Table 2.

New Therapeutic Perspectives for the Management of Immune-Related Adverse Events²³

Treatment	irAE Indications	Protocols
Anti-IL-1 blockade	Severe irAE during acute phase; severe or refractory arthritis; chronic	Anakinra 100 mg once per day, or canakinumab 300– once every 8 weeks
	Inflammatory; demyelinating polyradiculoneuritis; psoriasis-like reactions;
	Psoriasis exacerbation; severe and anti-TNFa refractory colitis; myasthenia
	Gravis; encephalitis; aseptic meningitis; myocarditis; pneumonitis
Anti-IL-6 blockade	Severe irAE during acute phase; severe or refractory arthritis; large vessel	Tocilizumab 8 mg/kg intravenously once per month or subcutaneous 162 mg once per week
	Vasculitis; uveitis; myocarditis; pneumonitis; myasthenia gravis
Intravenous immunoglobulins	Guillain-Barré syndrome; subacute and chronic inflammatory demyelinating	Intravenous immunoglobulins 400 mg/kg per day for 5 days, or once per month for a total of 3–4 courses
	Polyradiculoneuritis; subacute and chronic inflammatory neuropathies; immune
	Neutropenia; immune thrombocytopenia; facial nerve palsy; myasthenia gravis;
	Transverse myelitis; enteric neuropathy; encephalitis; aseptic meningitis
Anti-CD20 depletion	Systemic lupus erythematosus; severe Sjögren’s syndrome; ANCA-associated vasculitis; cutaneous vasculitis; autoimmune autonomic ganglionopathy; sensory ganglionopathy; nephritis; myasthenia gravis; transverse myelitis; enteric neuropathy; encephalitis; aseptic meningitis; hepatitis	Rituximab 1 g every 2 weeks for 2 courses or 375 mg/m2 once per week for 4 courses; ofatumumab 300 mg on the first day and 1000 mg on the second day; obinutuzumab 1000 mg on the first day; ocrelizumab 300 mg on the first and fourth day
Anti-IL-17 blockade	Severe colitis and anti-TNFa refractory colitis; severe or refractory arthritis; anti-IL-6 refractory irAEs	Ixekizumab 80 mg subcutaneous once every 2 weeks; brodalumab 210 mg subcutaneous once every 2 weeks; secukinumab 150 mg subcutaneous once every 2 weeks
Anti-TNFalpha blockade	Severe colitis; hepatitis; severe or refractory arthritis; nephritis; uveitis; pneumonitis; myocarditis	Infliximab 5 mg/kg once every 2 weeks; adalimumab 40 mg once every 2 weeks;
		Golimumab 50 mg once per month; etanercept 50 mg once a week; certolizumab
		400 mg once a month
Anti-integrin 4 blockade	Limbic encephalitis	Natalizumab 300 mg once per month
Anti-IL-23 and anti-IL-12 blockade	Acute phase, severe, or anti-TNFa refractory colitis; severe or anti-TNFa	Ustekinumab initial dose 40 mg then 45 mg after 4 weeks and then 45 mg every 12 weeks
	Refractory psoriasis; severe or refractory arthritis
Janus kinase inhibitor	Severe or refractory arthritis	Tofacatinib 5 mg twice per day

Note: Reprinted from Lancet Oncol. 20(1). Martins F, Sykiotis GP, Maillard M, et al.New therapeutic perspectives to manage refractory immune checkpoint-related toxicities. e54–e64, Copyright (2019), with permission from Elsevier.²³Abbreviations: irAE, immune-related adverse event; IL, interleukin type; ANCA, antineutrophil cytoplasmic antibody.