Appendix: Search strategy and evidence selection

Appendix: Search strategy and evidence selection

Search strategy

General background, guidelines and technology assessments:

MEDLINE (via Ovid)

Database: Ovid MEDLINE(R) In-Process & Other Non-Indexed Citations and Ovid MEDLINE(R) <1946 to Present>

Search Strategy:

--------------------------------------------------------------------------------

  1. Glycopyrrolate/ (651)

  2. (Glycopyrronium or Glycopyrrolate or Cuvposa or Robinul).mp. (947)

  3. 1 or 2 (947)

  4. hyperhidrosis.tw. (2300)

  5. ((abnormal$ or excess$) adj3 (sweat$ or perspir$)).tw. (734)

  6. Sweating/ (5415)

  7. exp Hyperhidrosis/ (2734)

  8. 4 or 5 or 6 or 7 (8907)

  9. 3 and 8 (50)

  10. limit 9 to english language (45)

Embase (via Ovid)

Database: Embase <1988 to 2013 April 15>

Search Strategy:

--------------------------------------------------------------------------------

  1. Glycopyrronium bromide/ (3251)

  2. (Glycopyrronium or Glycopyrrolate or Cuvposa or Robinul).tw. (815)

  3. 1 or 2 (3348)

  4. hyperhidrosis.tw. (2541)

  5. ((abnormal$ or excess$) adj3 (sweat$ or perspir$)).tw. (809)

  6. Hyperhidrosis/ (4815)

  7. sweating/ (11869)

  8. 4 or 5 or 6 or 7 (16597)

  9. 3 and 8 (129)

  10. limit 9 to english language (120)

  11. limit 10 to exclude medline journals (19)

Cochrane Central Register of Controlled Trials (CENTRAL)

ID Search Hits

#1 MeSH descriptor: [Glycopyrrolate] explode all trees 197

#2 Glycopyrronium or Glycopyrrolate or Cuvposa or Robinul:ti,ab,kw (Word variations have been searched) 411

#3 #1 or #2 411

#4 MeSH descriptor: [Hyperhidrosis] explode all trees 133

#5 "hyperhidrosis":ti,ab,kw (Word variations have been searched) 215

#6 #4 or #5 233

#7 #3 and #6 in Trials 9

CRD HTA, DARE and EED database

MeSH DESCRIPTOR glycopyrrolate 2

(Glycopyrronium or Glycopyrrolate or Cuvposa or Robinul) 8

MeSH DESCRIPTOR hyperhidrosis EXPLODE ALL TREES 8

(hyperhidrosis or sweating or perspiration) 71

#1 OR #2 8

#3 OR #4 71

#5 AND #6 0

Manufacturers' websites

Merz

Shionogi

Robinul

Mercury Pharma

Evidence selection

Our literature search identified no randomised controlled trials examining the effectiveness of oral glycopyrronium bromide for treating hyperhidrosis. The search retrieved case series reporting various populations using different methods of administration of glycopyrronium bromide. No evidence was submitted from the manufacturer for this indication.

We reviewed the 5 case series that have evaluated the use of oral glycopyrronium bromide in people with primary (idiopathic) or secondary hyperhidrosis.

We excluded case series and 1 small randomised controlled crossover trial (n=13) assessing the topical application of glycopyrronium bromide solution/lotion/cream in people with primary or secondary hyperhidrosis. We also excluded case series evaluating the effect of glycopyrronium bromide for the iontophoretic treatment of the plantar and palmar skin (the licensed indication).