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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