Treatment of Acute Myocarditis in Immune Checkpoint Inhibitor-Induced Myocarditis

Acute myocarditis arising as a complication of immune checkpoint inhibitor (ICI) therapy is a serious immune-related adverse event requiring prompt, targeted clinical management. This page outlines the key considerations for this specific scenario.

Clinical Scenario

This protocol applies to patients who develop acute myocarditis attributable to immune checkpoint inhibitor therapy — a recognised and potentially life-threatening immune-related adverse event (irAE) distinct from other forms of myocarditis in its underlying mechanism and management requirements.

Treatment Approach (partial overview)

The management strategy in this setting involves targeted immunosuppressive therapy using monoclonal antibody agents. The specific choice of agent and the clinical pathway are detailed in the full protocol — only a general direction is outlined here.

Instant Access to Structured Evidence-Based Regimens

References

ICI-induced myocarditis
Infliximab or adalimumab, rituximab
Infliximab (monoclonal antibody against TNF-α): 5 mg/kg i.v. at weeks 0, 2, 6, then every ∼8 weeks (maintenance).
Adalimumab (anti-TNF-α fully human monoclonal antibody) 40 mg SC every week (or every 2 weeks, per clinical response).
Rituximab (monoclonal antibody against CD20 on B cells): 375 mg/m² i.v. weekly × 4 doses (1 month).

DOI: 10.1093/eurheartj/ehaf192

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