免疫检查点抑制剂相关心肌炎临床诊疗实施建议

Recommendations for clinical diagnosis and treatment of immune checkpoint inhibitors-associated myocarditis

摘要: 免疫检查点抑制剂(immune checkpoint inhibitors，ICIs)已被应用于治疗多种恶性肿瘤，为患者带来显著临床获益的同时，也带来了一系列并发症风险。ICIs相关心肌炎是其中较严重的并发症之一，日益为临床带来新挑战。本临床诊疗实施建议聚焦ICIs相关心肌炎的危险因素、诊断与鉴别诊断、临床分型及治疗、监测转归和治疗重启等关键临床问题，参考国内外相关共识或指南和新近发表的循证医学证据，结合临床实践经验，为ICIs相关心肌炎的临床诊疗提供指导和建议。

Abstract: At present, immune checkpoint inhibitors (ICIs) have been used in the treatment of multiple malignant tumors, which benefit for tumor patients. However, the ICIs-associated myocarditis has brought new challenges clinically. In this recommendations paper, the key clinical issues, such as risk factors, diagnosis and differential diagnosis, clinical classification and treatment, monitoring of outcomes, and restart of treatment for ICIs-associated myocarditis, were highlighted, and the practical guidance and suggestions for the diagnosis and treatment of ICIs-associated myocarditis were proposed by reference to the relevant consensuses or guidelines and newly published evidence-based evidences in China and other countries in combination with clinical experience.