Background We aimed to assess the efficacy of the "fast first and then slowly" steroid-tapering regimen used in managing corticoid-sensitive patients with severe irAE after anti-PD-(L)1 therapy. Corticosteroids are the primary therapy for severe immune-related adverse events (irAEs). Less is known about the standard steroid-tapering regimen for corticoid-sensitive patients. Methods This study was a single-center, retrospective medical record review of patients with severe irAE after anti-PD-(L)1 treatment for cancer from October 13, 2021 to October 20, 2022. The efficacy was assessed by Common Terminology Criteria for Adverse Events (CTCAE) grading system. Results Among the 187 patients with severe irAEs associated with immune checkpoint inhibitors (ICIs), 136 (72.7%) cases were corticoid-sensitive, and 96 (51.3%) cases were scheduled "fast first and then slowly" steroid-tapering regimen. And of these, 87 (90.6%) cases got irAEs solution. Conclusions The "fast first and then slowly" steroid-tapering regimen stayed shorter in the hospital. More studies are needed to confirm this efficacy and find more details about the steroid-tapering regimen.

中文翻译：

---

“先快后慢”类固醇逐渐减少方案治疗抗 PD-(L)1 癌症治疗后出现严重免疫治疗并发症的皮质激素敏感患者。

背景 我们的目的是评估“先快后慢”类固醇逐渐减量方案在治疗抗 PD-(L)1 治疗后出现严重 irAE 的皮质激素敏感患者中的疗效。皮质类固醇是严重免疫相关不良事件 (irAE) 的主要治疗方法。对于皮质类固醇敏感患者的标准类固醇逐渐减少方案知之甚少。方法 本研究是对 2021 年 10 月 13 日至 2022 年 10 月 20 日期间接受抗 PD-(L)1 癌症治疗后出现严重 irAE 的患者进行的单中心、回顾性病历审查。通过通用术语标准评估疗效不良事件 (CTCAE) 分级系统。结果 187例与免疫检查点抑制剂（ICIs）相关的严重irAE患者中，136例（72.7%）对皮质激素敏感，96例（51.3%）被安排“先快后慢”减量方案。其中，87 例（90.6%）病例得到了 irAEs 解决方案。结论“先快后慢”的类固醇逐渐减量方案在医院的停留时间较短。需要更多的研究来证实这种功效，并找到有关类固醇逐渐减少方案的更多细节。