Grade | Clinical features | Management |
---|---|---|
1 | Asymptomatic | Oral steroids—prednisone 1 mg/kg daily or equivalent with taper over 4–6 weeks after recovery Clinical and assessment every 2–3 days initially Delay checkpoint inhibitor until equivalent daily dose of 10 mg oral prednisolone or less |
2 | Symptomatic—limiting instrumental activities of daily living | As per grade 2 AND Radiological assessment every 2–3 days initially |
3 | Severe symptoms—limiting self-care activities of daily living | Hospital admission High-dose intravenous corticosteroids (methylprednisolone 2–4 mg/kg/day or equivalent) Cease immunotherapy permanently Commence immunosuppression if no clinical or imaging improvement after 2 days (such as infliximab, mycophenolate mofetil, cyclophosphamide) Wean steroids slowly over 6 or more weeks |
4 | Life-threatening respiratory compromise | As per grade 3 |
5 | Death | Â |