Drug · Topical · Microtubule inhibitor
Topical tirbanibulin
Klisyri 1% ointment.
Tirbanibulin is a topical reversible microtubule inhibitor (also acting on Src kinase signalling) for actinic keratosis. Its key advantage is the markedly shorter treatment regimen — 5 days, once daily — compared with 5-FU (2–4 weeks) and imiquimod (2–6 weeks), with comparable efficacy and milder local skin reactions.
CurrentLast reviewed 25 March 2026
Indications
- Non-hyperkeratotic, non-hypertrophic actinic keratosis on the face or scalp (up to 25 cm² treatment area).
Dosing
- Apply once daily for 5 consecutive days.
- Cover entire treatment area with a thin layer; gently rub in.
- Wash hands afterwards; avoid eyes / mouth / mucosa.
Adverse events
- Local skin reactions: erythema, flaking / scaling, crusting (less intense than 5-FU / imiquimod).
- Pruritus and pain (typically mild).
- Headache.
Practical
- Especially useful for patients who cannot tolerate prolonged 5-FU or imiquimod regimens.
- Cost is higher than alternatives.
- Counsel: avoid sun-exposing the treated area while inflammation persists.
References
- Blauvelt A et al. Phase 3 trials of tirbanibulin ointment for actinic keratosis. N Engl J Med; 2021.
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