4
Treatment
Table A2: Immunosuppressive Agents
Immunosuppressive
Agents Dosing Indications
Systemic
Corticosteroids
• Oral/IV prednisone 0.5–2 mg/kg/day
• IV methylprednisolone 1–2 mg/kg/
day
• Dexamethasone 10–20 mg IV
In general, from
Grade ≥2 irAE in
any toxicity
Topical Steroids Low strength
• Hydrocortisone 1%, 2.5% (class 7)
• Desonide 0.05% (class 6)
Medium strength
• Betamethasone valerate 0.1%
(class 4)
• Triamcinolone acetonide 0.1%
(class 4)
High strength
• Fluocinonide 0.05% (class 2)
Highest strength
• Betamethasone dipropionate 0.05%
(class 1)
• Halobetasol 0.05% (class 1)
Skin irAEs
Biological immunosuppressive agents
Abatacept
(CTLA-4 agonist)
500 mg IV every 14 days × 5 doses Life-threatening and
steroid-refractory
myocarditis
Alemtuzumab
(Anti-CD52)
30 mg IV single dose Life-threatening and
steroid-refractory
myocarditis
