Estudo da oxibutinina em pacientes com hiperidrose primária e sobrepeso
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Data
2017
Autores
Evangelista Neto, Ernesto [UNIFESP]
Orientadores
Koh, Ivan Hong Jun [UNIFESP]
Tipo
Dissertação de mestrado
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Resumo
O tratamento da hiperidrose em pacientes com sobrepeso apresenta restrições à simpatectomia devido à exacerbação da sudorese compensatória. A alternativa terapêutica com medicamentos anticolinérgicos tem sido a mais preconizada, porém o seu resultado permanece pouco estudado. Objetivo: Avaliar o efeito da Oxibutinina no tratamento da hiperidrose primária em pacientes com sobrepeso de forma qualitativa e quantitativa. Método: Os pacientes com sobrepeso foram submetidos à terapêutica com a oxibutinina por 30 dias (n=20) e avaliados pelos métodos qualitativo com o questionário de qualidade de vida (QQV) e quantitativo pela medida de Perda Transepidérmica por Evaporação de Água (PTEA) nas regiões das mãos, pés, tórax, costas e abdome. O grupo controle foi composto de pacientes com IMC<25 (n=22). Resultados: Após o tratamento com a oxibutinina, somente o grupo IMC mior ou igual a 25 mostrou uma tendência à melhora da qualidade de vida, no entanto sem significância estatística. A avaliação quantitativa realizada com medidas da PTEA mostrou melhora da sudorese nas mãos e nos pés. Houve melhora no abdome, porém sem significância estatística. No tórax e na região das costas houve piora da sudorese. Conclusão: O tratamento da hiperidrose primária com a oxibutinina sugeriu uma melhora na qualidade de vida dos pacientes com IMC maior ou igual 25, porém sem significância estatística. Nos pacientes com IMC<25 não houve alteração de qualidade de vida. Houve redução expressiva da sudorese nas mãos e nos pés, e exacerbação no tórax e nas costas. Ocorreu também redução da sudorese no abdome. As avaliações qualitativas e quantitativas não mostraram correlação entre si na análise do resultado da terapêutica com a oxibutinina, independente de IMC.
The treatment of hyperhidrosis in overweight patients presents restrictions to sympathectomy due to exacerbation of compensatory sweating. The therapeutic alternative with anticholinergic drugs has been the most recommended, but its result remains little studied. Objective: To evaluate the effect of oxybutynin in the treatment of primary hyperhidrosis in overweight patients in a qualitative and quantitative way. Methods: Overweight patients underwent oxybutynin therapy for 30 days (n=20) and were evaluated by qualitative methods using the Quality of Life (QQV) questionnaire and quantitative by the Trans Epidermal Water Loss (TEWL) in the regions of the hands, feet, thorax, back and abdomen. The control group consisted of patients with BMI <25 (n=22). Results: After treatment with oxybutynin, only the BMI group equal or greater 25 showed a tendency to improve the quality of life, however without statistical significance. The quantitative evaluation with measures of TEWL showed an improvement in sweating in the hands and feet. There was improvement in the abdomen, but without statistical significance. In the thorax and in the region of the back there was worsening of the sweating. Conclusion: The treatment of primary hyperhidrosis with oxybutynin suggested an improvement in the quality of life of patients with BMI> 25, but with no statistical significance. In patients with BMI <25, there was no change in quality of life. There was an expressive reduction of sweating in the hands and feet, and exacerbation of the chest and back. Simultaneously, there was also reduction of sweating in the abdomen. Qualitative and quantitative assessments showed no correlation with each other in the analysis of the outcome of oxybutynin therapy, regardless of BMI.
The treatment of hyperhidrosis in overweight patients presents restrictions to sympathectomy due to exacerbation of compensatory sweating. The therapeutic alternative with anticholinergic drugs has been the most recommended, but its result remains little studied. Objective: To evaluate the effect of oxybutynin in the treatment of primary hyperhidrosis in overweight patients in a qualitative and quantitative way. Methods: Overweight patients underwent oxybutynin therapy for 30 days (n=20) and were evaluated by qualitative methods using the Quality of Life (QQV) questionnaire and quantitative by the Trans Epidermal Water Loss (TEWL) in the regions of the hands, feet, thorax, back and abdomen. The control group consisted of patients with BMI <25 (n=22). Results: After treatment with oxybutynin, only the BMI group equal or greater 25 showed a tendency to improve the quality of life, however without statistical significance. The quantitative evaluation with measures of TEWL showed an improvement in sweating in the hands and feet. There was improvement in the abdomen, but without statistical significance. In the thorax and in the region of the back there was worsening of the sweating. Conclusion: The treatment of primary hyperhidrosis with oxybutynin suggested an improvement in the quality of life of patients with BMI> 25, but with no statistical significance. In patients with BMI <25, there was no change in quality of life. There was an expressive reduction of sweating in the hands and feet, and exacerbation of the chest and back. Simultaneously, there was also reduction of sweating in the abdomen. Qualitative and quantitative assessments showed no correlation with each other in the analysis of the outcome of oxybutynin therapy, regardless of BMI.
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Citação
NETO EVANGELISTA, Ernesto. Estudo da oxibutinina em pacientes com hiperidrose primária e sobrepeso. São Paulo, 2017. [70] p. Dissertação (Mestrado em Ciência cirúrgica interdisciplinar) - Escola Paulista de Medicina (EPM), Universidade Federal de São Paulo (UNIFESP), São Paulo, 2017.