Cibinqo
Cibinqo (abrocitinib) is used to treat moderate-to-severe atopic dermatitis (also known as eczema) in adults and children ages 12 years and older. It's taken by mouth, typically once daily. Cibinqo (abrocitinib) isn't a first-choice option for this condition because it has a FDA black box warning for the potential to cause serious side effects, such as cancer and infections. Some of the more common side effects of this medication include nausea, cold symptoms, and headaches.
What is Cibinqo (abrocitinib)?
What is Cibinqo (abrocitinib) used for?
Moderate-to-severe atopic dermatitis (eczema) in people age 12 years and older who didn't respond to other treatments
How Cibinqo (abrocitinib) works
Cibinqo (abrocitinib) is a Janus kinase (JAK) inhibitor. It blocks an enzyme (protein) called JAK in the body that plays a role in inflammation. By stopping this enzyme from working, Cibinqo (abrocitinib) lowers inflammation to relieve symptoms of atopic dermatitis.
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What are the side effects of Cibinqo (abrocitinib)?
Common Side Effects
- Nausea (6-15%)
- Common cold (9-12%)
- Headache (6-8%)
- Acne (2-5%)
Other Side Effects
- Infections
- Dizziness
- Tiredness
- Vomiting
- Mouth and throat pain
- High blood pressure
- Skin rash
- Stomach discomfort and pain
Serious Side Effects
- Stroke: sudden weakness in your body, trouble speaking, confusion, dizziness
- Arterial thrombosis (blood clot in the heart): chest pain; short of breath; pain in the jaw, neck, or back; feeling weak or light-headed
- Pulmonary embolism (blood clot in the lung): cough, chest pain, trouble breathing, racing heart
- Deep vein thrombosis (blood clot in the leg): leg cramp, swelling, pain, muscle tightness
- Serious bleeds: bleed or bruise easily, bleeding that's hard to stop, coughing blood, stomach pain, blood in urine or stool
- Serious infections: fever, difficulty breathing, diarrhea, weakness, cough, stomach pain, sweating, chills, burning when you urinate, urinating more often
Source: DailyMed
More on Cibinqo (abrocitinib) side effects
The following side effects have also been reported
Side effects that you should report to your care team as soon as possible:
- Allergic reactions—skin rash, itching, hives, swelling of the face, lips, tongue, or throat
- Blood clot—pain, swelling, or warmth in the leg, shortness of breath, chest pain
- Change in vision
- Heart attack—pain or tightness in the chest, shoulders, arms, or jaw, nausea, shortness of breath, cold or clammy skin, feeling faint or lightheaded
- Infection—fever, chills, cough, sore throat, wounds that don't heal, pain or trouble when passing urine, general feeling of discomfort or being unwell
- Low red blood cell level—unusual weakness or fatigue, dizziness, headache, trouble breathing
- Stomach pain that is severe, does not go away, or gets worse
- Stroke—sudden numbness or weakness of the face, arm, or leg, trouble speaking, confusion, trouble walking, loss of balance or coordination, dizziness, severe headache, change in vision
- Unusual bruising or bleeding
Side effects that usually do not require medical attention (report these to your care team if they continue or are bothersome):
- Acne
- Headache
- Nausea
- Runny or stuffy nose
- Sore throat
- Stomach pain
- Vomiting
Pros and cons of Cibinqo (abrocitinib)
Pros
Works well at treating eczema for both adults and children age 12 years and older
Taken once per day by mouth
Can be used along with topical treatments for eczema
Can be taken with or without food
Cons
Raises your risk for serious side effects, such as blood clots and infections
Not a good choice for people who have trouble swallowing because the tablets can't crushed and there isn't a liquid version available
Not safe for people with serious liver or kidney problems
Safety in pregnancy or breastfeeding isn't clear
Pharmacist tips for Cibinqo (abrocitinib)
You should be up-to-date on all your vaccinations before starting Cibinqo (abrocitinib). Most people can still get most vaccines, including the flu shot, while taking Cibinqo (abrocitinib). But you shouldn't get live vaccines, such as the live nasal flu vaccine and MMR (measles, mumps, and rubella vaccine) because it's not known how your body will react to the vaccine.
