Do you manage a patient presenting with ICI-induced PMR-like syndrome using the same glucocorticoid dosing and tapering schedule you would apply to primary PMR, or do you treat it as a distinct entity requiring a lower steroid dose given evidence suggesting it tends to be milder?

Thank you for the excellent question. Since ICI-induced PMR-like syndrome is often milder than primary PMR, and because prolonged glucocorticoid exposure may attenuate the anti-tumor efficacy of ICIs, I generally aim to use the lowest effective steroid dose and taper more rapidly than I would for primary PMR. In my practice, I typically start prednisone at 20 mg daily and, if symptoms improve promptly, taper as follows: 20 mg for 2 weeks, 15 mg for 2 weeks, 10 mg for 2 weeks, and then decrease b...