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Table 7 Symptom-driven up-dosing rules

From: Protocol for a double-blind, randomized controlled trial on the dose-related efficacy of omalizumab in multi-food oral immunotherapy

Symptoms to OIT home dosing since last up-dose

Management

No symptoms at all

Up-dose as planned

Double next planned % up-dosing

Transient mild (CoFAR grade 1)

Up-dose as planned

Keep next planned % up-dosing the same

Transient moderate (CoFAR grade 2) or persistent mild (CoFAR grade 1)

Up-dose as planned

Decrease next planned % up-dosing by half

Persistent moderate symptoms (CoFAR grade 2)

Do not up-dose

Decrease next planned % up-dosing by half

At any time, if systemic or severe local reaction (CoFAR grade ≥ 3)

Decrease to previously tolerated dose

Decrease next planned  % increase by half