Make sure to mark your appointments on your calendar to see your provider and get any tests done on time. For example, your provider will order blood tests to screen you for certain infections and to check your blood cell count before you begin treatment. Your provider will also order blood tests a month after you started Cibinqo (abrocitinib) or a month after they've raised your dose. This will help your provider make sure Cibinqo (abrocitinib) is safe for you to take.
You can take Cibinqo (abrocitinib) with or without food. If it's hurting your stomach, taking it with food might help.
Take Cibinqo (abrocitinib) once daily at about the same time each day. Swallow the tablets whole with water and don't split, crush, or chew them because this can affect the way the medication is released in your body.
Cibinqo (abrocitinib) can raise your risk of getting a serious or life-threatening infection. If you develop symptoms of an infection (e.g., fever, cough, difficulty breathing, diarrhea, weakness, sweating, chills) while taking Cibinqo (abrocitinib), go to the hospital right away so you can get tested for an infection. You might have to stop taking Cibinqo (abrocitinib) so your body can fight the infection.
Cibinqo (abrocitinib) can lower your platelet count. Antiplatelet medications, like clopidogrel (Plavix), should be avoided during the first 3 months of treatment with Cibinqo (abrocitinib) due to the risk of bleeding. But taking low-dose aspirin (up to 81 mg per day) should be safe if recommended by your healthcare provider.
Taking Cibinqo (abrocitinib) might affect your ability to get pregnant. Talk to your healthcare provider if you have concerns about fertility.
If you accidentally miss a dose of Cibinqo (abrocitinib), take it as soon as possible. But if it's less than 12 hours until your next dose, skip the missed dose and take the next one at your regularly scheduled time.
Frequently asked questions about Cibinqo (abrocitinib)
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What are the risks and warnings for Cibinqo (abrocitinib)?
Cibinqo (abrocitinib) can cause some serious health issues. This risk may be even higher for certain groups. If this worries you, talk to your doctor or pharmacist about other options.
Serious infections
Risk factors: Current infection | Past infections that keep coming back | Other conditions that raise your risk of infection | Living in or traveling to places with high rates of TB infections | Taking medications that weaken your immune system
Cibinqo (abrocitinib) can affect your body's ability to fight off infections. This can raise your risk of serious bacterial (e.g., tuberculosis (TB)), viral (e.g., herpes, hepatitis), or fungal infections. Your provider will routinely monitor you for infections before and during treatment with Cibinqo (abrocitinib). If you notice any signs of infection during treatment like fever, chills, body aches, or cough, let your provider know right away.
Possible higher risk of death
Risk factors: Age 50 years and older | High blood pressure | High cholesterol (fat) | High blood sugar
Though this hasn't been seen with Cibinqo (abrocitinib), use of JAK inhibitors for rheumatoid arthritis has been linked to higher risk of death for some people, such as older adults with at least one heart-related risk factor. Talk to your provider about the risks and benefits of using Cibinqo (abrocitinib) before you start treatment.
Possible risk of cancer
Risk factors: History of cancer | People who smoke
Some people who took JAK inhibitors reported they developed cancer during treatment. These cancers included lymphoma and skin cancer. Some cancers have been reported by people taking Cibinqo (abrocitinib) during clinical studies. Because of this, your provider will monitor you for your risk of cancer during treatment. Additionally, make sure you schedule yearly screenings for skin cancer and let your provider know if you notice changes to your skin. Wear protective clothing and use sunscreen if you're out in the sun, and avoid UV light (e.g., tanning beds) to lower your risk of skin cancer.
Risk of heart attack, stroke, and other blood clots
Risk factors: Age 50 years and older | High blood pressure | High cholesterol (fat) | High blood sugar | People who smoke | Past blood clots
People who took JAK inhibitors reported blood clots in various parts of the body, including the heart and brain. While these conditions haven't been linked to Cibinqo (abrocitinib), these risks are still possible. Get medical help right away if you experience symptoms of blood clots, such as the following.
