Muscle pathology – Patient stable – Severe Yes

October 29, 2026

Myocarditis algorithm – Stable patient - Severe - No

Non-severe and smoldering definitive

  • Withhold ICI
  • Prednisone 1 mg/kg
  • + reassess troponin levels after +/- 24 and 48h
  •  

No response at 48 h: reassess then escalate to 1–2 mg/kg and/or add ruxolitinib or MMF

Slow taper if improving

 

Isolated Troponin
of
unknown significance

  • Seek alternative diagnosis
  • Consider withholding ICI pending diagnosis
  • Repeat CK and troponin I or T in 24 h

Monitor troponin levels at each subsequent ICI cycle.