Table 3.
Suggested uniform standardized ISR scoring system
| 0 = No | 1 = Mild | 2 = Moderate | 3 = Severe and undesirable | |
|---|---|---|---|---|
| Injection site reaction | None | Erythema OR tenderness OR itching | As 1 and pain OR swelling OR signs of inflammation | Ulceration or necrosis |
| Maximal diameter ISR | NA | Max 5 cm | Max 10 cm | Max 15 cm OR any diameter and systemic reaction OR flare‐up previous IS |
| Duration of symptoms | ≤1 day | 2–14 days | 2–6 weeks, reversible | Permanent |
| Sequelae | None | Minimal and tolerated by patient | Hardly tolerated OR wish for treatment by patient | Permanent despite treatment OR no treatment options |
| Likely impact on next dose | None | Injection site can be used in rotation AND no dose adaptation | Injection site should be avoided in rotation OR change dose regimen | Injection site cannot no longer be used OR discontinuation |
| ADL limitations | None | Minimal | Functional | Self‐care limitations |
ADL = ‘Activities of daily living’ and are defined as bathing, dressing and undressing, feeding self, using the toilet, taking medications, preparing meals, shopping for groceries or clothes, using the telephone, etc.