Immune-related hepatoxicity

Immune-related hepatoxicity

STARTFINISHCreated with SnapWhat grade?STARTFINISHCreated with SnapGrade 1ALT or AST > ULN -<3X ULNSTARTFINISHCreated with SnapAssessmentExclude other drugrelated causes of liverdysfunction.STARTFINISHCreated with SnapManagementProceed withtreatmentSTARTFINISHFollow-upRepeat LFT in 1 week,if worsening, treat asper G2/G3 pendingseverity.STARTFINISHCreated with SnapGrade 2ALT or AST 3-5X ULNSTARTFINISHCreated with SnapAssessment(see info for details)STARTFINISHCreated with SnapManagement- Witholdimmunotherapy- Recheck bloodsevery 3 days- If raised ALT/AST for...STARTFINISHFollow-up- Recheck bloodsevery 3 days- Once G1, weansteroids over 2 weeks- Rechallenge when...STARTFINISHCreated with SnapGrade 3ALT or AST 5-20X ULNSTARTFINISHCreated with SnapAssessment(see info for details)STARTFINISHCreated with SnapManagement(see info for details)STARTFINISHFollow-up- Once G2, change tooral prednisolone1mg/kg and weanover 4 weeksIf mild G3, option to...STARTFINISHCreated with SnapGrade 4ALT or AST > 20X ULN