputation Hyperhidrosis

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

CROSSOVER

This is a Prospective, Double Blinded, Placebo Controlled, Randomized, Cross-over trial.
Primary Study Purpose

TREATMENT

Blinding Strategy

DOUBLE

Participants Investigators
Participants and investigators in the trial will be blinded.

Study Groups

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Glycopyrronium Cloths then Placebo

Participants that are randomized to Glycopyrronium cloths for 4 weeks, then 2 week wash out, then cross over to placebo cloths for 4 weeks.

Group Type OTHER

glycopyrronium cloths

Intervention Type DRUG

Qbrexza is an anticholinergic indicated for topical treatment of axillary hyperhidrosis in adults and pediatric patients 9 years of age and older

Placebo

Intervention Type DRUG

Placebo for this study are cloths that look like the qbrexza cloths but do not have any active ingredient.

Placebo then Glycopyrronium Cloths

Participants that are randomized to placebo cloths for 4 weeks, then 2 week wash out, then cross over to Glycopyrronium cloths for 4 weeks.

Group Type OTHER

glycopyrronium cloths

Intervention Type DRUG

Qbrexza is an anticholinergic indicated for topical treatment of axillary hyperhidrosis in adults and pediatric patients 9 years of age and older

Placebo

Intervention Type DRUG

Placebo for this study are cloths that look like the qbrexza cloths but do not have any active ingredient.

Interventions

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glycopyrronium cloths

Qbrexza is an anticholinergic indicated for topical treatment of axillary hyperhidrosis in adults and pediatric patients 9 years of age and older

Intervention Type DRUG

Placebo

Placebo for this study are cloths that look like the qbrexza cloths but do not have any active ingredient.

Intervention Type DRUG

Other Intervention Names

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Qbrexza Cloths

Eligibility Criteria

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Inclusion Criteria

1. History of limb amputation with limb-amputation surgery at least 6 months ago
2. Have a prosthetic device

4\. HDSS of 3 or greater (at screening) 5. ASDD-m Item 2 severity score \>= 4 (at screening) 6. PFFQ score \>= 4 (at screening)

Exclusion Criteria

1. Open sores or wounds on residual limb (at screening and baseline)
2. Known sensitivity to glycopyrronium tosylate or other component of Qbrexza
3. Pregnant or lactating.
4. Use of botulinum toxin within 1 year of the baseline visit
5. Use of topical aluminum chloride within 1 month of the baseline visit
6. Any significant concurrent condition that could adversely affect the patient's participation and/or the assessment of the safety and efficacy in the study in the opinion of the investigator
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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University of Utah

OTHER

Sponsor Role lead

Responsible Party

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Stephanie Z Klein

Assistant Professor, Dermatology, Principal Investigator

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Stephanie Z Klein, MD

Role: PRINCIPAL_INVESTIGATOR

University of Utah

Locations

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University of Utah MidValley Dermatology

Murray, Utah, United States

Site Status

Countries

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United States

References

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Hansen C, Godfrey B, Wixom J, McFadden M. Incidence, severity, and impact of hyperhidrosis in people with lower-limb amputation. J Rehabil Res Dev. 2015;52(1):31-40. doi: 10.1682/JRRD.2014.04.0108.

Reference Type BACKGROUND
PMID: 26230919 (View on PubMed)

Strutton DR, Kowalski JW, Glaser DA, Stang PE. US prevalence of hyperhidrosis and impact on individuals with axillary hyperhidrosis: results from a national survey. J Am Acad Dermatol. 2004 Aug;51(2):241-8. doi: 10.1016/j.jaad.2003.12.040.

Reference Type BACKGROUND
PMID: 15280843 (View on PubMed)

Chren MM. The Skindex instruments to measure the effects of skin disease on quality of life. Dermatol Clin. 2012 Apr;30(2):231-6, xiii. doi: 10.1016/j.det.2011.11.003. Epub 2011 Dec 20.

Reference Type BACKGROUND
PMID: 22284137 (View on PubMed)

Hagberg K, Branemark R. Consequences of non-vascular trans-femoral amputation: a survey of quality of life, prosthetic use and problems. Prosthet Orthot Int. 2001 Dec;25(3):186-94. doi: 10.1080/03093640108726601.

Reference Type BACKGROUND
PMID: 11860092 (View on PubMed)

Nelson LM, DiBenedetti D, Pariser DM, Glaser DA, Hebert AA, Hofland H, Drew J, Ingolia D, Gillard KK, Fehnel S. Development and validation of the Axillary Sweating Daily Diary: a patient-reported outcome measure to assess axillary sweating severity. J Patient Rep Outcomes. 2019 Sep 5;3(1):59. doi: 10.1186/s41687-019-0148-8.

Reference Type BACKGROUND
PMID: 31486951 (View on PubMed)

Lamb YN. Topical Glycopyrronium Tosylate in Primary Axillary Hyperhidrosis: A Profile of Its Use. Clin Drug Investig. 2019 Nov;39(11):1141-1147. doi: 10.1007/s40261-019-00853-x.

Reference Type BACKGROUND
PMID: 31571127 (View on PubMed)

Solish N, Bertucci V, Dansereau A, Hong HC, Lynde C, Lupin M, Smith KC, Storwick G; Canadian Hyperhidrosis Advisory Committee. A comprehensive approach to the recognition, diagnosis, and severity-based treatment of focal hyperhidrosis: recommendations of the Canadian Hyperhidrosis Advisory Committee. Dermatol Surg. 2007 Aug;33(8):908-23. doi: 10.1111/j.1524-4725.2007.33192.x.

Reference Type BACKGROUND
PMID: 17661933 (View on PubMed)

Ziegler-Graham K, MacKenzie EJ, Ephraim PL, Travison TG, Brookmeyer R. Estimating the prevalence of limb loss in the United States: 2005 to 2050. Arch Phys Med Rehabil. 2008 Mar;89(3):422-9. doi: 10.1016/j.apmr.2007.11.005.

Reference Type BACKGROUND
PMID: 18295618 (View on PubMed)

Provided Documents

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Document Type: Study Protocol and Statistical Analysis Plan

View Document

Other Identifiers

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IRB_00139912

Identifier Type: -

Identifier Source: org_study_id

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