Once troponins start to decrease, I start the steroid taper and follow troponin levels. If they rise, I slow the taper. I also get serial ECGs, esp if there were arrhythmia manifestations of myocarditis. Don't forget to assess for the need for PJP prophylaxis with Bactrim or pentamidine and PPI sinc...

Patients with ICI myocarditis are treated with 1g solumedrol for 3-5 days and then transitioned to oral prednisone at 1mg/kg per day. In general, a slow prednisone taper is recommended (i.e. decrease by 10mg per day every 1-2 weeks). Prior to de-escalating steroid therapy at each stage, there should...