When would you consider tapering glucocorticoids in a patient with ICI-associated myocarditis?
2 Answers
Mednet MemberInvited Expert
Cardiology · Memorial Sloan Kettering Cancer Center
Answered on
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...
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Mednet MemberInvited Expert
Cardiology · University of Texas Southwestern Medical School
Answered on
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...
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