NICE has recommended Axhidrox (glycopyrronium bromide) cream for routine NHS use in adults with severe primary axillary hyperhidrosis whose symptoms are not adequately controlled with lifestyle advice, topical aluminium‑based antiperspirants or oral antimuscarinic medicines, or for whom these options are contraindicated or not tolerated.
The decision marks the first time NICE has evaluated and recommended a treatment specifically for hyperhidrosis.
Severe primary axillary hyperhidrosis is characterised by excessive underarm sweating beyond what is required for normal temperature regulation.
The condition can have a greater impact on quality of life than other dermatological conditions and remains under‑recognised and under‑diagnosed. Hyperhidrosis affects an estimated 1% to 5% of the population and can significantly disrupt daily activities, social interactions and emotional well‑being.
Axunio UK said Axhidrox is designed to block the signalling pathway that activates sweat glands, helping reduce excessive sweating. As a self‑administered topical treatment, it can be managed largely in primary care. NICE estimates that around 75,000 people in England may be eligible for treatment.
Richard Baderin, Managing Director at axunio UK, said: “Hyperhidrosis can have a profound impact on many aspects of daily life, yet treatment options have historically been limited.”
He added: “The NICE recommendation for GPB cream represents an important milestone for adults living with severe primary axillary hyperhidrosis and provides access to the UK’s only licensed topical anticholinergic treatment for this condition.”
The recommendation is supported by evidence from a multicentre phase 3a study followed by a phase 3b extension. In the phase 3a trial, GPB 1% cream achieved a statistically significant reduction in sweat production compared with placebo and delivered approximately two‑fold higher response rates. Quality of life improvements were also reported.
In the phase 3b study, median sweat production was reduced by 65.6% after 12 weeks of treatment, with sustained improvements up to 72 weeks. Adverse events were mostly mild to moderate and did not worsen with longer use.