Legs (deep vein thrombosis): leg cramp, swelling, pain, muscle tightness
Lungs (pulmonary embolism): cough, chest pain, trouble breathing, racing heart
Heart (arterial thrombosis): chest pain, short of breath, pain in the jaw, neck, or back, feeling weak or light-headed
Brain (stroke): sudden weakness in your body, trouble speaking, confusion, dizziness
Eyes: vision changes, pain
Low blood cell counts
Cibinqo (abrocitinib) can lower the number of red blood cells (RBCs), white blood cells (WBCs), and platelets in your body. This can raise your risk for bleeds, anemia, and infections. Your provider might order blood draws to check your blood cell counts. Let your provider know if you experience possible symptoms of low blood cell counts, such as the following.
Bleeds (low platelet count): small, flat red spots under your skin, blood in your urine or stool, easy bleeding or bruising
Anemia (low RBC count): feeling tired, headache, pale skin, fast heart rate, trouble breathing
Infections (low WBC count): fever, chills, tiredness, cough, body aches, runny nose
High cholesterol
Cibinqo (abrocitinib) can raise your cholesterol levels. Your provider will order cholesterol tests regularly while you're taking Cibinqo (abrocitinib). Let your provider know if you have high cholesterol, or are taking medications for high cholesterol, before starting Cibinqo (abrocitinib).
Cibinqo (abrocitinib) dosage forms
Typical dosing for Cibinqo (abrocitinib)
The typical starting dose is 100 mg by mouth once a day. Your provider might raise your dose to 200 mg once a day if your skin symptoms haven't improved after 3 months.
Your dose might differ if you have kidney problems, if you're taking a medication that interacts with Cibinqo (abrocitinib), if your body breaks down Cibinqo (abrocitinib) poorly based on genetic testing, or if you're having side effects.
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Cibinqo (abrocitinib) contraindications
Taking antiplatelet medications (e.g., blood thinners) except for low-dose aspirin (81 mg daily), during the first 3 months of treatment
What are alternatives to Cibinqo (abrocitinib)?
Moderate-to-severe atopic dermatitis (eczema) in people age 12 years and older who didn't respond to other treatments
Rheumatoid arthritis (RA) in adults
Psoriatic arthritis (PsA) in adults and children ages 2 years and older
Eczema (atopic dermatitis) in adults and children ages 12 years and older
Ulcerative colitis (UC) in adults
Crohn's disease (CD) in adults
Ankylosing spondylitis (AS) in adults
Non-radiographic axial spondyloarthritis (nr-axSpA) in adults
Polyarticular juvenile idiopathic arthritis (pJIA) in adults and children ages 2 years and older
Moderate-to-severe eczema - for people 6 months and older
Moderate-to-severe asthma - add-on maintenance for people 6 years and older
Long-term sinus congestion with nasal polyps - add-on maintenance for people 12 years and older
Eosinophilic esophagitis - for people 1 year and older
Prurigo nodularis (long-term itchy skin bumps) - for adults
Chronic obstructive pulmonary disease (COPD) - add-on maintenance for adults
Long-term hives - for people 12 years and older
What is the latest news about Cibinqo (abrocitinib)?
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References
Best studies we foundAmerican Cancer Society. (n.d.). Lymphoma.
Centers for Disease Control and Prevention. (n.d.). Fungal diseases.
Deeks, D., et al. (2021). Abrocitinib: First approval. Drugs.
Eichenfield, L.F., et al. (2021). Efficacy and safety of abrocitinib in combination with topical therapy in adolescents with moderate-to-severe atopic dermatitis: The JADE TEEN randomized clinical trial. Journal of the American Medical Association Dermatology.
Mikhaylov, D., et al. (2023). Oral Janus kinase inhibitors for atopic dermatitis. Annals of Allergy, Asthma & Immunology.
O'Shea, J. J., et al. (2013). Janus kinase inhibitors in autoimmune diseases. Annals of the Rheumatic Diseases.
Pfizer, Inc. (n.d.). About the Cibinqo pregnancy registry.
Pfizer Inc. (2023). Make Cibinqo part of your everyday routine.
Pfizer Laboratories Div Pfizer Inc. (2023). Cibinqo- abrocitinib tablet, film coated [package insert]. DailyMed.
U.S. Food and Drug Administration. (2021). FDA requires warnings about increased risk of serious heart-related events, cancer, blood clots, and death for JAK inhibitors that treat certain chronic inflammatory conditions.
Whitley, R.J. (1996). Chapter 68 Herpesviruses. Medical Microbiology. 4th edition.
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