Table 4.

Management of hepatitis related to ICI therapy.

	Grade 1–2 hepatitis	Grade 3 hepatitis	Grade 4 hepatitis
Criteria	AST or ALT 1–2.5 × ULN and/or total bilirubin 1–1.5 × ULN	AST or ALT >5 × ULN and/or total bilirubin >3 × ULN	AST or ALT >8 × ULN
ICI therapy	Continue but with close monitoring	Discontinue	Discontinue
Steroids	Consider oral steroids	High-dose IV steroids for 48 h and taper with oral steroids	High-dose IV steroids
Other drugs to consider	None at this stage	• Mycophenolate mofetil 500 mg BD if no improvement after 48 h of steroids	• Longer duration of high-dose IV steroids • Anti-thymocyte globulin • Toclizumab (anti IL-6 antibody)

BD, twice daily; IV, intravenous; ULN- upper limit of normal.