Tirbanibulin

How it works

It is a microtubule and Src kinase inhibitor that disrupts tubulin polymerisation, arresting proliferation and inducing death of the rapidly dividing atypical keratinocytes in actinic keratosis.

Prescribing in practice

• Apply only to the treatment field for the short specified course and avoid the eyes, lips and inside of the nostrils, washing hands after application.
• Expected local skin reactions include erythema, flaking, crusting and swelling that typically peak in the first week and then resolve.
• Avoid applying to broken skin or using more than one treatment course on the same area concurrently without specialist advice.

Monitoring

No laboratory monitoring is required; review the treated field for resolution of lesions and of local reactions after the course.

Counselling the patient

• Use for the short prescribed course only and do not cover the area with an occlusive dressing.
• Local redness, flaking and crusting are expected and settle within a few weeks.
• Avoid washing or touching the treated area for several hours after applying, and use sun protection.

Evidence & guidelines

Efficacy in actinic keratosis of the face and scalp was demonstrated in two phase 3 randomised controlled trials.