Skip to main content

Table 1 Definition of severe immune-related adverse events and diagnostic workup.

From: Severe toxicity from checkpoint protein inhibitors: What intensive care physicians need to know?

Severity of IrAE grade Outpatient versus inpatient care Corticosteroids Others immunosuppressive drugs immunotherapy
1 Outpatient Not recommended Not recommended Continue
2 Outpatient Topical steroids or systemic steroids oral (0.5–1 mg/kg/day) Not recommended Hold temporarily
3 Inpatient Systemic steroids oral or i.v. 1–2 mg/kg/day for 3 days then reduce to 1 mg/kg/day To be considered for patients with unresolved symptoms after 3–5 days of steroid course
Organ specialist referral advised
Hold and discuss restarting based on risk/benefit ratio shared with patient
4 Inpatient
Consider ICU admission
Systemic steroids i.v. methylprednisolone 2 mg/kg/day for 3 days then reduce to 1 mg/kg/day To be considered for patients with unresolved symptom after 3–5 days of steroid course specialist consult referral advised Discontinue permanently