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 |