Table 7.

Symptom-driven up-dosing rules

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