12
Treatment
Table A2: Immunosuppressive Agents
Immunosuppressive
Agents Dosing Indications
IVIG (non-selective
immunosuppressant)
2 g/kg over 2-5 days in divided doses
of 400-500 mg/kg
Hematological irAEs,
SCAR, pneumonitis,
myositis, MG,
GBS, encephalitis,
demyelinating
disease, and uveitis
Leflunomide
(non-selective
immunosuppressant)
Loading dose of one 100 mg tablet per
day for 3 days
Moderate or
refractory
inflammatory
arthritis
Methotrexate (MTX)
(non-selective
immunosuppressant)
Starting dose of 15 mg PO weekly,
with daily folic acid supplementation
Moderate or
refractory
musculoskeletal and
ocular irAEs
Mycophenolate
mofetil (MMF)
(non-selective
immunosuppressant)
0.5–1 g orally every 12 hours Steroid-refractory
hepatitis, nephritis,
pneumonitis,
myocarditis,
myositis, and
hematological irAEs
Plasmapheresis
(non-selective
immunosuppressant)
Several courses as needed Myastenia gravis,
GBS, demyelinating
disease, encephalitis,
myositis
(cont'd)