Comparing Botox^® and Xeomin^® for axillar hyperhidrosis

Recently, Xeomin^®, a novel botulinum toxin (BT) type A drug became available. Separation of complexing proteins reduced the size of its BT component, thus potentially affecting its tissue diffusion, adverse effect profile and therapeutic properties. We report the first use of Xeomin^® in an autonomic indication. A total of 46 patients (34 females, 12 males, age 32.7 ± 13.2 years, disease duration 14.2 ± 12.0 years) with symmetric bilateral idiopathic axillar hyperhidrosis and a previously stable Botox^® treatment received 50 MU of BT in 5 ml of 0.9% NaCl/H₂0 in each axilla. The patient, the injector and the observer were unaware of which axilla received Xeomin^® and which Botox^®. The therapeutic effect as measured from the BT application to the onset of its decrease lasted 3.2 ± 1.4 months and was excellent in 89% and good in 11% of the patients. Side-to-side differences of the therapeutic effect (onset latency, extent, duration) were neither detectable by the patient nor by the physician. Injection site pain was identical and adverse effects did not occur. Xeomin^® can be used safely and effectively for the treatment of axillar hyperhidrosis. Size differences between Xeomin^® and Botox^® do not affect their therapeutic efficacy, tissue diffusion and adverse effect profile. Identical potency labelling allows easy exchange between both products.